September 9, 2008

Are You Rattled By Conflicting Advice?

By Marisa Duffy

TO SPRAY or not to spray? Last week pregnant women were lumbered with another piece of research to weigh up. This time it concerned the use of perfume and scented lotion which has been linked to male infertility in rats. It comes hot on the heels of a steady stream of conflicting dos and don'ts for expectant mums.

Annette Briley, a research midwife with Tommy's, a charity that provides expectant parents with information on pregnancy, was sceptical about the dangers of perfume to unborn babies. During her 28-year experience, she says women have always wrestled with conflicting advice but that today they have even more to think about. "All the scanning and screening we have for babies - that worries women now, " she says. "In the olden days women got pregnant and if they got past 12 weeks they would just see what happened. If there was a problem with their baby they just accepted it. Nowadays we screen, offer a diagnostic test if there is an abnormality and we're asking women to make decisions the whole way through." She is also concerned by the rise of the internet, a hotbed of unreviewed information and horror stories.

Here, she deals with the issues most commonly raised by mothers- to-be.

Morning sickness: how sick is normal?

"As long as you're keeping fluids down, it's usually okay. If you're not keeping anything down, including water, then see your doctor. It is normal for morning sickness to become afternoon or evening sickness. By week 13 most women will feel better; feeling sick throughout your pregnancy is rare. Sickness can come back later in pregnancy when the baby is in the breach position so the head is near the mother's stomach and gastric emptying is affected. If the baby is very active it can also feel nauseating."

If I can't eat, my baby won't grow properly.

"Yes it will. Your baby is a complete parasite and will take everything it needs; the mother will be left short. We know that because if we look at the evidence from the Second World War from babies born in concentration camps where mothers were starved and during the Dutch famine disaster, they were small but they were properly formed; it was the mothers who were malnourished."

Bleeding always mean a miscarriage.

"Bleeding doesn't necessarily mean something bad has happened and is common in early pregnancy, particularly around the time the woman would have had a period or would have ovulated. Early bleeding can be associated with lifting heavy loads or shopping, so obviously those things are best avoided. If you are bleeding after sex, it is probably best to abstain until it settles. Post-coital bleeding is quite common during pregnancy because the cervix is very vascular (blood vessels are full) and easily grazed. It's nothing to worry about. Generally, if bleeding is painless and it's early on, it's less of a problem. If you bleed and there is pain, even if there is only a little blood, you must get help because if it's early on it could be an ectopic pregnancy."

A longed-for pregnancy is always a happy one.

"Pregnancy is quite a difficult time mentally for both partners, especially with a first baby, because it's a major change to your lifestyle. Often, people who have been trying for a while are so focused on getting pregnant that when they achieve it, it's really difficult because they haven't thought past that moment. Everyone around them assumes they will feel joy, but if you feel tired and sick and your back aches and you're peeing every two minutes, you can be really quite down. All your hormones kick in and you're much more emotional anyway. A report two years ago suggested that up to 30per cent of ante-natal women report feeling depressed."

Is it true that pregnant women should avoid pate, soft cheese and seafood?

"It's a good idea to avoid soft cheese but in terms of seafood, avoid shellfish, not white fish, which is really good for brain and eye development. Basically, it's things that aren't pasteurised. Pate has liver in it, which is obviously a problem because of the vitamin A. It's linked to birth defects, and seafood contains mercury. Mayonnaise bought in jars is fine, but home-made mayonnaise is best avoided because of the raw eggs. Otherwise, eat what you fancy as opposed to what you think you should; your body will let you know what it needs."

An odd glass of wine won't do any harm.

"Lots of women don't drink in early pregnancy at all because it makes them feel ill and it's probably their body telling them that it's not good. The problem with alcohol is that we don't know how much is too much so we err on the side of caution and say none. A lot of women, before they know they are pregnant, have been drinking and they beat themselves up for the whole of their pregnancy and it is probably fine. The bottom line is that the occasional glass of wine is probably going to do you no harm. It's the binge drinking that's the problem. Spirits are worse than wine."

I smoked / took recreational drugs before I knew I was pregnant. Have I affected my baby?

"Yes, of course it can affect your baby. But it is a 'can', not a definite yes or no. The best thing you can do is stop as soon as you realise you are pregnant. A recent paper suggested that even if you gave up smoking in the third trimester, it was better for your baby than not giving up at all. Smoking is a real addiction so if you cut down that is fantastic, although we do recommend giving up completely. Similarly, loads of women have had one binge before they realise they are pregnant. For the vast majority is it usually fine."

Tea and coffee are best avoided.

"Again, a lot of women go off tea and coffee in pregnancy and start drinking herbal teas. If you're giving up tea and coffee because of the caffeine, it's in a lot of other drinks such as Coke and in chocolate. If you're drinking 12 cups of coffee a day that's not a good thing so limit your tea and coffee."

I should be eating for two.

"No. Women who are pregnant do get the munchies; blood sugar drops much more quickly because you are using up more sugar so crave sweet things. It's therefore better to eat smaller meals more often. Keep a banana handy, not a chocolate bar. The amount of food you eat will undoubtedly change because once the nausea has passed, your appetite will increase because you're growing a baby. The secret is not to use it as an excuse to pig out. Just remember, whatever you put on, you are going to have to lose."

Exercise is best avoided.

"If you are a complete couch potato, this isn't the time to take up marathon running but if you are used to exercise, listen to your body. Your stamina changes, your posture changes but if you're used to exercise, there's no reason not to continue. If you don't normally exercise, gentle exercise will be fine. Swimming is great, as is walking. Women in pregnancy feel more tired because when sleeping, they're not totally resting, so do things in moderation. Most women find by the third trimester that they have become larger so it's much more difficult, but aqua-natal classes are good."

I kept taking the pill before I knew I was pregnant. Have I harmed my baby?

"No, certainly there have never been any reported cases. In the old days, the pill used to have massive doses of hormones. Today, they give you the minimum amount to stop you getting pregnant (or not! ) There is very little you can do about it. If you have smoked or drank or taken any pills when you are pregnant, it is worth telling your doctor and midwife as they can look out for all sorts of things at the ultrasound scan."

I can't take painkillers.

"Any medication is best avoided in pregnancy. Headaches can happen in pregnancy because of dehydration so have a pint of water first. Avoid homeopathic remedies during the first 14 weeks as we don't really know what the effects might be."

What about dyeing my hair?

"There is no evidence directly to link hair dye with birth defects but equally there is no evidence that it doesn't do any harm. So it's probably not a good idea to dye your hair yourself. Go to a salon and tell them you are pregnant. People seem to know about not taking medicine during pregnancy but then apply steroid cream, not realising that it is sucked into the skin and chemicals from the dye can seep into the scalp.

Can I take a flight?

"There is no problem with flying but you must make sure that the airline knows you are pregnant and that your insurance covers you. You are at greater risk of DVT on long-haul flights so wear flight socks, move about and carry your hand-held maternity notes, in case there is a problem."

As part of the Let's Talk Baby campaign, Tommy's midwives are visiting Asda stores to answer pregnancyrelated queries. Asda Bridge of Dee, September 13, 10.30am-2.30pm; Asda Livingston Supercentre, September 13, 10.30am2.30pm; Asda Edinburgh Supercentre, September 14, 10.30am-2.30pm; Asda Glasgow Fort, September 14, 10.30am- 2.30pm.

Originally published by Newsquest Media Group.

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