Wound care exposing a pregnancy.

[dreadlordmrson]

Would hospital care after minor dog attack injuries expose a first trimester pregnancy?

Details:
I have a story I'm currently working on set in a modern type world, and a plot point where one of the two main characters is attacked by a pack of street dogs and gets some minor scratch and bite injuries. I'm thinking just a few stitches at most. I can guess they'll need "just in case" antibiotics and rabies shots because of the bites, but would common care involve any tests that would expose an early pregnancy?

Goals:
I'm trying to keep the pregnancy a surprise for the other main character later in the story, so a "some hospitals would do these tests but some wouldn't" could be ruled that this time it wasn't done. But if it's very common to do certain blood or other tests that would easily reveal a pregnancy, that's a problem. And having the other main character who's acting as their savior/caregiver in this scenario decide not to get them treatment wouldn't be in character or suit his arc in the story, even with minor wounds that in theory could be treated at home.

Do I need to change details of the attack, or depict this medical team as negligent? Or is the stealth of this pregnancy safe?

Comments

[winterbird]

There's a chance, tbh, because a very common question before certain antibiotics and vaccines (and they might want to do a tetanus as well) is "is there any possibility you could be pregnant?" - If the answer is yes, or 'maybe,' that's probably when they'll do a urine or blood test or something similar to double check.

This would rely on the character a) knowing there is a chance and b) that question happening where the other main character isn't around them. Some hospitals, especially post-Covid, don't let companions come through into the actual treatment area, so it might just be that your main character has to wait in the waiting room while your pregnant character gets treated. The last two times I've been in an ER, no one's partner/s or family member/s came through into treatment areas with the exception of parents of very young children, and no one contested that either. So you definitely have a plausible reason to separate them during active treatment.

On the other hand, if both of your characters need the same treatment, I find it difficult to see a way to get them both separated so that your other main character won't hear 'is there any chance you might be pregnant?' Like, these questions are not subtle and they're said in front of everyone (including other patients etc.) in a busy critical care / treatment / rapid response area. This kind of response in a hospital is not a 'you get a private room for treatment' scenario. It's a 'get these meds into you ASAP / get some bloods / get the hell out and come back if you have these symptoms' scenario.

If your main character has any experience with medical stuff, it might be that they just know the question 'could you be pregnant' is coming and pull a staff member aside to tell them while thinking there's very little chance that they actually are - again, they'd have to know / connect the dots between sex + pregnancy, but 'is there any *chance* you could be pregnant' literally just means 'have you had sex recently.' So if they have, they should answer 'yes,' because I'm assuming this isn't an immaculate conception scenario.

There are SO many meds that you will not give someone if they *might* be pregnant, and plenty of antibiotics fit into this category. Especially broad spectrum antibiotics that you might give after a dog attack, like Gentamicin. It's not even about the tests, necessarily, the character is just going to be asked - likely more than once - if there's a chance they could be pregnant. I cannot imagine any scenario where a medical team would be so negligent as to not ask this question, especially as more than one staff member often asks it (it's whoever has the meds at the time).

(I'm not a medical expert but I have been in hospitals/emergency rooms many, many times and have spent thousands of hours dealing with medical stuff and researching medical stuff and I cannot tell you how many times I've had to answer the question 'is there any chance you might be pregnant?' before meds + scans)

Imho the best way to have the other MC not hear about it is probably:

a) other MC goes 'no no you need the treatment more than me you go first I can wait' (and their dog attack is far less severe and/or has no broken skin' - so pregnant MC IS separated from other MC through the "saviour/caregiver" act of 'you need this more than me.'

b) other MC is told that they can't go in with pregnant MC due to limited beds/space (this is less likely / plausible if they come in together with exactly the same issues because it's easy to just get two batches of similar/identical treatment for people who came in together which means you might need to address the severity of other MC's attack)

c) other MC is just separated enough in the treatment area from pregnant MC and the place is noisy enough that they just literally don't hear repeated 'is there any chance you might be pregnant?' - honestly if the rapid response or critical care section is noisy and busy enough, they'd only need to be about 5 beds away from each other to make this possible.

