Breaking the Good News?

I recently read an advice column in the news paper concerning how to tell people you are pregnant. The writer was concerned with how to give the good news to a friend who had been struggling with infertility. I was struck by the thoughtfulness of the writer to be so considerate as to realize the mixed emotions that are processed by those wanting children when they hear that someone near them is expecting. The advisor (I think it was Dear Abby, but I can’t specifically remember) recommended to tell the person in private or consider writing a note to inform them, giving them permission to process the news however they needed to emotionally, before they have to see you. I thought this was really good advice.

I remember during my adoption journey, that it didn’t bother me when close friends got pregnant or adopted, but sometimes when I would hear the ‘good news’ from acquaintances it would sometimes upset me, I’m embarrassed to say. I’m not exactly sure why. I guess if it was someone I knew, then I could identify with their journey, but it was harder to process when I didn’t know the entire story. For some strange reason it would also bother me when TV characters had babies. I remember one specific Blue’s Clues I was watching with Ryan. Mr. Salt and Mrs. Pepper were having another baby. Umm, really! Couldn’t they just be happy with a baby Paprika! But NO, here comes cute little baby Cinnamon. It’s funny now, but it really ruined my day.

On a related note I will often get asked by patients when is it safe to tell people that they are pregnant. Especially those that have previously struggled with infertility, I get the sense sometimes, that they feel that if the doctor tells them it’s OK to spread the word then nothing can happen. Each person’s situation is different. I can give them the statistics for their pregnancy, but deciding how and when to tell the good news is a personal decision. Some patient post their pregnancy test on twitter as soon as it comes back with a double line, others anxiously await the second trimester to feel safe to speak a word.

Some reassuring numbers for those waiting to tell:

In a healthy women less than 32 years old with no history of previous miscarriage the chances of having a miscarriage drop to 3% after a heart beat is seen at 7 weeks. This number drops to less than .5% after entering the second trimester. The risk of miscarriage does increase with age >35, smoking, medical condition and history of previous miscarriages. Even with these risk factors, though, the chance of loss decreases with each advancing week. So if you are looking for a ‘safe point’ to tell, after seeing a heart beat is a reassuring time. If you want an even ‘safer’ point, then second trimester is better. Really, the best time to tell, is when you feel it’s the right time to tell.

I get to hear from my patients some cute stories of ‘how’ they spread the news to their family; like framing their ultrasound picture to be opened at holidays, making a video featuring the news or having the good news written on cake. However you tell have fun with it, but be sensitive to those who may have a difficult time with hearing it.

I’d love to hear some feedback on ways you have told people about your pregnancy and also from our readers who have struggled with infertility on how they think is the best way to ‘break the good news’.

Symptoms: Hunger w/ Cravings and Aversions

I am 10 weeks along in my pregnancy and all of a sudden I am hungry ALL THE TIME! Dr. Rupe talks about this symptom in the book. Hunger, with cravings and aversions.

I'm hungry all the time but not much sounds good to me. I am blessed in that I don't suffer from extreme nausea or vomiting during my first trimester. Just a touch of queasiness from time to time. But I have lots of food aversions and honestly, they seem to come and go. One minute chicken sounds good, the next anything related to my feathered friends makes me want to puke. It makes it very challenging to eat healthy during these early stages of pregnancy.

My hope is that after I share my pregnant point of view on this symptom, Dr. Rupe will chime in with another entry that gives the facts and some good, doctorly advice on how to handle this early pregnancy dilemma.

Preparation is perhaps the most important action you can take when trying to eat healthy in your first trimester (and throughout your entire pregnancy for that matter). Since I know that chicken is hit or miss for me right now, I have to be ready with other options. What does sound good? Make a list of foods you have not been averse to and make sure you keep them around. Any kind of meat is tough for most women I talk to in their first trimester. What other forms of protein can you stomach at this stage?

I don't hear much that fruits and vegetables bother women in pregnancy so focusing on those things is a good idea. I've eaten a lot of salads (the tangy vinegar helps the queasiness) along with citrus fruits (sour is great for nausea). When all else fails look to whole grains. Toast and whole wheat pasta are mild and will give you the carbs you need for energy. Try to find some form of protein to add to it though. Cheese is a good idea. Lastly, make sure you drink lots of water to keep you from dehydrating. Water is also just a great cleansing agent. It almost resets my system to drink a tall glass of cold water. Chicken might sound yucky but after downing 8 oz of agua, it might not be so bad.

We'd love to hear your pregnancy menu secrets. What worked for you?