The news is out. You're pregnant! Everyone is delighted for you... and then come the warnings. From your doctor to your mother-in-law to your neighbor's grandma — everyone has their opinion on what you should and shouldn't be doing (and drinking and eating), and they're not afraid to tell you.
Pregnancy "rules" vary depending on where you live and are a relatively new phenomenon (my own mother, pregnant in the late '70s and early '80s, doesn't recall being given any "rules" beyond the very vague and entirely subjective "don't drink too much.")
Obviously, rules are there ostensibly to help keep pregnant people and their babies safe, but some rules are definitely more important than others. Ahead, we break the big ones down for you — and reveal how real-life moms deal with them during their own pregnancies.
The official line: Don't booze when you're pregnant. "No amount of alcohol is safe or recommended during pregnancy," says Sherry Ross, an OB-GYN and women's health expert at Providence Saint John’s Health Center in Santa Monica, California.
"Abstinence reigns as the prevailing wisdom because it is safe for everyone," explains Dr. Ian Tong, chief medical officer at Doctor On Demand. "But if your cultural norms dictate some alcohol consumption, you should consult a physician to receive individual guidance," he adds.
A 2015 report published in Pediatrics deemed alcohol consumption hazardous during all stages of pregnancy; however, the same report showed that 1 in 10 women still drink while pregnant. And in practice, not all doctors draw a hard line. One mom, Madeleine D., says, "My OB told me, 'Go ahead and have a glass of wine. My wife had an occasional drink with each of our kids. They're weird, but I'm pretty sure that's not why.'"
For our more on drinking during pregnancy, take a look here.
Unlike alcohol, you probably won't find a doctor who'll give even occasional cigarette use the greenlight during pregnancy. "Smoking during pregnancy is a known health problem to both the fetus and the newborn," says Ross. "Risks include low birth weight, preterm labor, abruption of the placenta (placenta detaches from the uterus), sudden infant death syndrome, an increase in childhood respiratory infections and possibly learning disabilities. Risks to the mother include preterm labor, premature breaking of the membranes (water breaks), small and unhealthy placenta, miscarriages and ectopic pregnancies." Besides, pregnancy — even health in general — is just one of a myriad of reasons to quit smoking. So why not get on that, stat?
While caffeine in large quantities has been linked to miscarriage during the first trimester and "excessive" daily consumption may decrease the baby’s birth weight, the results of research remain unclear — and most doctors agree you don't have to skip your daily coffee.
"Consuming less than 200 milligrams of caffeine a day [the equivalent of a 12-ounce cup of coffee] is considered a safe amount for a growing baby," says Ross. For moms-to-be who suffer from chronic headaches during pregnancy, doctors often recommend daily caffeine consumption. "My OB told me not to give up my morning fix," says Jessica R. "He said, 'By all means, have your coffee. More than six cups isn't recommended.'" Is that much really recommended for anyone, though?
The “rules” around herbal tea during pregnancy are murky at best. No U.S. regulation specifically addresses herbal tea, and the Food and Drug Administration doesn't regulate the safety and effectiveness of herbal products the way it does prescription drugs and even over-the-counter medicines. If clinical studies are the end-all, be-all for you, know that there's a dearth of research to confirm either the safety or risk of herbal teas during pregnancy. That said, there are probably a million moms who swear by peppermint or ginger tea as a remedy for morning sickness, so do with that information what you will. And you can always check out the American Pregnancy Association for information on what herbal teas you might want to avoid during pregnancy.
Certain seafood, like shark, grouper, swordfish, halibut, king mackerel and tilefish have high levels of mercury, which may cause fetal brain damage and developmental delays. To get your fish fix during pregnancy, it's best to stick to varieties thought to be low in mercury, such as shrimp, canned light tuna, scallops, oysters, squid and salmon. The American Congress of Obstetricians and Gynecologists says you can eat up to 12 ounces per week.
Oh, and if anyone tells you off for eating salmon nigiri during pregnancy, simply point them in the direction of the 127 million Japanese who consider eating raw fish to be a good neonatal nutrition practice. "I ate sushi all throughout my second pregnancy (my OB said it was OK) and my daughter is not only fine, but smarter than her brother — and I didn't enjoy anything good while pregnant with him," says Anna L.