[dreadlordmrson]

Thank you for your reply.

God it really sounds like I've doomed myself trying to have both these plot points at the same time.

Okay, breaking down details I left out because I kind of was looking for my worst case scenario/didn't know what was relevant.
A. Both characters have been VERY sexually active for months. And the pregnancy would be around 2 ish months along (I'm still working the exact timing). They weren't thinking about pregnancy before, but once asked would be super aware that it was possible.
B. The rescuer isn't injured at all, he scared the dogs away by showing up and being loud.
C. The injured character is a cat person in a world where that makes them legally pets, so they would have much less autonomy to be seen independently from their human. And even if they were seen alone, it still exposes the pregnancy to the pregnant character and the audience, which is also more than I wanted. And them hiding it on purpose doesn't suit my characters or story direction.

Expanding on the original dog scene plans:
The dogs would have stolen an important bag from the character and they chased the dogs to get it back, got cornered in an alley, and suffered some scratches and small nips while fishing the important item from the bag out from under a dumpster.
I think I either have to figure out a way the dogs would still be a terrifying force that leaves them scared of dogs without any bites or major wounds, or switch to say, being robbed/mugged by humans and drop the dog phobia thread from the plot entirely.

Thanks again! You've given me a lot of helpful information about the obstacles I set myself. Even if it hurts to realize I've put myself in a situation where I can't have both plot points the way I want them.

[winterbird]

Tbh if you're doing a world where say, the cat person is a pet (is the world also a dystopia? Because that then makes this pretty easy - except I thought you wanted rescuer main character to not know, and not both characters to not know - in which case I am a bit confused) then there's no reason all medical care questions won't go through rescuer/other character.

But I'm now just confused as to who's not meant to know they're pregnant because it sounds like not just the rescuer but *also* the pregnant person both aren't meant to know? In which case, why would anyone find out at this point in time?

[dreadlordmrson]

Sorry, I did set that up for confusion didn't I?
It's meant to be a surprise to both of them, because the human character wasn't thinking about it (he's oblivious sometimes) and the cat character wasn't even aware that's a possibility.
Totally my fault for not being clearer about my goals on the pregnancy reveal.

The idea is that... *goes to look at his timeline* The pregnancy happens on Christmas and it's not discovered until summer. The attack was meant to be in early spring. I wanted to have the character go through several other plot beats including starting therapy before the pregnancy entered the picture.

I didn't want anyone to find out. I just suddenly realized that they might find out completely by accident because of my planned dog attack plot point. I was trying to see if I could still get away with the attack as planned or had to scrap or at least change it to keep the pregnancy surprise intact.
Me, about an hour before deciding to write the post: "Wait, damn, if Kuro gets hurt worse than 'bandaid and kisses', Ren would get them professional treatment, and I don't know if that would bring a reveal too early."
I thought about asking Reddit first, but then remembered this community, and y'all are so much less anxiety inducing.

As for the dystopia... If I sit down and be honest... it was originally meant to be a petplay kinkfic. But it grew a plot on me and now I'm more worried about character arcs and making sure major character moments are telegraphed the way I want them to be. The dystopian implications of the setting are a constant sword of damocles over my head. I'm trying to ignore them and write my happy ending story about love and overcoming trauma. Like, I'd say 50% of my conversations I have with a friend about this setting/story include at least one moment of "I'm fighting so hard to not get into how messed up this world would be if it was real."
I'm going to need to very carefully write the content warnings when anything progresses to a postable point.

