Rei Dunn contacted us about her experiences trying to take a skeptical look at the process of getting pregnant. She had such a great set of stories to tell that we asked her to contribute a guest post! Rei is a clinical psychologist in California who specializes in sexual health and behavior, severe mental illness, and incarcerated populations. For fun, she reads, goes to the beach, exercises, and exasperates her spouse. Her baby is due in December.

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A world of woo opened before my eyes when I decided that I wanted to get pregnant. Being a science-minded lady woman, I take this choice very seriously, and wanted to do it with the best information and resources possible. Fifteen minutes on the Internet, however, slammed me with what I can only call the Pregnancy Industrial Complex (PIC)- a fear-mongering, pink-and-blue, stork-trimmed tidal wave of websites with confusing, conflicting information.

Don’t dye your hair. Tap water is a government conspiracy to kill fetuses and reduce global population. Don’t eat soft cheese or fish or you will DIE! Take vitamins, but don’t get hypervitaminosis! Don’t clean out the litter box – your cat is trying to KILL YOU (I already knew that).

Seriously? What does science say about healthy pregnancy? I am determined to wade through the hype to and find the best science available for incubating my fetus.

Hair Dye

Hair dye is commonly eschewed by the PIC based on the proposition that it’s absorbed through the skin and thereby causes fetal malformations. Studies as recent as 2005 show a small relationship between hair dye and neuroblastoma (cancerous tumors common in children under five). Studies of actual cosmetologists working 40 hours a week during their first trimester indicate that increased risk had many confounding factors, such as working in poorly ventilated salons and working in salons that also did nail services. Risk disappeared for women working fewer hours who did few chemical treatments. However, most studies show no correlation at all for hair dye and increased fetal malformation, low birth weight, or early onset of labor. Most general-information websites, like the American Pregnancy Association, suggest caution when applying hair dye, by following the directions carefully and rinsing it thoroughly, and waiting until after the first trimester if you want to play it super-safe.

Drinking Tap Water

Did you know that tap water (dramatic chord, cue thunder and lightning) is chlorinated? All conspiracy theories aside about chlorination being part of a government conspiracy for population control, chlorine does break down upon ingestion into trihalomethanes (THMs), one of which is chloroform. The University of Birmingham presents a study of 396,049 infants in Taiwan and found a correlation between some birth defects and water with high levels of THMs, which they say is 20 micrograms per liter. The EPA permits 80 parts per billion of THMs in tap water, indicating that well-regulated drinking water is just fine.

One alternative to tap water is bottled water, and despite bottled water companies touting that they are held to the same standards as tap water, many independent tests show this sometimes not to be the case. To be fair, independent tests often show tap water to be outside of the EPA’s parameters. Still, bottled water generally has just as much chlorine as tap water, maintaining the risk if the THMs are high. More, bottled water often doesn’t have fluoride, which can be helpful for pregnant women in preventing pregnancy-induced gingivitis, which can happen when your fetus re-directs the nutrition that keeps your gums and teeth healthy.

Another alternative is well water, though well water generally has far fewer regulations than tap water and can only be considered on a well-by-well basis for its safety.

For the bottom line, tap water that is well-regulated, and not stinky or discolored, is just fine.

Prenatal vitamins

I take prenatal vitamins. The first day I did, I was having a bear of a day at work and when I finally got a potty break, I sat down, closed my eyes to rest while I went pee… and when I opened my eyes again, the stall was visibly brighter. My pee was auto-fluorescing, making a glowing halo around my tookus. Maybe they should be called pee-natal vitamins…geeeet it?

In my pre-pregnancy exam, my ob-gyn and her intern recommended I take prenatal vitamins with folic acid, iron, and calcium, and most internet information sources substantiate this, and also recommend D, C, thiamine, riboflavin, niacin, vitamin E, zinc and iron. But are prenatal vitamins actually necessary? It depends. Even if you’re a vegetarian and planning your pregnancy, anyone who is good at calculating your nutrition with the food that you eat, and are able to manage your portions of leafy greens, fruit, and protein to meet the recommended intake, you probably don’t need to take vitamins. That person is not me, though. I have a wonky work environment and schedule, I am throwing up everything I eat due to “morning sickness,” and honestly, I’m just anxious, so I do the vitamins and day-glow pee.

The risks of poor nutrition are real. Folic acid prevents spina bfida, when the neural tube doesn’t close and causes paralysis and mental retardation. Calcium prevents pregnant women from losing their bone density and prevents dental problems from their fetus re-routing their nutrition when there’s not enough. You need enough iron to allow for your blood and your fetus’s blood to carry enough oxygen. Again, a well-planned diet will get you and your fetus enough of these things. Conversely, if you take too many vitamins, you can get “hypervitaminosis,” or vitamin toxicity, particularly in A, D, E and K. In mild forms, hypervitaminosis results in nausea – think if you’ve ever taken a vitamin on an empty stomach, you ralph it back up. Toxicity is severe, and includes dizziness, drowsiness, blurred or double vision, pain and swelling in your bones, and liver damage. Managing overdose includes being careful of extra things you’re eating in addition to your vitamins, like, if you eat several bowls of fortified cereal a day. Choosing to take vitamins really comes down to your personal dietary and planning skills, lifestyle, and managing good nutrition for your fetus.

