pregnancy, Women's Health

WHEN IS IT “SAFE” TO TELL PEOPLE YOU ARE PREGNANT

I was at an end of the year kindergarten party this week. After consuming the usual amount of sugary snacks associated with such class parties, but before saying their dramatic goodbyes that also included full body hugs, each kindergartner circled up to say what they were looking forward to most this summer. Most announced various beach and Disney trips, but one little girl began jumping up and down and squealed, “I’m excited about summer because my mommy has a baby in her belly!” Based on the way her mom’s eyes widened and jaw dropped open in horror, I’m guessing this new baby news was not yet meant to be public knowledge.

It’s hard to know when it’s ‘safe’ to tell people you are expecting. In this age of social media, it is difficult to tell just family and close friends. Even when you try to keep it quiet, the news has a way of sneaking out like it did for my friend whose great aunt had recently joined “The Facebook” and accidentally posted her congratulations on her wall instead of a private message.

Everyone’s biggest fear is making a big public pregnancy announcement, only to have to sadly announce a loss a few weeks later. With my first pregnancy, we called all our friends and family the day we found out. We simply couldn’t contain our excitement. Sadly about a week later, we experienced a loss. It really stunk having to then tell everyone we had a miscarriage, but at least people knew why I was sad and could offer their sympathy and support, which was very helpful. With the next pregnancy I was very guarded and waited until after 12 weeks before I shared the news.

When I see a couple for their first pregnancy appointment, after we see the heart beating strongly on ultrasound and they breathe their initial sigh of relief, one of the first questions they ask is “Is it safe to tell people we are expecting?” I get a sense they feel that if I give them the blessing, all will be OK. While I can never offer a guarantee, I can offer statistics that provide some reassurance as to when it’s safe to let all their great aunts know the exciting news.

Chance of miscarriage after a normal first trimester ultrasound (maternal age <35):

  • At 5 weeks the risk of loss is 8%
  • At 6 weeks the risk of loss is 7%
  • At 8 weeks the risk of loss is 3%
  • After 12 weeks the risk of loss is < 1%

While many women choose to wait until after the first trimester to tell their news, if the baby has a normal heart beat at 8 weeks, their chance of a normal pregnancy is 97%.

Risk factor that might increase the chance of miscarriage:

  • Maternal age >40
  • History of >2 miscarriages
  • Diabetes
  • High blood pressure
  • Lupus
  • Untreated thyroid disease
  • Abnormally shaped uterus

Sadly, miscarriage is very common with up to 15% of pregnancies ending in loss. This rate can increase an additional 10- 25%  if you count “chemical pregnancies,” when a woman’s initial home test is positive only to have her cycle start a day or two late. Due to the high rate of chemical pregnancies, I encourage my patients not to rely on ultra sensitive home tests days before their period will normally start, but instead try to wait until they are at least a week late.

The decision of when to announce your pregnancy is a very personal one. I was initially horrified when I realized I was going to have to “unannounce” my first pregnancy after my loss, but eventually I was thankful I had the support of all my friends as my heart was healing. For those looking for the best time to share your news, know this: the risk of loss drops dramatically once you have seen a healthy heart beat, and then becomes extremely low after the first trimester. 

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