[winterbird]

Fwiw, as someone writing dystopian omegaverse currently, happy endings happen in dystopias all the time. You only need to look at our *current* world to see that. A dystopia =/= you not being able to find these characters their happy ending, their contentment and comfort. They just find it within the context of that world, and plenty of people ignore that they're in a dystopia and don't even know that they're in one all the time *gestures wildly at the world right now.*

So as much as that seems an issue now, as long as you're solid on your content warnings (people owning other people as legal pets is always going to be a dystopia even if it's done in the best possible way tbh), there's no reason you can't focus on the things you want to focus on without focusing on the huge downsides. People write contemporary romance etc. all the time without pointing out the dystopian nature of the societies we live in (or without realising they are, say, when they write a love story that has a medical throughline where they're worried about how they're going to afford they're medical care - that's an encounter with a dystopian universe! But we suspend our disbelief more to focus on the romance rather than 'oh shit, politically that really sucks.')

Ymmv of course! But I think you'll be just fine on that front. I find for myself and for my readers, people actually like happy endings happening in dystopias right now (even if the dystopia part is largely in the background and ignored), because well, it's...relatable, and it resonates. We need to know there can be hope and love and care and happiness in hard and unfair worlds, because we're living in one.

So no matter what you decide re: the pregnancy plot (thank you for explaining this!) I think the 'people own hybrids as pets' part will definitely work out.

As to the pregnancy reveal, is it just cat people who exist? Or many types of animal people? Because if that's the case, it might be that you can fold into your worldbuilding that there might be hybrid/cat-people hospitals that specialise in cat-people, but maybe your MC can only find a hospital for humans, and takes them there, and gets the whole 'if anything gets worse make sure you chase this up in a specialist clinic' but...nothing gets worse, and so they just don't?

Idk how much you've thought about medical care in this world (it sounds like a lot so please ignore this!), but we can't take our dogs/cats to the hospital, and hybrids feasibly might not be cared for in every hospital in your universe. Or there might be specialist centres, but where... in the case of an emergency, they'll do what they can for hybrids? Something like 'ah normally I'd go here but they're not open / don't do emergency / are telling me to contact this hospital' etc.

It might be a way to also gloss past questions that are / aren't asked. Or tests that are / aren't done. It could also be a situation where your MC does good medical care in the field and that prevents needing stitches etc. (like if they have butterfly bandages etc. in a First Aid Kit) and flushes the wounds first and so on.

But yeah if you really like this storyline and it does sound like a good, whumpy storyline, rather than killing the storyline you love, you could alter the medical system around the storyline instead? Might actually be easier, especially when it comes to answering 'well why didn't the doctors do X or Y' with 'well they don't specialise in animal hybrids / that's not how medicine works in this world / animal hybrids don't always get consistent care in every health facility.'

Maybe? fdslakjfdsa

[dreadlordmrson]

"We need to know there can be hope and love and care and happiness in hard and unfair worlds, because we're living in one."

God yes. I love exploring this in other stories, both reading and writing.
It wasn't where I wanted to go with this one, but the message of being able to find what happiness you can even in a messed up system is so important and sometimes incredibly uplifting.
I keep the goblin zeppelin "different stories resonate with different people" comic on tap to express exactly that sentiment.

Oh man. Oh man your questions are activating my worldbuilding brain and let me tell you, I'm a worldbuilding lover and more than half my energy writing this story has been on restraining my worldbuilding impulses to keep certain elements of this world shallow and focus on the important story beats. I have so many old chewed-on AUs scattered around where all my fun was in building the setting and I never ended up making a proper story for them. I'm trying desperately to do this one the other way around.
(This is not saying don't ask. I need you to know that you asking about this is lighting an excited fire in my eyes.)

