The concept of risk is especially salient to obstetric care. Unknown factors can still be responsible for peri-natal morbidity and mortality in circumstances that appeared to present little risk, while perfectly healthy infants are born in high-risk circumstances: a contradiction that patients and providers struggle with on a daily basis. With such contradictions comes the potential for the over-estimation of risk during pregnancy in order to assure a positive outcome. Understanding and addressing the estimation of risk during pregnancy requires acknowledging the history of obstetric risk in addition to understanding risk-related psychological theory. A relationship of trust between provider and patient is vital in addressing risk over-estimation, as is encouraging the development of self-efficacy in patients. Ultimately obstetric care is complex and efforts to avoid pre-natal risk exposure based on heightened perceptions of threat may do more harm than the perceived threat itself.