When To Tell People You Are Pregnant (In A Post Roe V. Wade World)
/When Should I Tell People That I Am Pregnant Is A Top 5 Most Commonly Asked Question In My Line Of Work
I hate when blog posts about food make you scroll all the way to the bottom to get the recipe. You search for “pancake recipe” and someone talks for pages about what they love about pancakes and end their post with a recipe. Personally, I just want to make pancakes. I am more of a pancake eater and less of a person who writes about how pancakes make me feel. When it comes to when to tell people about your pregnancy I have both a simple answer for you which I will tell you right now, as well as a more complicated one that takes some explaining. I will cut to the chase and give you the simple answer and then you can keep reading if you want to understand on a deeper level. Fair warning I get pretty deep. : )
You should share your news of your desired pregnancy right away with anyone whom you would share bad news of loss and grief with. Allow your closest family and friends to participate in both the joys and sorrows of your life.
I hope your pregnancy is filled with joy but we all know that life is not always joyful and not always simple. The reason that people often wait to share the news of their pregnancy is that they do not want to have to later go back and tell people that there was a problem or complication in the pregnancy. So, if you would tell your best friend that you had a miscarriage or are struggling with an abnormal test result then you should also share the news that you are expecting. You may want to wait however for your larger social media reveal. If an unexpected miscarriage happens or you receive bad news in your pregnancy and you have already made a Facebook post about it then it can feel a bit awkward and sad to have to re announce the bad news. Medical challenges could come up at any point in the pregnancy but you have to share the news at some point, so when will you do it?
Most people are sharing their pregnancy news once the odds have increased that their pregnancy will continue, or once a pregnancy has made it out of the first trimester and normal genetic testing results have been received.
Learn more about the concerns that are most worrisome related to sharing your pregnancy news:
ACOG (American College Of Obstetrics & Gynecology) Fact Sheet On Miscarriage
ACOG Fact Sheet On Genetic Disorders
Miscarriage Predictor Calculator
Check out this Miscarriage Predictor Calculator I found.
Rates Of Miscarriage As A Function Of Maternal Age
The chart below depicts the increasing risk of spontaneous miscarriage as women age. Most miscarriages are thought to be due to a genetic concern specific to that pregnancy and older women are more likely to have eggs with abnormal genetics. Remember though, a new pregnancy is a whole new set of genetics with its own set of risks.
https://geneticsandfertility.com/services/general-infertility/maternal-age-reproduction/
Rates of Miscarriage According To Weeks Of Gestation
Most miscarriages happen early in a pregnancy. It is not impossible to have a loss past 12 weeks but significantly less likely. If genetics are the cause for the loss then most times the pregnancy is not able to grow past a certain point meaning less likely to continue past 12 weeks.
https://www.aafp.org/pubs/afp/issues/2007/1101/p1341.html
Risk Of Chromosomal Abnormality According To Maternal Age
As mentioned above, older moms have higher rates of chromosomally abnormal pregnancies. There are certain genetically different pregnancies that do NOT end in miscarriage but continue to grow. The most commonly tested for conditions being Trisomy 18, Trisomy 13, and Trisomy 21.
http://denverholisticmedicine.com/advanced-maternal-age
How Can I Hide My Pregnancy When I Feel So Terrible?
There is an argument to be made however for sharing your news early. The first trimester is laden with symptoms of nausea and fatigue that can be very challenging to disguise. If your boss or employer is understanding then often they can make accommodations to allow you to continue to work. Additionally telling your employer will also help them understand why you are shutting your office door and taking naps at lunch. Depending on the severity of symptoms some women are able to power through and pretend they are not debilitatingly tired and sick while others must go to lengths such as requesting disability and or take temporary leave from work. It does not always work out well though and I have known women who have lost their job as a result of their extreme first trimester symptoms. Waiting to tell your extended network must be balanced with the challenges of first trimester symptom management.