So, on animal people in this setting.
Cats were a given because I started with Kuro as a cat person. This story was inspired by a fanfic I was reading where someone made a character into a catboy and was having him undergo dehumanizing abuse and I went "okay but what if it was sexy and NOT those characters". And -- this is relevant -- I took the fandom character and started to turn him female and then my brain went "no, trans boy".
So later I'm picturing the dog attack. It was a very early development so I got emotionally attached to it and have been grappling with it fitting in the story for... two months now? Ish? And I'm picturing non-people dogs. No anthropomorphization at all.
And then I'm talking to my friend all "I kind of like the idea of adding dog girls to the world but I need these animal dogs" and they joke that all the pet animals in the world should be sexually dimorphic with male animal-animals and female animal-people.
Which runs smack first into the issue that my catboy is trans. And I'd have to either have his transgender issues run into trans species (gendering as human male) or a whole new kind of dysphoria that I didn't want to do (fem anthro to masc zoomorph). So I went "okay, DOGS are dimorphic, but all cats are humanoid".

And then later I make a joke about sheep and cows so yeah those are animal people too... but they aren't relevant to the story and would be entirely out of camera, so that's just lore.

"Do animal people get human medical care, or veterinary care?" was a pretty important question I asked early on, though it was more about the insurance. I was trying to determine how much of a financial sacrifice Ren was making to take proper care of Kuro. I ended up with animal-people being treated as animals medically both for keeping Kuro that much less human, and for the meaningfulness of Ren freely and without hesitation sacrificing his finances to make sure Kuro is cared for.
I maybe didn't make the best choice when I intentionally didn't bring up the veterinary possibilities for this question. I thought "I should know specifically about human hospitals because what they do would be my worst-case (from a plot angle) scenario for how Kuro would get treated."

You're right that I could argue that because of the veterinary angle plus this being an alternate world, I could twist things to allow me to keep both plot events. But I think, now that I've chewed this over and gotten the answers from people here... it really will be better for the story if I use a human attack. Both to remove medical treatment from the plot beat, and because it ties back into other elements of the story better.

Thank you so, so much for this chat. If you want to ask any more questions/talk more, we should probably move to my blog or private messages. Both to not clutter this one, and also because there's some relevant details I have very cautiously been talking around because they're distressing/triggering.

--
Aside, some worldbuilding that slipped past my attempts to restrain myself:
Wait if cat people are like anime catgirls/boys then they could easily disguise as humans. That must be a common trope ALL OVER this world's media. And it would be done very differently depending on the genre. A horror movie having a killer than turns out to be an animal in disguise. A comedy where the animal has to pretend to be their injured/missing owner and fumble their way through doing a human job ala Chicken Boo. Etc.

[independence1776]

As a woman of child-bearing age, I literally can't get ER-level medical care without peeing into a cup at some point in the process. (As an ambulatory patient without life-threatening issues, that is.) However, what are the patient privacy laws like in your setting? Because HIPAA laws in the US are all about who gets access and who doesn't. If your pregnant character doesn't give consent for the other character to find out, they can't be told. The basic HIPAA page about this.

[dreadlordmrson]

"As a woman of child-bearing age, I literally can't get ER-level medical care without peeing into a cup at some point in the process."

God, I'd forgotten about that, because I'm a trans guy and have been so visibly masc for a long time. I think I've only been to the ER once since I was old enough to start being asked that. Not many people are going to look at my big scruffy beard and go "that one needs to be asked about pregnancy". Thanks for the reminder.

[magid]

^ This!!!

Actually, even *after* child-bearing age, I still had to pee in the cup, just in case, for a non-zero number of years. Not one time did a medical professional believe my no, nor did they ask further questions about my no (different reasons might have different implications, or make me sound like an actual human adult, I dunno).

eta: In fact, the last time I was in the ER, it was possibly for $SevereKidneyThing, so when they asked me to pee in a cup, I thought they wanted a sample for that. Nope, it was the unauthorized pregnancy test; they had me give a second sample when I had to return to the ER less than 12 hours later, having not dealt with the issue the first time. Gah!

[dreadlordmrson]

"Not one time did a medical professional believe my no, nor did they ask further questions about my no (different reasons might have different implications,"
"having not dealt with the issue the first time."

I'm so so sorry. Every time I hear about situations like that it gets me angry.
A medical professional should care WHY, because of the implications it could have on your health.
It's absolutely maddening that so much of women's/uterused health gets reduced down to pregnancy viability.

