Background: The risk of preeclampsia and intrauterine growth restriction can be assessed in the first trimester combining maternal characteristics, biophysical and biochemical measurements. The early risk identification allows targeted follow up and prophylactic treatment with acetylsalicylic acid but potentially influences the pregnant woman’s experience and mental well-being. A structured follow-up involving psycho-social support might improve patient care and decrease the burden of being identified as a woman at risk of a potentially life-threatening pregnancy complication. We describe the utilization of an early psycho-social intervention and concerns raised by the participants. Methods: Secondary analysis of the early psycho-social interventions as part of a prospective cohort study. Results: 92.1% (441/479) participated in the early psycho-social intervention. 86.6% had at least one risk and load factor: 56.7% reported fears, 44.0% had mental illnesses in past or present and 36.7% reported social constraints. Experiences of violence were reported by 25.9%. Additional support was required in 27.7% of cases. More than 90% of women recommended a similar conversation for other women in a similar situation. Conclusions: An early psycho-social intervention for pregnant women at risk is well accepted and many report risk and load factors which can be addressed by the psychologist. Some women require additional support which can be instituted afterwards. Trial registration: The study was registered at clinicaltrials.gov (number NCT04514276, registered 14/08/2020) and DRKS (number DRKS00017713, registered 09/06/2020).