What is the recommended approach for disclosing a baby's gender to a pregnant woman?

Disclosing Fetal Gender to Pregnant Women

When disclosing fetal gender to pregnant women, use the patient's preferred terminology, confirm their desire to know the information beforehand, ensure privacy during disclosure, and prioritize clear, empathetic communication over speed of delivery.

Pre-Disclosure Assessment

Before revealing fetal gender information, clinicians should:

• Confirm the patient's desire to know fetal gender, as approximately 81% of pregnant women wish to know the sex prior to delivery, though preferences vary 1
• Ask about preferred terminology (e.g., "baby" vs. "fetus"), as women show significant variation in their preferences for these terms, with education level influencing these preferences 2
• Use the patient's chosen name and pronouns throughout the interaction, particularly important for transgender and gender-diverse pregnant individuals who may experience gender dysphoria during pregnancy 3

Communication Approach

Information Quality Over Speed

Prioritize the quality and clarity of information delivery rather than rushing to provide results, as women consistently value information quality far more than promptness when receiving pregnancy-related news 2. This principle applies equally to routine gender disclosure and abnormal findings.

Environment and Privacy

• Ensure privacy during disclosure, as this is more important to pregnant women than some information quality variables or promptness 2
• Create a supportive, non-judgmental environment where patients feel comfortable expressing their reactions, whether positive, negative, or ambivalent 4

Empathetic Delivery

• Demonstrate empathy and respect during the disclosure, as information-provider behavior significantly impacts patient experience 2
• Use gender-inclusive language when appropriate, particularly for transgender and gender-diverse patients who may have varying degrees of comfort with gendered terminology 3

Special Considerations for Transgender and Gender-Diverse Patients

Language Sensitivity

• Confirm preferred language and terms before discussing pregnancy-related information, as individuals may have different degrees of dysphoria around gendered language and anatomical names 3
• Avoid assumptions about how the patient wishes to discuss their pregnancy or fetus based on their gender presentation 3

Trauma-Informed Approach

• Recognize that pregnancy can exacerbate gender dysphoria, anxiety, and depression in transgender and gender-diverse individuals 3
• Maintain confidentiality about the patient's transgender status, sharing this information only when necessary for safe care and with the patient's consent 3

Documentation

• Record the patient's preferred name, pronouns, and communication preferences in the medical record to prevent repeated uncomfortable conversations 3, 5
• Document whether the patient wished to know fetal gender and their reaction to the information for continuity of care 2

Common Pitfalls to Avoid

• Do not assume all patients want to know fetal gender before confirming their preference, as approximately 19% may prefer not to know 1
• Avoid rushing the disclosure in the interest of efficiency, as this undermines patient satisfaction 2
• Do not use legal names that differ from preferred names during clinical interactions, particularly for transgender patients 5, 6
• Never make assumptions about patient reactions based on fetal gender, as maternal intuition about gender is no better than chance (51% accuracy) and does not predict emotional response 7