Identity

Pregnancy Doesn't Have to Feel Like a Perpetual Guilt Trip

When I overhear a fellow preggo order decaf, I want to yell, “Even the straight, cis male doctors say it’s safe to drink five cups of coffee a day!”
Pregnancy Doesn't Have to Feel Like a Perpetual Guilt Trip
Collage by Cathryn Virginia | Photos via Getty Images
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A column about being a pregnant trans dad, and all the prejudices, healthcare challenges, personal dilemmas, and joys that come with making a family in 2021.

Anyone who has tried to conceive in a pre-planned way, or whose partner has, knows about the two-week wait. It’s the gulf of time between a) the act of insemination/embryo transfer/sex and b) the day a pregnancy test will give an accurate result. The two-week wait is a temporal blackhole of boredom, hope, and pessimism. I was in constant doubt over whether to act like I was pregnant “just to be safe,” or whether to relax and not stress about it, also “just to be safe.”

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Some people cope by taking a pregnancy test every day of those two weeks. This, at least, is doing something. Maybe they’ll see the faintest line days early, then watch the line darken each morning, their thrill emerging with it. Or, some test early and get no line. But because it is too early, they remind themselves it’s not “bad news,” and still feel better for doing something.

In the case of intrauterine insemination (IUI), which is what I did, people usually self-administer a “trigger shot” before the procedure; an injection of the hormone that triggers egg release. This is so the clinic can be confident of insemination timing; they have about a 12–48 hour window. 

What I forgot—until my pregnant nonbinary buddy reminded me—is that this trigger shot contains the same hormone that the body produces to give a positive pregnancy test result: hCG. So when I caved and took a test a few days before the end of my two-week wait in May, the very faint positive line might still have been the trigger shot in my system. As my friend explained this via DM, I let out a pained chuckle. Could this process be any more tortuous?

Thankfully—understatement of the year—each day, that positive line got darker. That doesn’t happen if it’s hCG from the trigger shot. It was happening because a cluster of cells was busy multiplying in the lining of my uterus. 

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At about four weeks pregnant, around 10 a.m. one morning, I felt the subtlest hint of nausea. This is early but, for me, normal. I felt nauseous throughout my first pregnancy and, strangely, this time it was reassuring. When you’ve been trying to conceive for over a year, and especially if that process involved a loss, any physical evidence of a pregnancy is reassuring. This can be true minute to minute, hour to hour. In those early weeks, if I felt sick in the morning, then fine, then sick again in the afternoon, I’d be reassured all over again. If it sounds emotionally draining: Bingo.

Once you’ve miscarried, the knowledge that everything can be fine one minute and irrevocably lost the next stays with you. It’s a physical memory, like if you’ve ever gone over the handlebars of your bike; just thinking about it makes it feel like it’s happening again. But this also lasts longer. Perhaps it’s more like having wooden pegs clamped to your skin, from one wrist, up one arm, across your shoulders and down the other arm. Everything is pulled slightly taught, keeping you on edge, making you move carefully. 

As the weeks pass and the statistical risk of miscarriage decreases, the pegs unclamp one by one. But you can’t shake the knowledge that a tiny risk remains until the day your baby is safely delivered. Because you’ve felt that bottom drop out before. There’s always one peg pinching your skin uncomfortably tight.

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At around 10 weeks, I started having to remind myself that nausea is “a good sign”. At this point, it became all-encompassing, like being on a pitching sailboat morning, noon, and night.

I always reassured myself that if I had pregnancy nausea a second time, I’d turn to modern medicine without hesitation or delay. In my first pregnancy, I’d been nervous in a different, lighter way; nervous of any “risk,” e.g. taking any medication whatsoever, even if my logical brain knew they weren’t really risks at all. 

This time around, I understand more about pregnancy on an intuitive level. I know what “risk” means when it comes to things like anti-sickness medications that have been used by millions of pregnant people without incident for decades. In fact, I now see the lay conversation around “risk” in pregnancy relating to certain medicines or forbidden foods as essentially an elaborate guilt trip—one, of course, that is overwhelmingly laid on women.

