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How to Make a Plan after an Unexpected Pregnancy

Maybe you held the test in your hand, unable to move, in a state of shock. Maybe you cried. Maybe you laughed. Maybe you shook the test, thinking that would change the result. (It won’t.) Maybe you felt an unexpected swell of excitement. Maybe you threw up. No matter how you reacted, you are not alone — according to a March 2016 article in the The New England Journal of Medicine, 45% of all U.S. pregnancies in 2011 were unintended.

An unplanned positive pregnancy test can bring up varied and often conflicting emotions. Your first thought will likely be, “Can this be real?” Almost always, the answer is yes. We explain why below, share ways to navigate your feelings and suggest important next steps.

Can I trust these results?

True false positives are rare. Pregnancy tests work by detecting the hCG (human chorionic gonadotrophin) hormone, which your body normally produces only when you are pregnant. Most home pregnancy tests are 99% accurate.

A pregnancy test can give a positive result after a recent pregnancy, whether or not that pregnancy resulted in a baby. Because pregnancy tests detect low levels of hCG, it is possible that a test may give positive results even if you are not pregnant.

Fertility medications that contain the hCG hormone sometimes affect results as well. Finally, while highly unlikely, certain medical conditions, including ovarian cysts, tumors, cancers, hormone disorders and rare kidney disease, can cause a spike in hCG levels, resulting in a false positive.

Many women take two tests (or more) to be sure about their results, but if you see two lines, a plus sign or the word “PREGNANT,” you are, except in the rarest of circumstances, pregnant.

Accept conflicting and confusing emotions

Your initial reaction to an unplanned pregnancy is just as valid as the reaction you have when you wake up the next morning and realize you weren’t dreaming. It is OK to feel scared, excited, embarrassed, ambivalent, inadequate, calm, resentful, eager, unprepared, joyful or sad. You are certainly not the first woman to feel any of these emotions while shakily holding a positive pregnancy test behind a closed bathroom door. These feelings do not define you as a person.

If you feel conflicted, remember you’re human and it’s OK if your reaction doesn’t match the portrait of parenthood most often painted. You have been surprised. This was not planned, and you recognize that it’s a big deal. Myriad, conflicting feelings can coexist. Give space to them all.

Be honest

Denial is common. “This can’t be happening.” But eventually denial will have to give way to reality, and your path forward will be a bit smoother if you can accept it sooner. Outside influences — your beliefs, your partner, your friends, your family, society in general — may put you at odds with how you think you should feel and how you really feel. Being honest with yourself isn’t always easy, but it will save you time and serve as a good road map for the future.

If you feel conflicted, remember you’re human and it’s OK if your reaction doesn’t match the portrait of parenthood most often painted. Myriad, conflicting feelings can coexist. Give space to them all.

Seek help

You may feel alone. Sometimes it’s helpful to share your feelings with a trusted friend, sibling, parent, partner, co-worker or neighbor, but only if you feel comfortable doing so.

Contact your doctor as soon as possible. Remember, about half of all pregnancies are unplanned. Medical professionals are used to providing resources and offering support. Online forums and communities also can connect you with women who are going through exactly what you’re going through in real time. Sometimes it’s easier to be honest with strangers; often, they become lifelong friends.

Next steps

After the immediate shock, call your ob-gyn or other health care provider for a quick appointment. (If you don’t have one, call your primary care doctor for a referral.) Confirming the pregnancy with bloodwork or an ultrasound is the next step. If you’re curious about pregnancy do’s and don’ts, a conversation with your doctor will help you make healthy decisions.

Seek support from people you trust. Drop judgment. You may not feel very brave right now, but you are strong. This is a surprise that is now part of your story, so it’s no wonder your feelings are so visceral and mixed. Sometimes it helps to think of all the women who have dealt with this scenario since the beginning of time. They persevered. You will, too.


Finer, L. B., & Zolna, M. R. (2016). Declines in Unintended Pregnancy in the United States, 2008-2011. New England Journal of Medicine, 374(9), 843-852. https://doi.org/10.1056/nejmsa1506575