Most pregnant women are understandably keen to avoid anything that could potentially harm them or their baby. Minimising risk factors and knowing what to avoid during pregnancy are some of the ways to reduce the likelihood of problems, but there is a limit to how much you can control.
Worldwide, 6% of babies are born with a serious birth defect of genetic or partially genetic origin. Congenital anomalies (also referred as birth defects) affect approximately 1 in 33 infants and result in approximately 3.2 million birth defect-related disabilities every year. This increases when mothers are exposed to factors that can cause birth defects to their developing baby. Many birth anomalies can be prevented and treated. An adequate intake of folic acid, iodine, vaccination, and adequate antenatal care are key.
Keeping informed and knowledgeable about what you can do is important. It may seem while you are pregnant that every horror story soon finds its ways to your ears. Filtering what you want to hear and what you’d rather not takes some energy and you’ll find it’s not always possible to block out what you’d like to.
It is common during pregnancy for mothers to worry about all the “what if’s” that can happen and how they would deal with them if they did. It makes good common sense to eliminate or at least reduce potentially hazardous influences in life generally, but especially during pregnancy.
A diet high in folic acid is important, especially in the first trimester. Low folic acid has been linked with babies having a higher incidence of neural tube defects, for example, spina bifida. The daily recommendation is that every pregnant woman should take 400μg of folic acid – even from before she is pregnant. Foods high in folic acid are green leafy vegetables (like spinach, broccoli and lettuce), fruit (such as bananas, melons and lemons) and meat (such as liver and kidney).
Some foods are considered too risky for pregnant women to eat. These foods will increase a pregnant woman’s chances of contracting an infection called Listeria – otherwise known as food poisoning. Listeria can lead to miscarriage, premature delivery or even stillbirth. It is a food-borne illness, which can be transferred in foods such as soft cheeses, pâtés, cold “deli” style meats, coleslaw, sushi, soft-serve ice-cream, unpasteurised milk, products made from unpasteurised milk, and ready-to-eat seafood dishes. Prevention is better than cure, so ensure that refrigerated foods are stored correctly (sealed properly) or kept cold enough (make sure your fridge is set at 40C), wash your hands before preparing food, rinse raw fruit and vegetables under running water before preparing, don’t use the same cutting board for your meat as for your raw produce, and wash your hands, knives and cutting boards afterwards. Also make sure you cook your meat thoroughly, and consume perishable and ready-to-eat foods as soon as possible.
Some fish are potentially risky to eat during pregnancy. High levels of mercury are found in some fish species and when a developing baby is exposed to high levels of mercury they can have problems with their nervous system. Stay away from those higher up in the food chain and that are predatory such as shark*, king mackerel, tilefish, marlin*, southern blue fin tuna, orange roughy* and swordfish*. Avoid raw, undercooked or contaminated seafood – so forget about your sushi craving.
* These types of fish are perilously low in numbers or are being caught using environmentally destructive methods – not eating them will do you both good.
The current recommendation regarding safe alcohol consumption in pregnancy is that there is no proven safe amount. The placenta does not completely filter out alcohol and a percentage still makes its way to the baby. If you had been drinking alcohol when you conceived try not to worry. The important issue is that you abstain for the remainder of your pregnancy.
If your doctor is aware of you being pregnant and they prescribed you medication, do not stop taking it. There is a risk to your own health (e.g. if you’re an epileptic or diabetic) if you stop suddenly, but if you are in any doubt double check with your doctor or pharmacist.
The general guidelines around medication use in pregnancy are:
Avoid taking anything unless you have to – i.e. it was prescribed to you by your doctor, who knows you are pregnant.
Do not self-medicate and assume something is safe just because it is labelled “natural”.
Some medications are safe to take during pregnancy, but others are not and their effects on your unborn child is unknown, so make sure whomever is prescribing or recommending a remedy/ drug to you KNOW you are pregnant – don’t just assume.
Consult your doctor or pharmacist if you are at all unsure.
If you do take a medication make sure you take the right dose, at the right time, and how it is recommended, i.e. on an empty stomach or otherwise.
There are associated risks with taking some herbal or natural therapies during pregnancy, particularly in the first trimester when the baby is forming. Again, check with your doctor or pharmacist regarding what has been proven to be safe and what is potentially toxic. Just because something is labelled as being “natural” is not a sign of quality control or safety. Be careful of herbal teas as well – rather check with your doctor before drinking them.