Who knew it was so confusing? What should women do? Hide their symptoms and let co-workers wonder? Tell their employer and ask to be treated differently in a work environment that often pretends women and pregnancy do not exist? Women are left to worry and wonder what will come of their jobs when they are open and honest about their change in status. Yes, there are laws to protect your employment but the truth is in 2022 in the US women still have to wonder how their employer will respond. Legal action required to defend your job is often not accessible for most women, especially when you are more worried about getting a paycheck, putting food on your table and your day to day expenses than changing the world.
How Can I Get Support If No One Knows You Are Pregnant?
Some may make the argument that even in the cases of loss and struggle that we should talk about it openly and share our experience so that others don't feel alone and others may better support you. It can be eye opening to see how once you tell someone you had a miscarriage you suddenly learn that many women in your network have experienced the same loss. We do not talk about our grief openly and maybe we should. The truth is that our US culture is not one set up for community support. Some individuals are lucky and were born into a supportive community or others smartly have built one, but our society often celebrates to a fault independence and the strength of doing it on your own which makes being vulnerable and sharing your struggle a shameful and often isolating experience.
Disclaimer: This is where my post WOULD have stopped prior to June 2022 strike down of Roe v. Wade however here we are.
Now That Roe V. Wade Has Been Struck Down It’s Different…. For Some
The Supreme Court ruling in June 2022 that struck down Roe has led to even more uncertainty about our rights and options as women. The decisions of our government are based in a limited understanding of pregnancy and reproduction and display how gravely misunderstood and underappreciated women’s health is in the United States. This new limitation on our own autonomy and control over our bodies and the interference in the ability of medical providers to do their jobs to provide the healthy and right care for each individual adds a wrench to the conversation about when to share your pregnancy news.
This post is not about whether abortion is right or wrong, but the ability for women to get the medical care they need and the lack of conscience and lack of intellect that the residual state level laws show regarding knowledge of reproduction and women’s health.
Please set aside your feelings on abortion for a moment to consider that many women, depending where they live and economic resources available to them, will now have to hide their pregnancy until they are 100% sure they will be continuing the pregnancy for fear of legal repercussions. In a country with already poor maternal health outcomes and lack of family support many underserved women are now going to avoid care or seek care in unsafe ways.
Please consider:
That the decision to terminate a pregnancy is a choice that even women with a DESIRED pregnancy must at times make depending on the health of the pregnancy, the health of the woman, and the physical ability of that woman to carry the pregnancy.
Can you answer any of these questions for me? How sick does a woman have to be to legally get an abortion? How close to death must she come? How much emotional pain must she suffer before the state will allow her to terminate a pregnancy? Why is someone without a medical degree making these decisions?
If you live in a state where you no longer have the option to terminate a pregnancy, or if you legally can not terminate a pregnancy past a set number of weeks then women may be forced to carry a pregnancy to term that is medically not advised to be continued. For example, often genetic testing cannot confirm a genetic abnormality in a pregnancy until approximately 15-20 weeks. Yes, tests may suggest an abnormality earlier but not before 10 weeks and most women are not willing to terminate a desired pregnancy until they are certain of the results and follow up confirmatory testing is complete.
A woman with a desired pregnancy needs the option to terminate a pregnancy just as much as a woman with an undesired pregnancy.
Therefore the woman reading this post who is happy to be pregnant but finds out that her pregnancy is not one that can/should/or she wants to continue may now be forced to hide that pregnancy if she wants the option to travel out of state and receive the medical care she needs without fear of serious legal repercussions.
Consider these examples:
Two common chromosomal abnormality causes of a pregnancy that is abnormal but continues to grow are Trisomy 18 and 13. These many times are picked up with Non Invasive First Trimester testing. Not all genetic concerns can be tested for in the first trimester, but these two we can sometimes uncover. Diagnostic testing is performed to confirm the accuracy of these tests and typically performed in the late first or early second trimester.