[lilysea]

This varies enormously by country

women in the US are FAR more likely to be asked if they are pregnant in the Emergency Department (or given a pregnancy test without prior consent)

than women in Australia are.

As an Australian woman, I've NEVER been asked if I was pregnant in an emergency department, even when I was in my teens/20s/30s/40s.

The only time I have ever been asked re pregnancy was when I was getting an xray of my neck (not at the emergency dept, at a regular xray clinic) and I asked for a lead apron for my abdomen and the tech said "why, are you pregnant?" and when I said no, I just wanna limit my radiation exposure as much as possible, the technician was really grumpy and reluctant to give me the lead apron.

[dreadlordmrson]

"the technician was really grumpy and reluctant to give me the lead apron."
God that's so annoying, I'm sorry. It's perfectly reasonable to want to reduce your exposure, and it's not hard to let you use an apron that's there for that purpose already.

I really should be thinking about the differences between countries, since the setting is a jumbled mashup of American and Japanese culture.

Thanks for your reply.

[lilacsigil]

I have been to emergency care in Japan, as a cis woman in my 20s, and I was asked once, said no, and they didn't make me do a test. In Australia, I've never been asked unless I was having treatment where it was relevant (X-Ray, radiation therapy, some medications), and in those cases even though I said no, they required a test.

The antibiotics most commonly used for a dog bite would not require them to ask.

[dreadlordmrson]

Thanks for the extra information on a Japanese care situation!

[winterbird]

Depending on when you were in your 20s, really effective broad-spectrum antibiotics like Gentamicin may not have been in broad use in Japan yet because antibiotic resistance wasn't as much of a problem as it is now, so the need for so many broad-spectrum antibiotics hadn't yet applied pressure onto hospitals to have easy reach for good ones, but they absolutely are now (just double checked, Gentamicin went into broad ER use in Japan around the 2010's). It might be better to indicate the years in which you were being treated, because unless you were in your 20s in the 2010's/2020's - you might not be up-to-date on the antibiotics they prefer now and the questions they're asking as a result of those antibiotics.

(Gentamicin is a VERY good first-line broad-spectrum antibiotic except when someone is pregnant).

You might find in a modern setting, things have changed a lot. But I'm not sure when you were in your 20s!

[lilacsigil]

Good point! I was there before 2010. But where I live now, gentamicin isn't a first-line antibiotic unless the eye or brain is involved (because of the ototoxicity risk).

[winterbird]

Ah I'm in Australia, it's currently the first-line choice for all sepsis possibilities across multiple tertiary hospitals in Western Australia (from someone treated for sepsis in the ER er...four weeks ago). My eyes/brain were not directly involved. (And I was taken off the Gentamicin once they cultured the bacteria and could target it directly, but Sepsis Protocol is to slam the bacteria with a broad spectrum as soon as possible regardless of risks, because a deaf / blind patient is better than a dead one).

[lilacsigil]

Also in Australia, though not WA, and gentamicin is absolutely first-line choice for possible sepsis, but not protocol for a standard animal bite unless there's other serious factors involved (e.g. I know someone diabetic who was given gentamicin for a persistent cellulitis infection in their leg, because their healing was poor and they lived in a rural area where they might not receive treatment swiftly enough if it progressed.)

[winterbird]

Yeah as an AFAB Australian person I have been aggressively asked this at *least* 3-6 times in the ER in the last 12 months multiple times specifically because of needing broad-spectrum antibiotics (and very specifically Gentamicin).

When was the last time you needed to be treated with broad-spectrum antibiotics in a hospital?

[lilacsigil]

DA In my case, 2024 and I wasn't asked, though I also wasn't given gentamicin.

[pallas_rose]

Hi hi, trauma surgeon here. The antibiotics they would get for a dog bite are safe in pregnancy, so that wouldn't necessarily trigger a test. If in the US or Europe, you likely would NOT get rabies vax unless there's a real suspicion the dog is rabid. In developing nations w endemic rabies you would get it. BUT you would then get it even if pregnant! So not necessarily a trigger for a pregnancy test either.

