Pregnant, MD: What’s Safe in Pregnancy Myth vs Fact, Part 1

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Photo Credit: Fiona Margo Photography

Hey mamas and mamas-to-be! There is a lot of confusing and alarmist information out there on the interwebs about the safety of lots of things everything in pregnancy. We all want to be safe, but also to not be deprived of allofthethings for 9+ months. This post is a quickie guide to set the record straight on some of the most common questions we pregnancy providers get. This, like all my posts, are not ever meant to replace the personal guidance of your own health care provider – when in doubt, as them! I’m breaking this down on the following very non-scientific scale:

Myth – Mostly Myth – Kind of Fact – Mostly Fact- Fact

No Coffee – Myth

Our family lived in Portugal when I was in Kindergarten and first grade, so that was about the time I started drinking coffee. No joke. So, when I was learning about pregnancy, you better believe I looked up all the information on this topic! I can’t tell you how many people I have talked to – even other doctors – who are under the impression people have to stop drinking all caffeine the moment they conceive. That’s just cruel.

My actual face if you told me not to drink coffee while pregnant.

The truth is, The Cochrane Review looked at the research and the best studies have shown no difference in pregnancy outcomes with moderate caffeine intake. What’s “moderate caffeine intake”? About 200mg caffeine daily. That’s one tall Starbucks brewed coffee or an espresso drink with 2 shots. Strong black tea has about 50mg per cup and regular or diet soda (bad for other reasons….but) about 35mg. Energy drinks vary widely – if you want to look up your specific fave bev, check out Caffeine Informer.

No Hot Tubs – Mostly Fact

This one is legit. Studies have shown that raising your core body temperature can increase the risk of miscarriage in early pregnancy and other complications later on in pregnancy. This is true whether it’s a high fever from being sick or you are in a hot tub, sauna, hot yoga, or even hot bath or shower at home.

Does this mean you can’t take a quick hot shower ever? No! You can go in any of these warm environments for a little while. What’s a little while? As soon as you feel hot, break a sweat, or of course if you feel light headed at all, leave and cool off immediately. If you can’t trust yourself to make that judgement, avoid altogether.

No Hair Treatment – Mostly Myth

The old types of hair treatments for dying and perming had toxic chemical derivatives which were potentially dangerous, especially in first trimester of pregnancy.

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Definitely got my hair did before these pics.

Newer dyes should be free of these chemicals and are ok. Highlights that aren’t applied to your scalp are also fine – just stay in a well-ventilated area because your breathing can be more sensitive during pregnancy. Perms and straightening treatments again vary – ask your salon if they offer safe, natural alternatives to the older more harsh treatments. More info HERE on American Pregnancy’s Website.

No Nail Polish – Mostly Myth

You can get your nails did with no worries as long as the salon uses good hygiene practices. One of my favorite midwives from my training at UCSF, Judith Bishop, wrote a great summary HERE on this. Any kind of polish and even fake nails are ok. Beware though – the chemical smells might make your sensitive nose and stomach unhappy!

No Cheese – Mostly Myth

The key here is *pasteurized*. You can get Listeria, a dangerous bacterial infection that can cause miscarriage, from unpasteurized dairy products. Pasteurized cheeses that are within their expiration dates and have been properly stored are fine. Even soft cheeses. Most restaurants should be able to tell you if their cheese is “raw” or pasteurized – if they can’t skip it.

appetizer assorted bowl cheese

No Lunchmeat – Kind of Fact

This again is due to Listeria concern. You should avoid lunch meat unless it’s been heating to steaming in the microwave, stovetop or oven. Not sure how you feel about warm lunchmeat, but this preggo is NOT for it! Opt for grilled chicken, tuna salad (no more than 2 servings per week though) or other choice if you don’t like warm sliced meat.