The scientific reason very little empirical data exists on what is and isn’t “safe” for the parent and fetus during pregnancy is that such experimentation, with potential exposure to harm baked in, would be unethical. I know that’s officially why doctors and midwives heavily couch all pregnancy-related health advice and cannot tell you straight whether it’s safe to eat that ripe sliver of jamón. 

I get it, and yet, it feels like we swing too far the other way. Our collective response to uncertainty needn’t be to socially mandate absolute, blanket self-denial and “personal responsibility” of those who are pregnant. We need not behave as if these fellow humans lack capacity to do their own risk/benefit analyses. Such analyses are necessarily personal and can be based on multiple factors, including individual experience and need, decades of general medical and scientific understanding (even in the absence of empirical study), and, yes, a pinch of common sense. 

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As things stand, we tell ourselves and each other that abstinence from coffee, sushi, nausea relief, and other things for which the associated risks are minuscule, theoretical or even disproven is really no burden at all. Rather, it’s all part of some fabled “fun and japes” of pregnancy, something a “good” mother, or sometimes father or parent, accepts with a sweet sigh and no self-interested wish to make an informed decision of their own.

My guilty secret is that whenever I overhear a fellow preggo order decaf coffee, I want to yell at the poor thing, “Even the straight, cis, male doctors say it’s safe to drink up to five—FIVE!—cups of coffee a day while pregnant! Stop denying yourself this fleeting pleasure for no reason! Caffeine does not make you a bad person!!!” Then I want to scream at the barista and any one else present, “And if you dare second-guess or raise an eyebrow at this aching, exhausted individual, I will personally kick you in the shins!”

Between 12 and 16 weeks, when every pregnancy fact sheet under the sun is telling me I’m about to feel better and develop the “pregnancy glow” (eye roll), I was feeling worse than ever. Add to that: I was actually throwing up, which had never happened the first time. 

I’d tried two anti-nausea meds, and neither properly helped. One enabled me to peel myself off the sofa for a few hours on a good day, but I’d still be barfing by bedtime. As I was resigning myself to nine solid months of nausea, another pregnant friend pointed out that my evening symptoms sounded more to her like acid reflux. 

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I immediately asked my doctor for the meds she recommended, something stronger than antacids, which were as good as matchsticks at holding back the lava flow in my abdomen. However, my usual GP was on leave, and her stand-in wanted me to try something different. Reader, he suggested I pop down to my local construction yard, buy some bricks and prop up the head of my bed. I appreciate that this trick works for milder cases of heartburn but—and I’m not a violent person—at that moment I could only imagine one use for such a brick. 

Rather than act out a revenge fantasy, I ignored this don’t-experience-pregnancy-so-won’t-take-it-seriously joker and went to a walk-in clinic to get what I needed. This medication made life livable again, and I can stay on it throughout my pregnancy. I’m now well into my second trimester. There’s still a background hum of nausea at all times, but I’m able to work and be an attentive dad. 

I still have to eat every two to three hours so the hum doesn’t get louder. Eating little, but often is a well-known strategy in the fight against pregnancy sickness. That is, if you’ve been through it. If not, you’re probably unaware—such is the socially-shrouded nature of the harsh realities of pregnancy, even today. 

Take it from me: If someone you know is pregnant and eating more often than usual, resist the urge to comment that “eating for two” is a myth. First, they know, and second, they’re probably just desperate to not feel nauseous for 10 minutes.

And while I have you, person who’s never been pregnant, this phrase “morning sickness”? It needs to die. It’s another cutesy fable, and a patronizing one at that. Pregnancy sickness can be debilitating. I hardly know anyone who only felt it in the morning. That might be when it's the worst and, like me, you need to eat half a banana before so much as lifting your head off the pillow. But if it’s that bad, it’s probably with you all the time. 

Which brings me to my last reason you should never judge someone with a bump ordering coffee. Chances are, they almost didn’t get out of bed this morning. Maybe they’re still silently questioning whether they should have left the house. Just be grateful they don’t throw up on you.