Elizabeth Johnson’s fourth pregnancy was a complete surprise. Just a few months earlier, her physician had told her she was probably in perimenopause. Her youngest child was in first grade and she’d recently given away all her baby gear. So, when she found out she was pregnant, her first reaction was “borderline terror,” says the Lansing, MI, mom. Each year more than three million American women find themselves staring in surprise at a positive pregnancy test. Some feel nervous and excited; others, angry and depressed. And why not? Beyond the practical matters of taking care of a baby, women facing an unplanned pregnancy deal with emotional concerns, including how to tell a partner the news and even whether they’ll be able to love and care for their child. Take Care of Yourself Even women who plan their pregnancies often find the reality of pregnancy and impending parenthood a bit scary and overwhelming, so the feelings that often go along with unexpected pregnancies—anger, depression, excitement, shock, anxiety—are perfectly normal. An unplanned pregnancy is a “massive adjustment,” says Ophelia Austin-Small, author of Surprise Motherhood: A Guide to Unexpected Adult Pregnancy and a surprise mother herself. “There’s a very real grief to, ‘My life was going to be X, but now it’s going to be Y.’ ” Give yourself time to cope, as your initial reaction will likely evolve. “It takes a little bit of soul-searching to say, ‘What do I really want, what am I capable of handling, and what are my support systems?’ ” says Kafui Demasio, M.D., M.P.H., a maternal-fetal medicine specialist at Montefiore Medical Center in Bronx, NY. And while you’re dealing with your emotions, mind your body. Stop drinking and smoking, and make an appointment with your health-care provider immediately. An unplanned pregnancy can be as healthy as a planned one if you take the right steps; in a recent Kaiser Permanente study, cigarette, alcohol, and drug users who got treatment early in pregnancy had the same health outcomes as women who didn’t use these substances. Develop a Support Network Once the shock has subsided, find someone you can talk to. For some women, this will take days, if not weeks, while others can reach out to a friend or partner in the first few hours. In Johnson’s case, her husband, Jay, provided the much needed support. While she panicked, he reassured her that everything would be all right. Of course, not all fathers are so encouraging. “Some partners are thrilled and excited, while others are out the door,” says Michelle Collins, C.N.M., an assistant professor of nursing at Vanderbilt University. Even those who stay may struggle with the idea of fatherhood. “The reality of the pregnancy didn’t dawn on my partner until after the pregnancy,” Austin-Small says. “I wanted to get the crib and stuff and he was like, ‘We don’t need to do it.’ ” If you’re unsure of your partner’s attitude toward a pregnancy, hold onto your news until you’re ready. “You don’t have to tell anybody right away,” Austin-Small says. “It’s OK to take a few days or a week or two to talk to your doctor, a therapist, or a friend before you tell the person you’re involved with.” Your friends and family can help you accurately evaluate your situation while providing emotional aid. “It’s very important to speak to those you trust,” Demasio says. “You may not realize the good or bad around you and may be missing important things that you need to take into consideration.” Understanding both the challenges and potential benefits of your pregnancy can help you realistically plan your future. Will You Bond With Baby? It’s not unusual for women to wonder if their conflicted feelings can affect their unborn child. “I worried that my being under stress could affect the birth weight,” says Kim Kankiewicz, a Roseville, MN, mom who learned she was pregnant while undergoing preparation for cataract surgery. Her concern was not entirely unfounded: Ongoing research is studying the effects of stress on pregnancy, Collins says. But most unplanned pregnancies, including Kankiewicz’s, end well. She gave birth to a healthy 7-pound, 11-ounce baby girl. Many women also worry that they won’t be able to love their baby, but experts say that fear is almost entirely unfounded. “For the most part, even with unplanned pregnancies, it’s a whole different ball game when the baby comes out,” Collins says. Five years later, Elizabeth Johnson is completely in love with her surprise child, a little girl she named Cathy. “I went through a lot of emotions,” Johnson says, “but it ended up being good.” Jennifer L.W. Fink’s surprise baby, Sam, is now 2. Fink has also written for Parents magazine and American Baby.