Surprise, You’re Pregnant! Now What?

The moment you learn you are pregnant is life-changing. It may be even more so if the news is unexpected. This happens more often than many realize—in fact, almost half of pregnancies in the U.S. are unplanned.

If you’re happily surprised by a positive pregnancy test and want to move forward with prenatal care, you may have missed some of the steps that usually come with planning for pregnancy. But don’t worry: Once the initial shock wears off, you can begin to focus on what comes next.

Here are eight things you can do right away to get your newfound pregnancy off to a strong start.

1. Book an appointment with an obstetric care provider.

One of your first moves should be to schedule an appointment to begin prenatal care. Your first visit ideally would be in about the first trimester. (It could be earlier or later depending on when you find out you are pregnant and other factors.)

Most people get their prenatal care from an ob-gyn, a doctor who specializes in women’s health care. If you don’t already have an ob-gyn and need help finding one, ask local family and friends for recommendations. You can also try the “find a doctor” service on your health insurance plan’s website or the resources featured on the ACOG website.

Other professionals can care for pregnant women, too. You can ask if your primary doctor, physician assistant, or nurse practitioner offers prenatal care. They may treat people with low-risk pregnancies. An important question to ask is if they also deliver babies since some may provide care only in a clinic. A certified nurse-midwife is another option. If you develop complications during pregnancy, you may need to switch to an ob-gyn or maternal–fetal medicine (MFM) specialist.

No matter who you choose, make sure they participate in your insurance plan before you schedule the appointment.

2. Double-check your health insurance coverage.

While you’re checking with your insurer, confirm that your policy includes coverage for prenatal care and birth. Another option to investigate is state-funded health insurance (Medicaid, Marketplace plans). Medicaid programs have a special enrollment period and qualifications for pregnancy, and most cover the entire cost of care through 1 year after delivery. If it doesn’t, you may need to apply for state-funded health insurance.

Learn which hospitals and birth centers are in-network so you’ll know where to go in case you have an emergency during your pregnancy. Also, confirm that your chosen ob-gyn delivers babies at that hospital or birth center.

3. Gather your medical history.

You and your ob-gyn should talk about your personal and family health history. Plan to bring detailed information to your first prenatal care appointment, including

• a list of all medications, vitamins, and supplements you are taking

• information on any preexisting health conditions

• dates and details of past surgeries

• information on previous pregnancies, including any that ended with miscarriage, stillbirth, or abortion

• any past experience with preterm delivery, preeclampsia, or gestational diabetes

• your vaccination records

• the first day of your last menstrual period (to help predict your due date)

If you already have a relationship with your ob-gyn, some of this information may be in their records. Still, they should ask plenty of questions at your first prenatal visit to make sure everything is up to date.

Note: Do not stop taking a medication prescribed for you until you have talked with your ob-gyn. Stopping a medication could be worse for you or your pregnancy than continuing, depending on the condition it treats. If needed, your ob-gyn can recommend a safer alternative.

4. Start taking prenatal vitamins.

Now is the best time to add a prenatal vitamin to your daily routine if you are not already taking them. Doing so ensures you get all the vitamins and minerals you need during pregnancy.

Folic acid (folate) is one of the most important nutrients for pregnancy. It can help prevent major birth defects of the fetus’s brain and spine called neural tube defects. Your prenatal vitamin should include at least 400 micrograms (mcg) of folic acid. It should have other important nutrients as well, including vitamin D and iron. Read Nutrition During Pregnancy for more on key vitamins and minerals during pregnancy.

5. Stop using unhealthy substances.

From the moment you learn you are pregnant, you need to avoid substances that could hurt a developing fetus, including nicotine products, alcohol, marijuana, and illegal drugs. These substances can cause serious problems such as birth defects, low birth weight, preterm birth, and stillbirth. Read Tobacco, Alcohol, Drugs, and Pregnancy to learn more about substance use during pregnancy.

If you need help stopping any substance, see your doctor right away. But if you use methadone or buprenorphine to treat opioid use disorder, keep taking it under your doctor’s close supervision. These medications are safe during pregnancy, and you don’t want to risk relapsing.

What about caffeine? It’s one of the most common questions I get from newly pregnant patients. The latest research shows caffeine is OK in moderation and does not lead to miscarriage or preterm birth. Experts recommend consuming no more than 200 milligrams of caffeine each day during pregnancy. That’s about two cups of coffee.

6. Follow a healthy diet.

Most people need only a few hundred extra calories per day to sustain a pregnancy. Instead of “eating for two,” think of it as eating “twice as healthy.”

Choose whole grains, fruits, vegetables, lean protein, and low-fat or fat-free dairy products as much as possible. Limit calories from added sugars and saturated fats.

You should also avoid certain foods that may make you or your fetus sick. The biggest concern is a bacteria called Listeria. Pregnant women are 10 times more likely to get sick from Listeria than the general population. Foods that may have this bacterium include

• raw fish, such as sushi and ceviche

• undercooked seafood, eggs, meat, and poultry

• cold deli meats (like sandwich meats) and hot dogs

• unpasteurized milk and cheeses

• refrigerated meat spreads and pâté

• smoked seafood

• unwashed fruits and vegetables

You should also avoid larger fish that are high in mercury, which is linked to birth defects. Examples include bigeye tuna, king mackerel, marlin, orange roughy, shark, swordfish, or tilefish. It’s OK to eat smaller fish, like tuna or salmon, two or three times a week. Read Nutrition During Pregnancy for more details on healthy eating during pregnancy.

7. Keep moving.

Exercise is great for your overall health, and this is true during pregnancy as well. For most pregnant women, about 30 minutes of moderate exercise most days of the week is a good goal.

How hard should you push yourself? If you’re healthy and you could do an activity before getting pregnant, you can keep doing it for as long as it feels good. But avoid anything that puts you at high risk of falling or hitting your abdomen, like skiing or boxing.

Walking, swimming, and yoga are among the safest exercises for pregnant women. Talk with your ob-gyn about your exercise plan to be sure it’s safe for you and your pregnancy. Read Exercise During Pregnancy to learn more.

8. Think about what parental leave will look like.

The sooner you can start planning for parental leave, the better. Familiarize yourself with your company policy and benefits. Your rights will depend on the state you live in, your industry, and the size of your employer.

Also, think about any accommodations you might need while you’re pregnant. For example, if your job involves a lot of heavy lifting or travel, you might need to make temporary changes to your role or schedule.

You can wait to tell your boss or human resources department about your pregnancy while you do this research. Once you’re ready and know your estimated due date, work with your employer on a plan that suits both of you.

Baby steps

Pregnancy can be overwhelming, even if it’s a happy surprise. My advice: Focus on caring for yourself and take things one day at a time.

If you’re feeling stressed, talk with your ob-gyn and supportive friends or family members. They can offer guidance and resources to help you prepare for a healthy pregnancy and birth.

Read more: The Top 6 Pregnancy Questions I Hear From First-Time Moms

Copyright 2026 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.