When and How to Announce Your Pregnancy

You just found out you’re pregnant! Maybe you were hoping and planning for this day, or maybe you never would have guessed in a million years that you would be here. But yet, here you are, staring at that little plastic stick with a very clear second line in the window. Your mind is probably racing, and one of the thoughts you may have already had is “Who should/can I tell and WHEN!?”

Some women choose to tell their partner right away, if their partner wasn’t already there with them when they got that positive. The more difficult decision is often when to tell the rest of the world (or at least the people in your world). You might be one of those people who cannot wait to tell EVERYONE! The excitement is just too much and the world must know right this second! That’s a very normal reaction to getting this kind of news, and there is absolutely nothing wrong with wanting to share your joy with others.

Why Others Choose to Wait

If you are one of those people who can’t wait to share, though, you might be trying your hardest to not tell everyone right away because you’ve already heard about the unwritten rule of not sharing the news of a pregnancy publicly until after the first trimester.

Many women choose to wait to share pregnancy news until at least after the first trimester because 85% of miscarriages occur during the first trimester. The risk of miscarriage goes down with every passing week of pregnancy, but the risk dramatically drops at 13 weeks gestation from 10% to below 5%. The risk drops to below 1% at 20 weeks gestation, and for that reason, some women choose to wait even longer to announce their pregnancy. They might feel that the loss itself would be painful enough without having to announce it to their friends and family, too.

Why Others Choose Not to Wait

Some people are very open about their desire for a child and their journey of trying to conceive, so it feels unnatural to them to keep their success in doing so a secret. Maybe they have been trying for a very long time and can’t imagine keeping the good news to themselves for over two months.

One in four women will suffer a pregnancy loss, and this type of loss is often suffered alone due to the fact that few people, if any, knew that the woman was pregnant in the first place. For that reason, some women choose to announce their pregnancy publicly as early as they themselves find out. They know that even if their pregnancy were to end in miscarriage, they would still want to share that information with the same people with whom they want to share their pregnancy news. They want to be supported by their loved ones through their loss just like they would have been supported through their pregnancy.

But what should YOU do?

Not everyone makes their decision about when to share their pregnancy news based on the risk of miscarriage or their overwhelming excitement to tell the world. There can be thousands of different reasons why someone might choose the specific timing of their pregnancy announcement, but the most important thing to remember is this…when and how you choose to announce your pregnancy is and should always be completely and entirely up to you.

And while you contemplate your decision on when to announce, check out these super cute ideas on how to announce!

Morning Sickness: What it is and how you can feel better

What is morning sickness?

Morning sickness is the common name for nausea and/or vomiting during pregnancy, also known as NVP. The name can be slightly misleading because NVP doesn’t always just occur in the morning. It can be worse in the mornings for some women, but it can also be worse in the evenings or just the same level of awful all day long. In fact, approximately 80% of women [suffering from NVP during pregnancy] report that their symptoms last all day, whereas only 1.8% report symptoms that occur solely in the morning.

Who does morning sickness affect and what causes it?

Nausea affects about 75% of pregnant women, while only about 50% of pregnant women actually experience vomiting. The exact cause of these symptoms in pregnancy are unknown, but observational data has shown that these conditions correlate with levels of human chorionic gonadotropin (hCG) and the size of the placental mass, which suggests that placental products may be associated with the presence and severity of nausea and vomiting.

How can morning sickness be managed?

There are a few lifestyle and eating habits that you can change that have shown success in managing the symptoms of morning sickness. The American College of Obstetricians and Gynecologists recommends adapting the following eating habits to help keep the nausea at bay:

  • Eat dry toast or crackers in the morning before you get out of bed to avoid moving around on an empty stomach.
  • Eat five or six “mini meals” a day to ensure that your stomach is never empty.
  • Eat frequent bites of foods like nuts, fruits, or crackers.
  • Eat bland foods. The BRATT diet (bananas, rice, applesauce, toast, and tea) is low in fat and easy to digest.
  • Add protein to each meal. 
  • Drink 8-12 cups of water per day, as dehydration can lead to more nausea.
  • If you like ginger, add ginger to your diet in the form of capsules, candies, ginger ale made with real ginger, or tea made from fresh-grated ginger. Ginger is very good for soothing the stomach.

Some pregnant women have success fighting off nausea and/or vomiting by taking Vitamin B6. If Vitamin B6 alone doesn’t seem to be enough to ward off symptoms, it can also be paired with doxylamine, an over-the-counter sleep aid. Both drugs, taken alone or together, have been found to be safe to take during pregnancy and have no harmful effects on the baby.

If nothing else is working to fight off the symptoms of morning sickness, antiemetic drugs may be prescribed for women who aren’t helped by other methods. An antiemetic drug that is often prescribed to pregnant women that helps prevent nausea and vomiting is ondansetron, also known as Zofran. It is important to note, however, that while ondansetron is highly effective in preventing nausea and vomiting, studies are not clear about its safety for the baby. Ondansetron also has been linked to heart-rhythm problems in people taking the drug, especially in those who have certain underlying conditions. Your care provider will be your best resource in helping you determine if taking ondansetron or another antiemetic drug is right for you.

How long will morning sickness last?

Nausea and vomiting of pregnancy usually begins between 6 and 9 weeks of pregnancy. For most women, it goes away by 14 weeks of pregnancy. For some women, it lasts for several weeks or months. For a few women, it lasts throughout the pregnancy. In a future blog post, we’ll talk about hyperemesis gravidarum, which is the term for the most severe form of nausea and vomiting of pregnancy that occurs in about 3 percent of pregnancies.