 

No Fish – Kind of Fact

Speaking of tuna…. The main concern with seafood is about mercury. Check out and print yourself THIS PDF from American Pregnancy if you want a quick guide to which fish are “highest mercury” aka, avoid entirely or just “high mercury” aka have no more than 2 small servings weekly or lower and you can enjoy at will.

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Photo by Skitterphoto on Pexels.com

What about sushi?? So, cooked sushi is always ok as long as you are paying attention to mercury issues. Raw sushi *theoretically* should all be flash frozen based on USDA safety regulations and therefore should NOT have the parasites that are of concern in pregnancy. However, you are putting your trust in the sushi fish purchaser and preparer in this care, so approach with caution.

 

 

 

 

No Strenuous Exercise – Mostly Myth

There are no strict guidelines regarding exercise in pregnancy because this is highly variable as to what is safe and normal for YOU. There are elite athletes who’s “norm” is to run 10 miles or lift hundreds of pounds of weights on the regular. There are couch potatoes who get winded walking up a single flight of stairs.

Seriously, though… Exercising in pregnancy is actually key to having a healthy pregnancy, easier delivery, and – get this – fewer stretch marks! The main guide here is how the exercise makes YOU feel. Yes, that’s right, you have to listen to your body. This is not the time to “push through” and override your body telling you it is hot, too winded or  overworked. You will need to be more cautious with yourself because your blood flow is altered, your body shape is changing and your muscles, ligaments and tendons will be affected by relaxin hormone eventually.

No Sex – Mostly Myth

OK, think about it. If having sex while pregnant was dangerous, do you really think humans would have survived this long? A lot of pregnant woman have their libido skyrocket thanks to increased blood flow to the lady parts (though if you don’t that’s nothing to worry about). It is ok and GOOD to have sex if you want to in pregnancy. Get. It. On.

A few words of caution though… If you have pain or bleeding during sex, stop. Have your doctor check you and tell you if it’s safe to continue having intercourse during your pregnancy. And if you’re pregnant and single – you need to be ultra careful about not contracting an STD. They can cause severe birth defects, miscarriage or stillbirth if contracted while you are gestating. Safe sex – good. Unsafe sex – bad.

No Smoking – Fact

This includes ALL smoking. Smoking cigarettes and being exposed to second-hand or even third-hand (if you smell it even though no smoke is around, that’s third-hand smoke) can cause complications in pregnancy. If you are smoking when you conceive, talk to your provider right away about how they can help you quit. If people around you are smokers, same goes. It is NOT sufficient for them to just go outside. If your sensitive sniffer can smell the smoke, you’re being exposed. 

What about pot? It’s legal now and stuff, and doesn’t it help with appetite? NO, not safe in pregnancy. Marijuana has been shown to increase rates of ADHD, anxiety and other cognitive disorders in children who were exposed in utero. Stay away.

No Alcohol – Mostly Fact

Saved the most controversial for last! So, here in the USA, all of the official guidelines from the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, the American Academy of Pediatrics, etc… go along these lines, “There is no amount of alcohol known to be safe in pregnancy”. So, pregnancy providers will tell you to abstain completely from the time of ovulation if you might conceive through birth.

The Royal College of OBGYNs (Britain’s version of ACOG) takes a slightly more relaxed tone, saying “The safest approach is not to drink alcohol at all if you are pregnant, if you think you could become pregnant or if you are breastfeeding. Although the risk of harm to the baby is low with small amounts of alcohol before becoming
aware of the pregnancy, there is no ‘safe’ level of alcohol to drink when you are pregnant”. None of the large studies done recently showed negative effects on the baby or child with having a few drinks per week. However, the risk of preterm birth with alcohol exposure and of the devastating fetal alcohol syndrome makes pregnancy providers approach this with significant caution.