Deli meat, unpasteurized soft cheeses such as feta, queso blanco, queso fresco, Camembert and brie, smoked foods and raw sprouts are all possible breeding grounds for the bacteria listeriosis, which can be fatal to a growing fetus — according to Karen Wright, a practitioner at Metro Integrative Pharmacy in New York City, which specializes in wellness and fertility. However, there is a workaround if you're craving a stack of cold cuts. "Listeria is destroyed at high heat," Wright explains. "Therefore, eating reheated deli meats or pasteurized soft cheeses would not be an issue."
Of course, every culture has its own take on what foods are best avoided during pregnancy. "I ate feta cheese," admits Nina M. "I'm Greek. My grandmother lived to be 102 and had five kids. You think she didn't eat any feta while she was pregnant? Ha."
This risk of eating undercooked meat, poultry and eggs during pregnancy is salmonella bacteria; however, this one affects the mother rather than the fetus. "Salmonella weakens the mother's immune system," explains Wright. "It does not cause [direct] harm [to the fetus] like listeria, but if the mother's immune system is weak, it could affect the development of the fetus." If you do get salmonella during pregnancy, the biggest risk is dehydration from vomiting and diarrhea, which can cause low amniotic fluid and birth defects. As soon as you can keep fluids down, a good measure is to sip water every 10 minutes, which gradually rehydrates your body, says Wright. To stay safe, make sure any eggs you eat are pasteurized and meat and poultry are cooked.
According to Ross, extremely hot temperatures can indeed be a problem during pregnancy. "Temperatures above 102 degrees F (38.9 degrees C), especially during the first six weeks of pregnancy, can cause defects to the baby’s brain and spinal cord and increase the chance of miscarriage," she says. "It’s best not to use a hot tub if you are trying to get pregnant or during the first trimester to make sure you are not putting the baby at risk for serious abnormalities — and the general rule is not to spend more than 10 minutes in a Jacuzzi that is set at 102 degrees beyond the first trimester."
That said, "Let's be clear about the difference between a Hot Tub and a hot tub,” says Dr. Katie Hicks, an OB-GYN in private practice in Massachusetts. “The first is the large shared 'spa' experience found in hotels, spas, and some rich people’s patios. Usually, these are maintained at about 108 degrees, and the hot water is constantly being replaced by more hot water," she explains, adding that "soaking in your own tub, as long as the temperature is moderate and not steaming, and you're not constantly refilling it with more hot water, is fine and soothing. In fact, we use this for pain relief in laboring mothers — the hospitals keep the water temperature below 104.”
Let's face it: As much sleep as possible during pregnancy is a very good thing. Sleep whenever you can, however you can. There should be no rules about this — but unfortunately, there is one. "In general, it’s best to sleep on your right or left side during pregnancy after 20 weeks," says Ross. "If you are sleeping on your back, the growing uterus puts added pressure on the vena cava, which is the large vessel that flows into the heart. If this vessel is compressed for long periods of time, it can cause decreased blood flow to the baby. Long term, this can cause stress to the baby, increase maternal blood pressure and cause you to feel dizzy."
The obvious problem is that — pregnant or not — it's pretty hard to control your body's natural impulses during sleep. "I don't plan to sleep on my back, but I wake up at least once a night and I'm on my back," says pregnant mom Lorraine D. But don't stress about unintentional back-sleeping; if you were in any danger, you'd feel nauseated and breathless long before your baby was deprived of oxygen. Just roll onto your side and try to fall back asleep.
Are you a terrible person if you just can't bear to go through your pregnancy with your roots as dark as night? Of course you're not. According to the American Pregnancy Association, research on the safety of hair bleach and dye during pregnancy is limited but suggests that the amount of dye that actually has the potential to reach the fetus is minimal. If you are worried, go for highlights, which won't apply any product directly on your scalp. Or leave any salon action until your second trimester, when your developing baby is less vulnerable.
Ultimately, like with everything else related to your health and safety during pregnancy, if you aren’t comfortable with bleaching your hair, then don’t bleach your hair. As for drinking an occasional glass of wine or a couple of cups of coffee, most doctors will tell you it’s probably safe. However, there will always be people willing to tell you — with loud voices or evil eyes — that you are putting your baby's life at risk with every sip, bath or plate of sushi. So do your research, and use your best judgment. Try not to stress (which may be even more dangerous to you and your baby than many of the above "rules"), and remember that not all risks are created equal.
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