Don’t eat….

Let’s start with fish. Everyone says “don’t eat fish,” and the issue with fish is that some kinds of mercury can cause birth defects in the nervous system of a fetus. A fish absorbs mercury through water, soil and atmosphere, and when you eat it, you absorb all of the mercury from that fish, which adds to whatever mercury you’re already harboring (this is called biomagnification). Avoiding fish high in mercury such as swordfish, mackerel, and tilefish, reduces this risk. Fishy options with less mercury are shrimp, crab, salmon, Pollock, catfish, cod and tilapia. Raw is a definite don’t, and smoked often isn’t thoroughly cooked to removed the possible presence of scary bacteria that can make you seriously sick- more on that next.

So cheese. I love cheese. The stinkier the better. I love cheese so much, I tell my partner “I love you more than cheese.” Hearing I couldn’t eat soft cheese while pregnant was devastating. The issue with cheese is pasteurization. Unpasteurized cheese has a risk of having listeria in it, bacteria that if you eat when you’re not pregnant, you’ll just get sick. If you contract listeria while pregnant, it is usually fatal to a fetus. Cheeses that are usually made from raw milk are brie, feta, Roquefort and gorgonzola, and queso blanco and panela. If you can find pasteurized versions, they would be safer. The FDA labels food made with pasteurized milk, so check the label.

Raw foods in general (and not just meat) require some caution due to risk of listeria, E. coli, and salmonella, which can cause premature birth, miscarriage, fever in the fetus, and meningitis in the fetus. Raw juice from the store or trendy juice bars require caution, and so do raw vegetables, particularly sprouts, clover, alfalfa, radishes, and mung beans. The bacteria from raw vegetables and fruits can give you diarrhea, but also your fetus can get diarrhea. Really. Fetal diarrhea. Diarrhea diarrhea diarrhea. How horrible is that?

Raw meat and deli meats are also happy homes for listeria. Undercooked or over-easy eggs, delicious hollandaise sauce, tiramisu, real Caesar salad dressing, all harbor salmonella risks. Cooking food thoroughly and using meat thermometers mitigate most of this risk.

Don’t Drink…

Avoiding booze may seem like a no-brainer, and the idea of giving up caffeine may seem impossible. The funny thing is, since becoming pregnant and declining alcohol at social gatherings, I’m surprised at the number of people who say “Oh, go on and have a sip!” I expected murderous glares from so much as looking at a glass of wine longingly. So. Most pregnancy information sites on the Internet will tell you that “no amount of alcohol is safe”; however, there is less risk in consuming small amounts of alcohol in the third trimester. Recent studies suggest that the risk from occasionally drinking small amounts of alcohol is low in late-term pregnancies. Should you drink? No. Are you going to forever regret a taste or sip in your later months? Probably not.

Caffeine is far more difficult to give up, because it’s everywhere- coffee, soda, chocolate, tea, and energy drinks. Also when you’re pregnant, you can be easily fatigued and caffeine is tempting. Caffeine is recommended by most sources to be limited to 200 mg a day, which is about twelve ounces of coffee. Sweet.

Don’t clean the litter box (or, Your cat is trying to kill you)

It’s probably true that your cat is trying to kill you. As for the litter box, when I heard that pregnant women shouldn’t change the litter box, I was stoked. The risk is from toxoplasmosis. Toxoplasmosis is a parasite that animals pick up from catching rodents outside. Indoor cats have a much lower risk, but still can get it from eating undercooked meat given to it as a treat. You can get toxoplasmosis independent of a cat, if you eat undercooked meat, or hunt rodents with your bare hands and teeth. Anyway. If cats ingest toxoplasmosis, the toxoplasmosis eggs come out in the cat’s poop and hatch after five days, making that when the risk to a pregnant person the highest. If your cat gets in the litter box and then scratches you, or you somehow you get cat poop in your mouth after hatching time (which is a whole other issue, because why are you touching your mouth when changing the litter box!? But anyway), it’s fatal to your fetus and will make you very, very sick.

The most important thing is that during pregnancy, the litter has to be changed LESS THAN EVERY FIVE DAYS to avoid this rare but lethal risk. My beau still insists on changing it for me, and I’m very appreciative. If you know a pregnant woman who lives alone and has a cat, changing their litter box would be a very nice thing to do to help out and keep her safe.

Sources:

It was hard to find sources that are consumers of research. The following sources are the ones I use, after fishing through a sea of woo:

www.MayoClinic.Com

www.americanpregnancy.org

www.otispregnancy.org/

www.cdc.gov/ncbddd/pregnancy_gateway/index.html

http://health.nih.gov/topic/Pregnancy