I know you are looking for a straight forward “yes you can have a glass of wine now and then” or “no, alcohol is truly dangerous”. We don’t have that yet. As a health provider, I follow the lines of saying, no amount is safe. As a woman physician, I know a whole lot of doctors who have read the studies and comfortably go ahead and have a drink now and then in the later parts of pregnancy. Ultimately, you’re in charge of making that decision for yourself and your unborn. Think about whether the anxiety when your kid seems hyper at age 3 that maybe they have subtle effects because you had a glass of wine at that dinner party is manageable vs the benefit you’ll really get from said glass of wine. You should for SURE never get drunk or even tipsy – that’s a no-brainer.

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Photo Credit: Fiona Margo Photography

What else?

This is why I called this Part 1… Please, comment away with questions, Myths you want busted, funny examples of crap your mother in law told you was unsafe in pregnancy! Part 2 will be based on your input. Whatcha wanna know??

Dr. Annie is a married mom of 2 with 1 more on the way (bump captured by Fiona Margo in the above pics, if you’re in the PNW look her up!!) and family physician in California.

Friday Faves: Summer Smoothies

Summertime is coming in hot across the country right now (see what I did there, hehe) and that means breakfast and snack time need refreshing makeovers. We love smoothies all year round, but especially when it’s 80 degrees already at 9 am, ain’t nobody wanna be slaving over a splattering pan of bacon and eggs.

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Photo by Suzy Hazelwood on Pexels.com

Smoothies offer densely packed nutrition, portability and refreshing yum-factor, it’s a win-win-win. It helps to do a little on-the-fly prep as your week goes by. Whatever extra fruit you have lying around about to go bad, chop it up and freeze it. Bananas (obvi), melon, berries, pineapple, mango and watermelon are all great frozen additions. OJ been sitting around for a while? Toss it in an ice-cube tray for future smoothies.

Here are some faves! Fire up that blender and enjoy.

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Photo by Kaboompics .com on Pexels.com

PB&J Smoothie

This is Annie’s OG smoothie from back in medical school and is still her go-to for a filling breakfast. You can make it thicker and have it as a smoothie-bowl with some nuts and fresh berries on top also. All measurements are super-approximate, I don’t actually measure anything.

3/4 Cup Frozen Organic Mixed Berries (I usually get from Costco)
1 small frozen banana
1.5 C spinach or kale
1 C Cashew milk (or any other creamy substance you like)
1 heaping TBS cashew, almond or peanut butter
Optional 1/2 C plain whole-fat yogurt
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Photo by Oleksandr Pidvalnyi on Pexels.com

Watermelon-Cucumber Refresher

Ultimate afternoon pick-me-up right here. Not super filling – great for after workout or if you didn’t quite eat enough of your kids’ leftover dino-nuggets at lunch to get you through till dinner 😉 It’s super hydrating and also packed with great vitamins with the watermelon and cucumber combo.

This one also makes a great alcoholic slushie if you cut out the yogurt and add a shot of vodka or gin instead.

1 C frozen watermelon chunks

1/2 C roughly chopped cucumber – if bitter, skin mostly removed

1/2 C plain whole milk yogurt

1 TBS fresh mint

Enough OJ or pineapple juice to be able to blend – the watermelon has a lot of water, so you won’t need much, start with 1/2 C.

Bonus Boosts

For added protein boost to any smoothie, consider throwing in a scoop of healthy protein powder.  Annie’s fave is NanoPro Vanilla Protein powder, Margo’s prefers Arbonne Vanilla Protein and Kristy’s go-to is Ascent Native Whey Protein Powder.

You can also add a super-food powder such as Youth Factor powder by Nerium or Lifeguard Greens to get a huge boost of anti-oxidant power.

Hope you all have fun getting your blend on this weekend! xoxo, Lockers To Littles crew.

Friday Faves: Summer Cocktails

With Memorial Day weekend coming up, we thought you all might be interested in mixing up the usual libations.

We’ll start with the fancy and finish with the simple. Cheers!!