Your best bet is radiologic imaging, specifically an XR or even better a CT scan. If you want to keep it an extremity bite, you might have it a puncture close to a hand or wrist bone, and they would be checking for a fracture there.

Happy to answer any follow-ups!

[lilacsigil]

+1 on the X-Ray! In my country they only usually ask if it's relevant, and I've been asked and made to do a test in both these circumstances.

It's also a great opportunity to separate the characters - the pregnant one goes off to X-Ray and the non-pregnant one has to wait in ER for someone to come do their stitches.

[dreadlordmrson]

Oh thank you, nice to have an expert chime in as well.

So the actual medical care itself wouldn't be the likely culprit for a reveal then, it sounds like.
But as everyone else says, the way a lot of USA hospitals will ask repeatedly about pregnancy "just in case" or out of habit, and that would put it into the characters' minds and they'd go check...

The rabies is really the easiest to wave away since this story is set in a world like ours (based on American and Japan), not actually ours, so I could have just said they don't have rabies as a major concern, if that had been the issue.

The dog attack had more been something I was emotionally attached to for the way it would let me whump the character and give them a "lowest point" in the middle of the story. Plus a few other personal appeal/story beat reasons, such as minor bloody injury and giving them a dog phobia to overcome. But I didn't want them to have any major lasting physical injuries. Keeping it to some blood and fear and lots of trauma.

It sounds from your post, that I could in theory get away with sneaking the pregnancy past. But from what others are saying, it would come across as unrealistic to especially American readers. I think I'll just have to kill my darling on this one and finally change the dog plot I've been fighting to keep in and replace it with something like a human mugging. It'll make me lose the later tension of the therapy dog plot vs the character's phobia, but it sounds like that's the better choice.
Thanks again for your time and answer.

[winterbird]

As a random tangent that's not connected to anything, Australia also doesn't have to worry about rabies (we have other viruses that are similar, but rabies isn't a concern here)

It'll make me lose the later tension of the therapy dog plot vs the character's phobia

I think you could still easily have tension here if say, during matching, the therapy dog wanted to take the person past things that made them phobic? (Alleyways, certain articles of clothing etc.) which could create its own tension where it's less 'fear of the dog' and more 'fear of what the dog is exposing them to re: triggers'?

[dreadlordmrson]

Thank you for the idea!

I was planning to have the therapy dog be at a set place my character goes to visit, but the idea of them going out together sometimes and my character getting anxiety because of going near triggering things is a promising idea.

[winterbird]

Tbh as with my previous reply, I still think you can have the dog storyline too! There's definitely options. A world with hybrids/cat people/nekos is a world where you can do so much with the medical side of things that grants you a lot of potential freedom to still have the dog attack storyline, so *fingers crossed*

[lilacsigil]

So, on the phobia point, my brother was attacked by a dog when he was 5 and I was 7. It was a small dog and he wasn't seriously hurt (though he was bitten on the face and there was a lot of blood) and that was more than enough for me to develop a dog phobia. So why not have the non-pregnant character bitten and the pregnant character pulling the dog away then staying with the bitten person while they get treated?

[dreadlordmrson]

Basically, the non-pregnant character is sick and in bed when the pregnant one leaves the house. They're going out shopping for medicine. Only after they've been gone a while does the guy get worried and go out looking for them, and discovers them under attack and saves them. It's meant to be a whole big moment of both "oh gosh he cares about me and came looking when I was gone too long" plus "oh no I made him come out in the cold looking for me when I was sick".

While I could have him being attacked by the dogs, he's only showing up after the dogs are already on the other character.
*squints at the story*
In theory I could have him show up all "oh there you are" and start to walk the pregnant character home then they're both attacked, but that means I can't have the big swoop in and be a savior moment...