The Different Types of Midwives in Utah

Did you know that in Utah, there are four different types of midwives that can legally practice here? In the state of Utah, women are legally guaranteed the right to birth however and with whomever they choose, which is what makes it possible for all four of these different types of midwives to be able to practice here.

The four types of midwives in the state of Utah are LDEM – Licensed Direct Entry Midwife, CPM – Certified Professional Midwife, DEM – Direct Entry Midwife, and CNM – Certified Nurse Midwife.

-CPM: Certified Professional Midwives have met the requirements for the North American Registry of Midwives (NARM). These requirements include either graduating from a midwifery program or school that is accredited by the Midwifery Education Accreditation Council (MEAC) or completing a non-MEAC accredited program and completing a preceptor program as a student under a NARM Registered Preceptor.

-LDEM: Licensed Direct Entry Midwives are also Certified Professional Midwives (CPM’s) who have met the requirements for the North American Registry of Midwives (NARM). In addition to being certified by NARM, they are also licensed by the state of Utah. A CPM can become an LDEM through many different avenues, including apprenticeship, self-study, and/or formal classes. They are also required to complete pharmacology training in Utah, which allows them to have limited prescriptive privileges.

-DEM: Direct Entry Midwives may or may not have met the requirements for the North American Registry of Midwives (NARM) but have not become a CPM.  DEM’s can obtain their education through apprenticeship, self-study, and/or formal classes. They are not licensed with the state of Utah, but are legally able to practice out-of-hospital midwifery.

-CNM: Certified Nurse Midwives have become a Registered Nurse and then completed schooling to become a Certified Nurse Midwife. Most CNM’s work in hospitals, as they are the only type of midwife legally able to do so in Utah. They are also legally able to carry medications, write prescriptions, and are typically under the supervision of a doctor. On the other hand, CNM’s can also choose to work with clients in birth centers or in the home.

Other important differences between the different types of midwives in Utah:

-CPM’s and DEM’s can deliver breech babies and twins, while LDEM’s and CNM’s cannot.

-All four types of midwives can carry oxygen, but only LDEM’s and CNM’s can carry and administer other medications such as lidocaine, Rhogam, Vitamin K, Eye ointment, IV’s, medications for hemorrhage, and antibiotics.

-LDEM’s have limited prescriptive privileges, while CNM’s are not limited in their prescriptive privileges.

If you plan to have your baby in a hospital but would like to be under the care of a midwife, you’ll want to seek out a CNM who works in a hospital. You can see last week’s blog post to learn more about the differences between midwifery care and ob-gyn care in a hospital setting.

**Much of the information included in this blog describing the different types of midwives in Utah has been provided by Tooele Midwifery and The Birth Center.

I want a hospital birth, but do I want a doctor or midwife?

You’re having a baby! It probably goes without saying that your mind is overflowing with questions after having just received this life-altering news. One of the most pressing of those questions is probably who your care provider should be. You know you want to give birth in a hospital, but you also know that there are so many doctors to choose from, and now you’ve also heard that there are in-hospital midwives. Where do you even start in navigating all of your options? Right here!

What is the difference between a doctor and an in-hospital midwife?

There are three main differences between a doctor (OB-GYN) and an in-hospital midwife (CNM):

  1. Education
  2. Models of care
  3. Types of pregnancies they care for (high risk or low risk)

Education.

In order to practice as an OB-GYN, a physician is required to have completed a bachelor’s degree, four years of medical school, and a four to seven-year medical residency that includes surgical training and is specific to obstetrics and gynecology. 

In the state of Utah, there are four different types of midwives that can legally practice (the differences of which you can learn about in this blog post), but the only type of midwife that can practice in a hospital setting is a Certified Nurse Midwife (CNM). CNMs must be Registered Nurses and they must also complete a Master’s Degree in Nurse-Midwifery.

Models of care.

The typical model of care for an OB-GYN is more medically-focused and medically-managed. Medical interventions are more commonly introduced and utilized under the OB-GYN model of care. An OB-GYN will typically play a very small role in the birth itself, as they are usually only present to catch the baby and for a brief period after the baby has been born. OB-GYNs are trained surgeons and can perform cesarean sections, if necessary.

The midwifery model of care is usually more naturally-focused and mother-and-child driven. The approach to care is typically more hands-off and less prone to medical intervention. A midwife is more likely to play a more active role in the labor and birth process. CNMs are able to carry medications and write prescriptions. They cannot, however, perform cesarean sections, so if a cesarean section becomes necessary, an OB-GYN will have to perform it.

It is important to remember that these are just general descriptions of the typical models of care for these two types of providers. This is not to say that these models of care are always implemented by every OB-GYN or midwife. There are certainly OB-GYNs that implement a model of care that is more like that of a midwife and vice versa.

Types of pregnancies they care for.

OB-GYNs can care for women with high or low-risk pregnancies. Some OB-GYNs specialize in or have more experience in certain types of high-risk scenarios, such as pre-eclampsia, placenta previa, multiples, etc.

CNMs typically only care for women with low-risk pregnancies. If a patient is receiving care from a CNM and later develops problems that cause her pregnancy to be deemed high-risk, it is likely that the patient will need to transfer care to an OB-GYN.

The choice to go with an OB-GYN or a CNM can seem daunting, but it essentially all comes down to what is most important to you pertaining to your birth experience.

Is it important to you that your provider be able to handle any and all medical scenarios that could potentially occur? Then an OB-GYN might be the best choice for you. Or is it more important to you that your provider play a more active role in your labor and birth experience? Because if that’s the case, a CNM might be more up your alley. Either way, the choice is entirely yours and your intuition will be your greatest guide!