Annie’s Picks:

Gin and Tonic Granita

This fantasical dessert-cocktail courtesy of Amanda on Chew Town Blog is as refreshing as it gets. If you’re somewhere like my part of California and looking at 90 degree temps for the weekend, this is the drink for you!

Gin and Tonic Granita | Chew Town Food Blog

I personally decrease the simple syrup from her recipe, but if you like it sweeter, adjust to your taste. I have converted her funky milliliter measurements (silly Australia) to ounces 😉  If you don’t have a juicer for cucumber, just blender them until they’re smooshy and push juice through a fine-mesh strainer.

GIN AND TONIC GRANITA

1/2 cup water
1/8 cup fine white sugar
5 ounces Hendrick’s Gin
16 ounces tonic water (I like FeverTree)
1/3 cup cucumber juice (made using household juicer)
Cucumber ribbons, to garnish

Combine sugar and water in a medium saucepan and heat over medium high heat, stirring until sugar has melted. Reduce to a simmer and continue to heat for 5 minutes. Remove from heat and set aside to cool.

Once cool, place in a medium baking dish and add gin, tonic and cucumber juice. Place in the freezer and each hour, take a fork, and fluff up the ice crystals freezing for at least 4 hours.

Serve topped with skewered cucumber ribbons. You can play around with adding mint or thyme to the simple syrup as it cools for more herbal flavor. Makes ~4 depending on your serving size.

Gin-Gin Fizz

This is one of my own creations. I’m admittedly a ginger-fanatic. The world has yet to make a ginger beer that’s gingery enough for me. If you prefer your ginger on the lighter side, omit the extra fresh ginger and/or swap out the ginger beer for club soda. You can also go full-domestic and make your own honey-sweetened ginger ale from This Post on Kitchen Stewardship (picture below from that blog).

natural ginger ale recipe

GIN-GIN FIZZ (for each)

1 oz Domain De Canton Ginger Liquor
2 oz good Vodka
1/2-1 tsp fresh grated ginger (can also buy in a jar or tube)
Juice of 1/2 lemon or lime (Meyer lemons are great too)

2 Tbs fresh mint leaves

Strong ginger beer (I recommend Cock and Bull) or club soda to top off 

Muddle first 5 ingredients together. Add ice and shake vigorously to chill. Strain into ice-filled glass.

Top with ginger beer, garnish with lime and mint.

 

Christiana’s Pick:

Blackberry Mojito

This tart little twist on a traditional mojito is absolutely perfect for a southern summer afternoon. Even better, an urban gardener can grow these ingredients themselves and make some seriously farm-to-table beverages. We personally made these with our backyard blackberry and mint harvest last year, and loved every sip.

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Photo by Jess Watters on Pexels.com
There are several takes on this recipe, here’s mine.
BLACKBERRY MOJITOS
Per serving:
  • 5-6 blackberries (frozen work great too, if you don’t have fresh ones on hand!)
  • Small handful of mint leaves
  • Juice of 1 lime
  • 1 1/2 tbsp simple syrup
  • 1 shot of good quality light rum
  • Club soda
Muddle blackberries, mint, lime, and simple syrup in glass. Add rum, and fill glass with ice. Fill to the top with club soda and ENJOY. Easy, peesy, mojito squeezy.

Margo’s pick:

Grown Up Cherry Coke

This one is fast and delicious. Goes great with burgers on the BBQ!

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Photo by Pixabay on Pexels.com

GROWN UP CHERRY COKE

Love Cherry Coke? You will love this:

1. A shot (or two) of Three Olives Cherry Voda

2.  Coke or Diet Coke

3.  Splash of Amaretto

You won’t taste the alcohol, and it will bring you back to the 90’s when cherry coke, lucky strike candy cigarettes and hot fries were your go to at the community pool!!

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Photo by Aaron Schwartz on Pexels.com

Enjoy any/all of these responsibly with 1 glass of water for every cocktail 😉 Dr. Annie’s orders!

With love from the ladies of Lockers to Littles