Updated September 2019



Really? No lunch meat or sushi during pregnancy, and I can’t touch kitty litter?? There are TONS of rules about what you should – and shouldn’t – be doing during your pregnancy. Perhaps you've already been admonished by an annoying coworker (remember interacting with your coworkers?) for eating sushi, or received an unwanted lecture from some stranger from under their masks about the dangers lurking inside a turkey sandwich. The truth of the matter is that the majority of miscarriages, stillbirths, and birth defects occur for reasons that are totally outside of your control. This will either give you comfort or totally freak you out; hopefully it’s the former. As it turns out, many of the pregnancy police rules come not from actual data or studies, but from the “why-take-a-chance” philosophy that pervades American medicine, no matter how infinitesimal the actual risk. (Why not install a meteorite-guard on your house???…) First, a biology lesson. Mr. (or Ms.) Fetus For moms carrying your own egg, only half of your tiny peanut is identical to your own biology (the other half belonging to your inseminator — otherwise known as your husband, boyfriend, guy at the bar that night, or, actual sperm donor). Because of this dissimilarity, your little ball of baby cells would normally be rejected by your body’s own immune system (much like with a transplanted organ). Thankfully, our immune systems have evolved to know NOT to attack the developing fetus. Essentially, your whole immune system lets down its guard for the duration of your pregnancy. As a result, pregnant women are more vulnerable to nasty stuff. This helps explain why you’ll get every strain of cold under the moon during the 3rd trimester, even if you are normally quite healthy. So, which of the rules are justifiable and which aren’t? Let’s have a look. Listeria Hysteria Listeria is the big bad bacteria that you want to avoid during pregnancy, mainly because it can cross the placental barrier and infect the fetus, which can result in miscarriage or fetal death. True, pregnant women are about 20 times more likely to get listeria than non-pregnant women, but EVEN SO, it is EXTREMELY rare, infecting only about 1 in 8,000 pregnancies per year. For the sake of comparison, your lifetime chance of dying in a car accident is about 1 in 500. It should also be noted that most listeria infections in pregnancy occur in the 3rd trimester, when suppression of Th1-mediated immunity is at its maximum. The highest-risk foods for listeria are preserved fish (lox and stuff), cheese from unpasteurized milk, deli meats, pâté (pa-TAAAAAY), and undercooked hot dogs. Stuff like that. But here’s the thing — any food that’s been indicted for carrying a possible listeria contamination in the last 20+ years seems to automatically get added to the “no-no” list. Celery, turkey, carrots, cantaloupe, etc. This doesn’t make any sense. Just because last year, packaged spinach was the culprit doesn’t tell you anything about a possible contamination this season, because it’s totally unpredictable. Some even suggest that eating a food (a particular soft cheese, say) that was associated with a previous listeria outbreak is actually safer because it’s statistically unlikely it would be contaminated yet again (not to mention, safety regulations). Bottom line: With those kinds of odds, you should worry more about your driving than your turkey sandwich. Sushi During Pregnancy Most American OBs say, “No sushi for you!” However, if you look at the data, 85% of seafood illness comes from eating raw shellfish – that’s right, bivalve mollusks, namely, raw oysters and clams. If you remove those foods from the equation, the risk of falling ill from eating seafood is 1 in 2 million servings. [By comparison, the risk from eating chicken is 1 in 25,000.] So…can we agree that we won’t eat raw oysters and clams? I mean, really? Millions of Japanese women are not wrong (and yes, with some of the best public health officials in the world, they’ve looked into it). Furthermore, fish in sushi in the US is almost always flash frozen before it gets to the restaurant (maybe one day, we'll get to eat at restaurants again 😬), so any parasites or bacteria in the fish would have been killed during the process. Bottom line: No raw shellfish, but your salmon roll shouldn't be any more scary than your chicken sandwich.

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