Coping with a “whoops” pregnancy

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UH-OH. That was the title of one of the emails I saw as soon as I got to my office yesterday. One of my patients had just found out that she was pregnant, for the fourth time, and she and her husband were already parenting three young children. The third of whom had also been relatively unplanned. About an hour later, I got a call from another patient. Same issue, this time an unplanned third pregnancy. And this patient had also completed her family, or so she thought. Both of my patients told me that although they believed in a woman’s right to choose, their choice was to continue with their pregnancy. So I am seeing them both this week, to talk about how they can thrive emotionally despite this unexpected challenge.

The 9-month adjustment

Given that about half the pregnancies in this country are unplanned, a “whoops” pregnancy certainly isn’t a rare occurrence. Every pregnancy requires a fair amount of emotional adjustment and preparation. But adjusting to the fact that one is going to be a mom, maybe for the first time and maybe for the fifth, with an unplanned pregnancy, can be more challenging. I joked with the second whoops patient yesterday that maybe that is why pregnancy takes nine months. Maybe that is the time it takes to get ready psychologically.

But being pregnant with a much wanted and planned for baby can feel very different from one that was the result of a birth control failure or a spontaneous act of passion. I have seen women have very different reactions, but a lot of them go through a series of emotions, starting with shock and/or denial, proceeding through anxiety, sadness, a feeling of being overwhelmed, and most often, finally a feeling of acceptance. One of my patients who long ago unexpectedly conceived her fourth child when she was 45, and believed she was long past even being able to get pregnant, told me years later that she had been depressed most of the pregnancy. Her youngest was already in school and my patient was finally able to have some freedom to pursue some of her career goals. However, that whoops “baby” ended up being her easiest and most gratifying child. She couldn’t imagine her life without her.

Imagining life 20 years from now might well seem unrealistic. Being pregnant right now, with a pregnancy you didn’t expect and may or may not want at this point in your life, is the real issue. If you have decided to continue with this pregnancy, don’t expect that it will take a day or two before you feel like celebrating. You may never feel like celebrating. And that is ok. Many women, even ones who experienced infertility and wanted to conceive more than anything, need weeks or months to adjust to the new situation. So don’t push yourself to feel happy. Don’t listen to other people telling you how lucky you are. Avoid feeling guilty. This isn’t something you went after. This is something which occurred, and most humans have a really tough time adjusting to change. Your baby will never know that you might have felt ambivalent. Your child won’t suffer from the emotions you might be feeling guilty about.

A couple of do’s and don’ts:

Don’t tell people that this was an accidental conception. Every one you tell has the potential to tell your child when he/she is older and no kid needs to know that they were unplanned.

Do take really good care of yourself. Eat well, avoid the usual pregnancy no-no’s. Whoops babies are just as vulnerable to the negative impact of alcohol, poor nutrition, and lack of prenatal care.

Don’t force yourself to be happy. You may end up there, but it might take time.

Do have compassion for yourself. Don’t underestimate how hard this may feel.

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