High Risk?

It's been 15 years since I've been pregnant, and a lot has changed since then- about my health! I'm almost 36, have 3 major pain disorders, heart problems, epilepsy, and both a cardiac loop recorder (implanted in my chest) and a spinal cord stimulator (runs from L2/3 to T9). I had my first two at a birth centre, monitored by midwives, as I had no risk factors then. Should I expect to be referred to a high-risk OB, and how is high-risk care different from regular care, besides closer monitoring?

Thanks for the input, everyone!