If you are pregnant, you have probably received a lot of advice from well-meaning friends, relatives and strangers - much of it probably conflicting and confusing.
Don't eat fish. Only eat certain fish. Don't dye your hair. No coffee. No wine. Make sure you exercise. Don't over exercise!
Before worrying that you might have already failed as a mother, relax. Unless you are taking lessons from Mad Men's Betty Draper, who tossed back swigs of gin between cigarettes, you are probably doing fine.
Some common concerns:
Can I drink even a little? Isn't it common in Europe for women to have a couple of glasses of red wine a week?
The American College of Obstetrics and Gynecology advises to avoid alcohol and I agree. Research that has been done in the area of alcohol and its effect on pregnancy has dealt largely with binge drinking - multiple drinks on multiple occasions. A sip of champagne on a special occasion does not cause fetal alcohol syndrome. Yet, with no research on moderate alcohol consumption, it's best not to take any risks.
If you had a few drinks before you realized you were pregnant, there is little chance that this poses a serious threat. Until recently, in some countries a drink or two a week was acceptable. But take note: most have adopted the no-alcohol stance. France now includes warning labels on its wine bottles cautioning pregnant women not to drink.
Incidentally, not only is wine on the don't list for pregnant French women - so are raw vegetables. Eating a salad in a restaurant in Paris while pregnant might elicit the same response as an expecting mom bellying up to a bar might in Los Angeles: outrage. Improperly washed produce can lead to a rare infection caused by a parasite, toxoplasmosis, found in soil, and this issue is as relevant in the US as it is in France. In addition, unpasteurized milk and cheese should not be consumed as they potentially could cause infections with a bacteria, Listeria, that may result in miscarriage.
Is caffeine allowed? How can I face the day without my coffee?
You do not have to entirely abandon caffeine. The American College of Obstetrics and Gynecology maintains that one to two cups of coffee - about 16 ounces - a day is safe. The March of Dimes suggests a bit less: no more than 200 mg of caffeine per day, about the amount in 12 ounces of coffee. That is based on a 2008 study suggesting pregnant women who consume more than that may double their risk of miscarriage. If consuming caffeine causes stress about the potential risks, then skip it. But, it is not necessary to hit the panic button because you chose to have a latte.
Which prenatal vitamins are best?
Prenatal vitamins are specially formulated to shore up any nutritional deficiencies in the mother's diet. They contain numerous vitamins and minerals, but pay special attention to their folic acid, iron and calcium content. Look for about 400 mcg of folic acid, 200 to 300 mg of calcium and 17 mg of iron. Also, be sure prenatal vitamins are fortified with iodine - many are not, and pregnant women need additional iodine to produce enough thyroid hormones for herself and her baby. The American Thyroid Association recommends that women ingest 150 micrograms of iodine a day during pregnancy, as this is used by the baby to make thyroid hormones that are critical for fetal brain development, as well as for many other aspects of fetal growth.
Can I exercise while pregnant?
If exercise was part of your routine prior to pregnancy, keep up this good habit with modifications to ensure your blood pressure is at a healthy level as your pregnancy progresses. Exercise will make you feel better, and prepare your body for birth. Note that changes in a pregnant woman's body, such softer ligaments, can leave them more vulnerable to injury. Low-impact activities like swimming, water aerobics and walking are ideal.
If you didn't exercise regularly prior to pregnancy, start with walking. It's easy to vary the pace and difficulty. Women with higher-risk pregnancies may need to limit their exercise. Remember to exercise common sense - avoid activities where you are likely to fall or be injured.
Can I eat fish?
The FDA recommends pregnant women eat no more than 12 ounces of fish a week. High in protein, low in fat, fish can be an excellent choice for pregnant moms. Salmon is especially good, because it's an excellent source of omega-3 fatty acids, important to fetal neural development. Sushi and smoked fish are off the menu, along with other raw foods. Uncooked fish brings the risk of bacteria or parasites. Skip fish that are high in mercury like shark, swordfish and king mackerel as mercury can interfere with fetal brain development.
What about sex?
Intercourse is safe throughout pregnancy. However, it's also normal for a woman's desire for sex to fluctuate during her pregnancy. Open communication between partners is key. As the pregnancy progresses, couples should figure out what's comfortable and what works for them. A doctor may advise against sex if a woman has a history or premature birth or has other conditions that might pose a risk. If this is the case, be sure to get a clear understanding of what "no sex" means - does it apply only to intercourse, or any stimulation at all?
Can I dye my hair?
There's no definitive research on hair dye and fetal health. Some chemicals used in coloring, straightening or perming hair can be absorbed through the scalp. As it hasn't been studied extensively, it's best for pregnant women play it safe and not worry about touching up their roots.
The bottom line is to let common sense and your doctor be your guides. Every woman is different and will experience her pregnancy differently, so it is important to find the best prenatal care possible and a doctor with whom you can comfortably share all your questions and concerns.