Dear TEB Team,

“I have a condition that makes my pregnancy high-risk so I can’t (safely) have an out of hospital birth and I need to see an OB and an MFM throughout pregnancy to monitor my condition. This is so opposite of what I’d prefer. I feel like I have no control over this experience, and I feel resentful that I can’t have the birth I really want — even if everything goes as smoothly as possible — which it may not. Then I feel guilty for feeling that way because I should be grateful there is a safe way for me and my baby to do this. I really don’t know what to do.”

Dear Reader,
First, let’s take a moment to honor what you’re feeling — because it’s a lot. On one hand, yes, you’re grateful for the medical care that keeps you and your baby safe. On the other, this experience right now feels so far from the intimate, low-intervention birth you’d envisioned. And that tension? It’s real, valid, and okay to feel. Resentment and gratitude can coexist — it even as it may feel messy and strange.

Here’s the truth: Pregnancy and birth often require us to hold two opposing truths at once. Wanting something deeply and not being able to have it doesn’t make you ungrateful — it makes you human. Let’s unpack this and explore some ways to reclaim a sense of agency, connection, and empowerment in your high-risk pregnancy journey.

1. Give Yourself Permission to Grieve + Be Honest

It’s okay to mourn the birth experience you wanted but can’t have. Acknowledging your feelings doesn’t diminish your gratitude for the care you’re receiving — it actually helps you process and move forward. Explore ways that you can release the full honesty of what you're feeling. This may be through drawing, writing, singing — whatever helps you get it out in a way that feels meaningful to you.

Find someone you trust to share these emotions with, whether it’s your partner, a friend, or even a therapist. Be transparent about this with your care team, too.

Tell your care team all about the aspects of an out-of-hospital experience and about the midwifery model that you liked and appreciated and wanted. Our medical providers are people, too. It's likely that they'll really understand the tension you're feeling (and if they don't — that'll give you time to find people who do — you deserve that). And the better they understand you, the more they can tailor how they care for you around what you really envisioned for yourself and how you're feeling about the more narrow options in front of you.

2. Focus on What You Can Control

While the overarching plan might feel out of your hands, there are still ways to make this experience yours:

• Build your support team. Consider hiring a doula who has experience with high-risk pregnancies. They can help you advocate for your preferences, even within a hospital setting, and provide emotional support throughout.
• Set the tone. Small things like music, lighting, or a comfort item in your labor space can make a big difference in helping you feel grounded.
• Explore birth preferences. Even in a high-risk situation, you may have choices around monitoring, movement, or how your baby is welcomed. Work with your OB or MFM to understand what’s possible within your care plan.

3. Reframe “Control” as Collaboration

Instead of focusing on what you can’t control, think about how you can work with your care team to make the best possible decisions together. High-risk care can feel clinical and overwhelming, but it doesn’t have to erase your voice. Ask questions, share your concerns, and make sure you understand the “why” behind recommendations. When you feel heard and informed, it’s easier to feel empowered.

4. Create Rituals to Feel Connected

If the medical side of pregnancy feels heavy, look for moments of joy and connection that remind you why you’re doing this.

• Write letters to your baby that you can read together someday.
• Celebrate milestones with something special, like a photo, a meaningful meal, or a small gift for your baby.
• Practice mindfulness or visualization exercises that help you connect with your baby and your body, even amidst the stress.

5. Redefine Your Birth “Success”

Sometimes, it helps to step back and redefine what success looks like for this experience. Instead of focusing on where or how you give birth, think about how you want to feel during the process: supported, informed, connected, or resilient. These are things you can cultivate, even in a high-risk pregnancy.

6. Give Yourself Grace

Feeling conflicted doesn’t mean you love your baby any less or that you’re ungrateful for the care you’re receiving. It means you’re navigating an incredibly complex situation, and you’re doing the best you can. Be kind to yourself as you move through these emotions, and remind yourself that it’s okay to ask for help when you need it.

While this isn’t the journey you hoped for, it’s still your journey. And even when it feels like everything is beyond your control, your love and care for your baby are the foundation of this entire experience. That’s something no condition, no circumstance, and no hospital policy can take away from you.