The current recommendation is for pregnant mothers to limit their caffeine intake. The safe limit for caffeine is considered to be 300 mg/day. An average cup size of drip-filtered coffee contains around 150-240 mg whereas instant coffee has 80-120 mg caffeine per 150 ml. Cola drinks need to be limited - a 375 ml cola drink contains 40-50 mg of caffeine. Stick to less than 1 litre a day, preferably unsweetened, and energy drinks to less than 1 can per day.
Lead, chemicals, X-rays, ionising radiation, nail polish fumes and air pollution can all pose a risk to pregnant women and their unborn babies. It is vital that you read the labels on all products and their precautionary warnings. If there is a chance you could be exposed to a potential hazard (hair dye or nail polish), ensure you are in a well-ventilated room and are wearing a protective mask and clothing. If your working environment is risky, let your employer know you are pregnant and see if you can arrange for an alternative working location.
Cigarettes contain nicotine and a host of other dangerous chemicals. Babies that are born to mothers who smoke are smaller than they would otherwise be. They are also at more risk of being born prematurely, dying from SIDS, developing asthma and other respiratory illnesses. Lactating mothers that smoke do not produce as much breast milk as they could and their babies can smell like cigarette smoke. Nicotine replacement therapies are not recommended during pregnancy so you will need to investigate other options.
Illicit or Recreational Drugs
Babies born to mothers who use recreational drugs are at increased risk of a range of complications. Miscarriage, placental abruption, stillbirth, prematurity, low birth-weight and addiction are common problems. If you are having trouble stopping your drug use, speak with your midwife or doctor.
It will be impossible to completely insulate yourself from the risk of illness when you are pregnant. Viruses and bacteria are not selective about whom they colonise; their primary focus is to look after their own interests and replicate in as many innocent people as they can. Just because you are pregnant does not mean you are exempt. Far from it. Pregnancy can mean a lowered immune response, which means you may be even more vulnerable than you usually are.
Become vigilant about hand-washing. Avoid inhaling when other people are coughing and sneezing, and if you happen to be unlucky enough to be in close vicinity with someone who is vomiting, hold your breath, at least temporarily. Many viruses are air-borne and hitch a ride on air particles, which are easily inhaled.
Two viral infections, which can potentially cause complications during pregnancy, are Rubella (German measles) and Chickenpox. Cytomegalovirus, Parvovirus (B-19), Toxoplasmosis and some STDs, such as Herpes Virus and Syphilis, are also dangerous. Speak to your doctor about proper vaccines to help keep you and your baby healthy.
Hot Baths, Mineral Spas, Saunas and Spas
In the early months of pregnancy, the foetus is very sensitive to their mother’s core body temperature. Any environment that causes this temperature to raise and stay high can potentially cause problems with foetal development. A normal temperature range for humans is around 36.1-37.3 °Celsius. Mothers in the early stages of pregnancy are advised to reduce their chances of contracting a fever-inducing illness. They are also advised to avoid remaining in an environment that elevates their temperature to above 39°C.
No need to take a trip to the pound with your beloved cat just yet, no matter what you’re told by other people. You will need to avoid your cat’s droppings though, so if it uses a litter tray, you’d be wise to ask your partner to empty it while you are pregnant. A parasitic disease called Toxoplasmosis can be transmitted in infected cat’s faeces and is easily transmitted to human hands and then the mouth.
If you need to dig in the garden, make sure you wear gloves and wash your hands well afterwards with soap and water. Likewise, it’s important to wash fruits and vegetables very carefully before eating them and to avoid foods you’re not sure about, such as garnish on food platters.
Threatening or violent relationships
The incidence of domestic violence within relationships is thought to be vastly under-reported. Pregnancy is a time when it can peak, especially when the baby has not been planned, when parents are young and unsupported, or there are additional stressors.
Unemployment, homelessness, drug and alcohol abuse can all make violence worse.
If you, your unborn baby or other children, or even your pets are at risk, you need to get help. Look in your yellow pages (or see below) for contact services in your area and speak with your midwife or doctor. Think about developing a safety plan and establishing a safety network of trusted people, who can help you if you need it. Contact your local SPCA for information on foster care for your animals.
The safest way for a pregnant mother to travel when in a car, bus, plane or any other vehicle is to be restrained by an approved seatbelt. Although it may feel uncomfortable, in the event of an accident, a correctly applied seatbelt could save your own, as well as your baby’s life.
For more information:
Personal Crisis Help services: http://www.southafrica.info/services/crisishelp.htm