What To Do When A Pregnancy Goes Wrong

Families dealing with pregnancy complications face not just physical, but also emotional and logistical challenges. Psychologist Dr. Hannah Cassedy offers guidance for when complications arise.

pregnancy complications

Let me be clear from the outset: I’m a psychologist, not a physician, so I’m not here to offer you advice about medical interventions during your pregnancy. But pregnancy complications aren’t just physical afflictions; they’re often emotionally burdensome as well. I’m here as someone who has worked with women and their families as they cope with the psychological fallout of medical complications during pregnancy. The endless days, weeks, or sometimes months on bedrest. The fear of not knowing what’s going to happen to your child or your body. The sleepless nights away from your baby in the NICU. All the things that are not at all part of the plan. They can take a toll on a woman’s sense of safety, on her relationships with family and friends, and on her attachment to her baby. That’s what I’m here to address.

Below, you’ll find some guidance split into two categories: one addressed to the friends and family who want to support a woman with pregnancy complications, and the other addressed to the woman herself.

For Friends and Family of a Woman with Pregnancy Complications:

Here are some general rules of thumb about what to do and not to do when a woman you care about is experiencing pregnancy complications.

  1. Don’t add stuff to her plate. Parents with pregnancy complications have enough to deal with, so be careful not to dump your emotional baggage onto them. During a time of crisis, the people at the heart of the crisis – in this case the woman with the pregnancy complication and her partner – should receive support from the people around them, and they should not have to give support to anyone else. So as a supportive friend or family member, one of your jobs is to make sure you keep your emotional baggage far away. Do not ask to be in the delivery room unless you’re invited. Do not try to hold the baby before your frienemy gets to. Do not show up at the hospital unannounced. All of these gestures might come from a place of love and of eagerness to connect with the baby, but they are also all subtle ways of asking the parents – the people in the throes of crisis – to take care of you, instead of the other way around.
  2. Encourage her to attach. Some parents with pregnancy complications feel reluctant to attach to the fetus because they fear it might not survive. If a woman chooses to continue such a pregnancy, it’s important for her and her partner to attach to it as much as possible, even if they are expecting it not to survive. Contrary to popular belief, attaching to the fetus actually helps relieve feelings of guilt and grief when complications arise or even when the pregnancy ends in loss. So as a friend or partner, you could encourage this attachment by, for example, using the baby’s name (if it’s available) or coming up with a nickname during the pregnancy. You could help put together a scrapbook of sonogram pictures and hospital mementos. You could ask about what the little peanut responds to in utero: does he seem to get a kick out of any particular foods? Any early indications of which parent he takes after? These kinds of innocent questions can help parents begin to feel connected with their baby in a healthy, helpful way.
  3. Speak up. Sometimes people freeze when they witness someone going through something difficult. They don’t know what to say, so they say nothing at all. Although you may be well-intentioned, saying nothing can make some women feel really isolated and alone. Try saying something like, “I know you’re going through something really tough and I want you to know that I’m thinking of you. How are you doing, really?”
  4. Tolerate her feelings. Once you ask how she’s really doing, it’s only fair that you accept her response, even if it makes you uncomfortable. She might say that she’s fine and that there’s nothing to see here. Okay, we can accept that. She might come back with a string of negative feelings about her pregnancy or her body or her family or who knows what; that’s okay too. The point here is to meet her where she is, and to accept her feelings as an honest and therefore important part of her pregnancy experience.
  5. Offer specific, practical help. Saying something like, “let me know if there’s anything I can do to help” is nice, but most people will be unlikely to take you up on such an abstract offer. Instead, offer specific, practical skills that you’re able and willing to volunteer. For example, “Can I drop off dinner at your front door (without coming in for a visit) every Sunday?” “Can I walk your dog on your way to work twice a week?” “Can I mow your lawn so you don’t have to deal with it?” Whatever it is, make it specific and – most importantly – make it something that you can commit to doing if she takes you up on the offer.

For Women with Pregnancy Complications:

I’m not going to guess what kind of pregnancy complication you have. Preeclampsia? Short cervix? Preterm labor? I have no idea. But I can guess that you might be feeling some of the following ways: scared, nervous, sad, angry. Whether or not this pregnancy was planned, the complications were not. You are now faced with things going way, way off plan.

Maybe you have to adjust to time at the hospital and away from home.

Maybe you have to take medical leave from work now before baby comes, which is just plain unfair.

Maybe you have to live with the fear of not knowing what will happen to your baby and to your body.

Sometimes women feel guilty for their reactions to pregnancy complications. They try to convince themselves that they should be happy that baby is arriving early, rather than not at all. They try to force logic on the situation, insisting that their feelings matter less than their baby’s health. I understand this logic. But I also think that mothers deserve to feel whatever it is that they’re feeling about things not going to plan.

Let’s say, for example, you were looking forward to your baby shower but have to cancel it because you’re on bedrest or because baby arrived way earlier than expected. I would argue that missing your shower is a loss. It’s a loss that might stand in for bigger losses, too, like the loss of how you were expecting your pregnancy to go. You might feel like you have lost the pregnancy experience you dreamed of and that every single woman on social media seems to have. You might feel like you lost the opportunity to have the birth experience that you always wanted and that you hoped to share with your partner. You might feel like you lost the opportunity for a healthy, chubby baby, or the opportunity to nurse from birth. These are all real losses, my friends. And losses deserve to be mourned.

Feelings of sadness, anger, frustration, envy, and nervousness about the unknowns are all normal parts of mourning the loss of an uncomplicated pregnancy, even if it ultimately ends with a healthy baby and mother. I know these are unpleasant feelings, and it’d be understandable if you wanted to get rid of them right away. But I’d encourage you to get to know those feelings a little bit. They’re part of your pregnancy experience, so they’re important. Try to honor your feelings about your pregnancy complications. Try to give yourself a little leeway – a little grace, if that word suits you – to start getting comfortable with the inevitably unpredictable, uncomfortable, and imperfect parts of parenting.

Naturally, I think that therapy can be very helpful for developing this kind of self-compassion. So can talking with your friends and family about how they can support you in a way that isn’t dismissive of your experience. It might help to share the first half of this article with them, too.


Dr. Hannah Cassedy is a Dallas-based clinical psychologist. She specializes in treating women with obstetrical complications, as well as adults who struggle with relationship issues.