There are also couples at risk for inherited disorders (recessive trait disorders) that have a chance of having a baby with the condition for which is passed down in their genetics. The woman or man conceiving is not affected but if a mother and father carry the same genetic trait, usually unknowingly, they have a 25% chance of having a baby with that particular disorder. We all carry recessive traits but some of us carry more severe types. Some of us then have the random luck of having a baby with a partner who carries the same trait. Often similar traits may run in certain ethnic backgrounds but even conceiving with someone from a different background does not rule out this concern. One example, SMA or spinal muscular atrophy, a disorder that gradually destroys the motor neurons which is required for activities such as walking, talking, swallowing and even breathing. ACOG reports that 1 in 40 to 1 in 60 individuals carry this trait. The children with this disorder often die by 2 years of age. Treatments exist that can extend this child’s life but often the condition is painful. Parents will now be forced to carry these pregnancies to term and watch their babies die. Maybe you think that is right, and that is your choice, but now many couples who disagree with you have NO choice. If a couple has the means to travel to a place where they can request a termination, hopefully legally and safely, they likely will now do so in secret. Many without the means will seek services in a more risky way. This couple may be happy that they waited to share the news of their pregnancy.
“In a 1976 article, researchers from the Center for Disease Control examined national abortion data from the three years surrounding the [Roe v Wade] rulings and estimated that the number of illegal procedures in the country plummeted from around 130,000 to 17,000 between 1972 and 1974. The number of deaths associated with illegal abortion decreased from 39 to five in that same time period; women who died as a result of illegal abortions typically were black, were more than 12 weeks pregnant and had self-induced in their own community. The researchers concluded that abortion services need to be improved and available more widely, especially for women at high risk for seeking illegal abortions, because “any actions which impede their access to legal abortion may increase their risk of death.” More than 40 years later, their words are a potent reminder of the dangers of restricting abortion access.”
(Link to the 1976 article referenced above)
The New Reality For Some
I am not trying to scare you but this is our new reality. I find so often couples having their first baby are blissfully naïve and I hope that it is always so for you. I hope that this article educates you and that you never have to learn through experience. Sharing the news of your pregnancy has always been a question of timing and, now the timing is just more complicated. Some couples share the news too early or too late and look back and think, why did I do that? For others it all goes smoothly and what time they shared the news is never given a second thought. With less safe abortion access and women potentially having to travel out of state to receive the care they need as well as the risk of legal repercussions for the choices they make I believe we will see more women waiting to share their “happy” news. If women usually share the news of pregnancy at 12 weeks they may choose to delay sharing the news until 20 weeks. This means more women struggling in silence day to day and suffering the consequences of their employers not understanding what is going on in the life of their workers. Whether it’s lack of paid leave, or lack of time for women to pump breast milk the US work culture seems to pretend women do not exist.
With no support for working parents, limited paid leave options, the cost of healthcare, the cost of childcare, the additional isolation and struggle imposed on women simply seems cruel. As a women’s health care provider it feels completely ignorant of the reality of reproduction.
I hope that your pregnancy is the norm…. One in which you share the news and you watch as the amazing life inside of you grows. I wish for you a supportive employer who is understanding and flexible as your needs change. I have seen many larger companies shift in this positive direction. But what about all of the women who do not have a job and or a partner to financially support her during this time or do not work for those progressive companies that provide support? I hope that you have a genetically normal pregnancy and do not have to make hard decisions about carrying a pregnancy to term that will not live. I hope that you dont have to face the physical risks and financial challenges of delivering that baby that may never come home with you. Most women will be fine. It is those women who really need medical care - the women with medical complications, the women with abnormal test results, black women in the south who are already threatened by elevated maternal mortality rates and racism, the women who are late to care because they are poor and underserved who are the most vulnerable that will suffer.
This brings me back to my main point which is you need a community around you when you are pregnant and as a new parent. A community to educate you, share information, support you in access to care and decision making and hug you when it’s hard to deal. So build your community that you trust and love and, come what may, they can support you through your pregnancy no matter how long it lasts. Your broader community can wait until you are ready.
Do you want to join the Sweet Pea Prep community and learn how to start your pregnancy off safely and thoughtfully? Take my free first trimester course Pregnant, Now What?!?!
