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Prenatal Self-Care: Sorting Fact from Fiction

not to do—during pregnancy.

Three of the most important things? Eat a well-balanced diet, take prenatal vitamins, and get at least 30 minutes of moderate exercise most days of the week. Here are a few more specific guidelines to help safeguard your baby and you.

Fish. Fish is a great source of protein. It’s also low in saturated fat and high in omega-3 fatty acids. That makes it good for your cardiovascular health and for your baby’s fetal growth and development. But there’s just one problem: Some fish are also high in methylmercury, which has been thought to affect fetal and newborn motor and cognitive skills.^1,2

A recent study by the American Journal of Clinical Nutrition found that mercury may have fewer negative effects on babies than previously thought, however. Following 1,200 pregnant women who ate 12 fish meals a week on average, the researchers found that women’s higher levels of fatty acids may have protected their children against the effects of mercury: These children ended up performing better on a battery of tests of motor skills and other functions than those whose mothers ate less.³

Until more studies can confirm these findings, however, continue to follow the FDA’s guidelines: Eat no more than 12 ounces of fish weekly. Choose fish high in omega-3s but lower in mercury, such as:

• Salmon
• Shrimp
• Pollack
• Catfish
• Canned light tuna ^1,2

Avoid fish that is higher in the food chain and, therefore, tends to be higher in mercury, such as:

• Swordfish
• King mackerel
• Tilefish
• Whale
• Albacore tuna^1,2

As for raw or undercooked fish such as sushi, that’s another story. It’s best to avoid it altogether. It may not only contain high levels of mercury, it may also cause parasitic infections or be contaminated by bacteria.³

Cheese and processed meats. The FDA and U.S. Department of Agriculture advise pregnant women to avoid certain foods that can cause listeriosis, a serious bacterial infection that is linked with miscarriage and stillbirth. Pregnant women are more likely to develop the infection due to weaker immune systems.

Although cases of listeriosis are rare, take precautions. Avoid eating:

• Hot dogs, luncheon meats, or leftovers unless you reheat them by steaming
• Soft cheeses, such as feta, Brie, or Mexican queso fresco
• Refrigerated pâtés or meat spreads
• Smoked seafood
• Raw or unpasteurized milk
• Raw or undercooked meats ^1,4

Other precautions. Limit foods and drinks containing saccharin. This artificial sweetener crosses the placenta and may remain in fetal tissue. Avoid raw eggs—such as in eggnog or raw cookie dough—which increase the risk of salmonella contamination. To further reduce risks of contamination, carefully wash fruits and vegetables, as well as cutting boards or utensils that have made contact with uncooked meat.⁴

Supplements. Be sure to take your prenatal vitamins. When it comes to supplementation, though, more isn’t necessarily better. Takng extra omega-3 fatty acids has not been shown to be helpful. And, there’s no need for extra calcium or vitamin D, unless blood tests show you’re deficient.¹

Caffeine. If letting go of your morning cup of coffee is something you’re not too keen about, there’s good news. Much of the research that found caffeine to be harmful during pregnancy is either old or poorly designed—or the results were confounded by cigarette smoking. More recent, better-designed trials have found no link between a moderate intake of caffeine and gestational age or birth weight.¹ Limit your intake to 150 to 300 mg a day.⁴

Alcohol and cigarettes. The same cannot be said of alcohol and cigarettes. For pregnant women, there is no known safe level of either one. Based on community studies, experts estimate that as many as 2 to 5 percent of the U.S. schoolchildren may have fetal alcohol syndrome.⁵ Even less than one drink per day during pregnancy has been linked to a smaller head circumference, height, and weight in children after birth up to age 6.¹

In addition, smoking in pregnancy is linked to problems such as:

• Miscarriage
• Placental abruption, where the lining of the placenta separates from the uterus
• Ectopic pregnancy, where a fertilized egg implants outside the main cavity of the uterus
• Preterm delivery

After delivery, many women start smoking once again, but staying smoke free continues to be important for your child. It can help prevent problems linked to smoking such as sudden infant death syndrome (SIDS) and asthma.¹

Hot tubs. Soaking in water that is 100 degrees F or higher may harm your baby. It’s been linked with first-trimester loss of the fetus and nearly a doubling in risk of neural tube defects.¹

Exercise. Unless you have a medical or pregnancy complication, try to get at least 30 minutes of moderate exercise most days of the week. Exercise may reduce risks of:

• Gestational diabetes
• Preeclampsia, a complication of pregnancy leading to high blood pressure
• Premature labor
• Postpartum depression

Now is not the time, however, to start new rigorous types of activities. Also, avoid higher-risk activities such as:

• Scuba diving, which can cause decompression sickness in the fetus
• Contact sports
• Hot yoga

Toxic chemicals. The International Federation of Gynecology and Obstetrics (FIGO) is the first global health organization to come out strongly against exposure to toxic chemicals, which are damaging human reproduction and health.⁶

According to the FIGO opinion, miscarriage and stillbirth, impaired fetal growth, and congenital malformations are among the list of poor health outcomes linked to chemicals such as pesticides, air pollutants, plastics, and solvents. Although you do not have control over all these, you can at least take steps to limit exposures to plastics and chemicals found in hair and skin products. Talk to your doctor about what to avoid.

In the meantime, here are tips from the Silent Spring Institute website, recommended by the National Institute of Environmental Health Sciences: In Your Personal Care.

Sources

1. Ob.Gyn.News: “Initial prenatal care visit is myth-busting time.”
2. Ob.Gyn.News: “What the Data Show About Common Concerns in Pregnancy.”
3. ABC: “Sorry, Pregnant Women, New Study Is Not a Carte Blanche to Eat Sushi.”
4. Zolotor AJ and Carlough MC. “Update on Prenatal Care.” Am Fam Physician. 2014 Feb 1;89(3):199–208
5. CDC: “Prevalence of FASDs.”
6. UCSF: “International Ob-Gyn Group Urges Greater Efforts to Prevent Toxic Chemical Exposure.”

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