Counseling While Pregnant

Being a genetic counselor in a prenatal clinic has its perks. During my pregnancies, I didn’t have to go far for appointments, I had insider knowledge about the best birthing rooms in our hospital, and I enjoyed practically unlimited ultrasounds. But I also had the anxiety produced by knowing “too much,” and the emotional job of helping other pregnant women whose pregnancies were not going as planned.

Dealing with loss

Most people wait to tell their boss they’re pregnant until they really have to. I told mine before it told my own mother (sorry, Mom). I was excited when my first ultrasound confirmed a gestational sac was there, but devastated when I lost it less than a week later. That experience increased my understanding of miscarriage and deepened my empathy for those that have experienced it. 

Even though the logical part of my brain knew that my loss wasn’t my fault, my emotional brain was not as easily convinced. It was hard not to run though every second of that short pregnancy wondering what I could’ve done differently. I know I’m not alone in those thoughts. I’ve heard many women ask if it may have been the Tylenol they took, or the exercise they did, or the coffee they had before they knew they were pregnant that caused their miscarriage. The answer to that is a resounding “no.” I had to remind myself of that answer as well.  

Miscarriages are incredibly common. It’s estimated that as many as 50% of pregnancies are lost, most before the woman even knows she is pregnant. The curse of these super-sensitive early pregnancy tests is that they make more women aware of very early losses that may have gone undetected before. Even these early losses are emotionally painful, especially for those eagerly waiting for that positive pregnancy test.

Round 2

Several months later, I was lucky enough to become pregnant again. I chose to go to an OB office down the hall (we didn’t do routine OB in our practice). I surprised my new doc with my very complete and detailed intake forms. Having my OB know I was a genetic counselor was interesting. On one hand, I felt safer with him knowing he couldn’t pull a fast one on me, but on the other, it was odd to be asked for my input on other cases during my appointment. I took some advice from my friend and did not disclose my profession to my birthing class. I was able to avoid the weekly Q&A sessions she ended up having in hers.

Knowing “too much”

That pregnancy also taught me a ton about ultrasounds. I had already spent a lot of time in the ultrasound room helping explain findings to patients, but I was a bit more… obsessive… over my own ultrasound pictures. When you know everything that could go wrong, it’s hard not to imagine it could happen to you. I kept having dreams that I was having quintuplets with different genetic conditions, so I wanted to see for myself that everything was “within normal limits.” Everything was, and I had a healthy baby boy.

Anxiety sets in

My next pregnancy involved even more anxiety. My daughter’s long bones (arms and legs) were a little shorter than they should be, and her head was a little bigger. I called my co-worker one night when I could not stop thinking about it. She told me, “Would you worry a patient about these measurements?” I had to admit I would not. But not worrying is much easier said than done! (She’s perfectly fine, by the way. But is still short with a big head).

Being pregnant in front of patients 

I always tried to hide the fact I was pregnant from our patients as long as I could since I sometimes had to give them difficult news. When I was going through my miscarriage, I had to see happy pregnant women, and it was not a good feeling. I would never want to add more emotions to what a patient is feeling by parading in front of them with a presumably healthy pregnancy. 

The one time I intentionally shared my pregnancy with someone was when the doctor wanted to use me as an example for a patient. The woman had been pressured to gain more weight by her family since she wasn’t showing very much, even though her baby was growing just fine. The doctor pulled me in the room because we were about the same size and had almost the same due date.  The doctor told her my baby was fine, too. After we talked for a little while, she started to believe us when we said she was on the right track. Self-disclosure on my part turned out to be helpful for her, but that’s not always the case. 

All in all, being a patient has made me a better counselor. I don’t assume to know what every woman is feeling because I’ve been pregnant myself, but I do have a greater sensitivity to what they could be going through.  Of course you don’t have to be pregnant (or have a pregnant partner) to know that a pregnancy can provoke emotions like excitement, anxiety, and fear. But actually feeling those emotions myself has made them more tangible for me. Pregnancy is a rollercoaster that I had watched other people ride many times, but riding it myself was a whole new experience.