Like so many other things, if it's not to your taste, just throw it out. It's possible that my card with pictures of my dogs will horrify and upset people who are afraid of dogs. Maybe your picture of your (born) children will upset someone trying to conceive or who just lost a child. Your holiday letter about the good things in your life might upset someone who's just suffered a death in the family, lost their job, or had their house foreclosed on. It's impossible to send anything that doesn't have the potential of upsetting somebody. I think expecting someone to call up everyone on their Christmas card list to ask, "Hey, are you okay with pictures of ultrasounds/babies/dogs for my card this year?" I think the onus is on the person receiving it to quietly dispose of whatever they don't care for.