In the age of social media, photos of soon-to-be moms are the new normal and ultrasound images are frequently posted to share the good news. But what should a provider do if they notice an abnormality in the scan shared with friends and family across the internet?

That situation happened when Joanna Gaines, co-host of HGTV’s “Fixer Upper,” shared an ultrasound image on her Instagram account. Amid all the comments of congratulations, a physician commented that the image looked to show the baby might have hydrops fetalis, a potentially fatal condition, reports STAT.

Authors and physicians Casey Humbyrd, MD, orthopedic surgeon and medical ethicist at Johns Hopkins University, and Kavita Shah Arora, MD, an OB-GYN and medical ethicist at Case Western Reserve University, examined if doctors are obliged to say something and what manner they should do so if they are obligated to.

They find it comes down to who initiates the patient-physician relationship. In the case of Gaines, the physician commented on her post, initiating the relationship and thereby placing the responsibility of providing the best possible care under the circumstances on that physician. However, privacy in this situation was an issue.

“Gaines, or any woman for that matter, has the right to publicize her pregnancy and medical information on social media if she chooses. But that doesn’t change physicians’ professional responsibility to her as a patient—even if she isn’t their patient yet,” Humbyrd and Arora wrote in STAT.