Is It Safe?: Answers For All Your Pregnancy Safety Questions

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Our Experts In This Episode

Dr. Michael Broder wrote the book The Panic Free Pregnancy. He is also an Assistant Clinical Professor of Obstetrics and Gynecology at the David Geffen School of Medicine at UCLA.
 
Dr. De-Kun Li is the author of a landmark study that linked caffeine consumption with miscarriage.  He is a senior research scientist at the Division of Research at Kaiser Permanente in Northern California.
 
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Welcome to your Pea in the Podcast, I'm Bonnie Petrie with everything you need to know about your body, your baby and the big changes ahead in your life as you begin your journey to becoming a mommy.
 
This week we're talking about what you can do...
 
"The American College of OBGYN doesn't recommend avoiding cat litter."
 
What you should probably stay away from...
 
"Cold lunch meats and for example lox, cured salmon. It can carry listeria so that is probably on the avoid list."
 
And a headline making study that has turned conventional wisdom about coffee in pregnancy on its head...
 
"Well those who had a coffee in-take more than 200 milligrams a day the miscarriage rate was doubled."
 
The obstetrician who wrote the book on how to have a panic free pregnancy tells us all about what you can and cannot do while you're growing your bean, and one of the authors on the latest research on caffeine in pregnancy joins us in this Pea in the Podcast.
 
You've heard the saying that when you are pregnant you're eating for two. Well that's true when you're making choices about what to eat or drink or what activities to participate in. You are making decisions for you and your baby.  That causes some women to panic.  It's a lot for which to be responsible.  Dr. Michael Broder is an obstetrician at UCLA Medical Center.  He sees that all of the time.
 
"I had patients coming into me constantly who were worried about one thing or another and most of the time the things they were worried about were things that they didn't need to be concerned about. These were people who were getting good healthcare and taking care of themselves and doing all of the right things. They seemed to be worried about lots of things that really weren't worth their time."
 
So he wrote The Panic Free Pregnancy, a book on things you can do during pregnancy, things you shouldn't do and things you should talk to your doctor about.
 
So what is first on the list? Well many women find out they're pregnant after they've missed their first period, and by then they are several weeks into their pregnancy and they worry the medicine they have been taking will hurt their baby. Dr. Broder says relax.
 
"You know it's funny it's probably easier to answer what you can't take than what you can because there are only a handful, maybe a dozen or so drugs that have been really found to be dangerous during pregnancy. Which is not to say that you should just go ahead and take anything willy nilly but that's the truth that the fetus is pretty well protected and it takes a very unusual medication to get past all of the barriers that nature has thrown up."
 
So let's start with the other the counter stuff.
 
"Things like Sudafed and Chlor-trimeton as an antihistamine and things like this are completely safe as are almost all the over the counter pain medications and so all of those things especially taken the way somebody normally would which is you know I have a cold, I take these things for a few days and then I stop."
 
You can take these kinds of medicines throughout your pregnancy. This was great news to me when I got a killer cold at 7 months long and I thought I would have to suffer through it unaided by any medicine.  I couldn't breathe.  I couldn't sleep.  Finally I called my doctor who reassured me over the counter medicines were just fine.
 
There are some medicines you really need to think twice before taking.
 
"I can tell you seizure medications are known to be dangerous during pregnancy, but even though they are known to be dangerous during pregnancy it's a good idea to stay on them.  In fact most of the time, because a woman who has a seizure while she is driving, that's much more dangerous than the risk that these medications might have."
 
That's definitely something you want to talk about with your doctor and weigh the pros and the cons.
 
Anti-depressants are controversial right now.  Some are linked to birth defects and some have been shown to cause babies to suffer from withdrawal after they are born.
 
"The thing with medications like anti-depressants is that it's really a case where you have to weigh the risks and benefits. And so, for example, depression...if a woman is depressed is it a higher risk of suicide and suicide is certainly more dangerous to a developing fetus than an anti-depressant so to put it in those stark terms you really have to think about what is it that you're trading off."
 
Again a conversation or two -- or twelve -- with your doctor, all throughout your pregnancy, are in order.
 
And there are some medications you should just never take if you're pregnant or trying to get pregnant. In fact some of them doctors won't even let you have unless you are taking a birth control pill like Accutane. They are called teratogens. The bottom line with all of this, as I said, is open communications with your doctor or midwife.
 
"If you're taking something over time, more than once consistently then it certainly makes sense to check anything over the counter or prescription with your doctor first."
 
For more information on medication and pregnancy, please go to The National Women's Health Information Center, the website of The Organization of Teratology Information Specialists (OTIS), and the website SafeFetus.com has a searchable database.  If you are concerned about medications that you may take while breastfeeding, you can go to the library and take a look at the quintessential book on the subject, Medications and Mothers' Milk by Dr. Thomas W. Hale, or head on over to KellyMom.com for a ton of useful information on medications and breastfeeding. 
 
You'll also hear a lot about what you can and can't eat. Dr. Broder said there are some foods you just should avoid while pregnant.
 
"The CDC has recommended that women avoid certain foods while they are pregnant, mostly because of the risk of listeria, which is a relatively uncommon infection, but one of the few that can cross the placenta and infect the fetus. So there's some like cold lunch meats and for example lox --  cured salmon -- that can carry listeria, so that is probably on the avoid list. And some soft cheeses as well; so the blue vein cheeses in particular are not a good idea but even things like Brie can occasionally have listeria, so generally that is not recommended.  So soft cheeses. But other than that there's not really much."
 
Some people worry about the possibility of other things like contaminate your food like salmonella in eggs.
 
"But if you prepare eggs, you know wash your hands, and actually salmonella infection rate of eggs have dropped dramatically in the last few years in the US, so that's probably even less risk. Then there's e coli which you can get in some meats, particularly hamburger, and you know the solution there is to cook it to medium, and again the risk of e coli infection is really in the mother, only, so it's something that is not pleasant but it is not particularly more dangerous for your pregnancy."
 
Some people are crazy about sushi.  They can't live without it.  Yeah, raw fish.  Now that sounds like something you should avoid while pregnant, right?
 
"The common assumption among women is that they just can't eat sushi during pregnancy and my response is you certainly can eat it. That any infection risk from eating sushi that might exist is really an infection of the mother risk. It's not a risk that the fetus will get infected, so the risk is no different when you're pregnant or not pregnant, and it is very small."
 
California roll, here I come.
 
Now here's a controversial one.  Peanuts.  Nuts in general.  Some experts do believe that eating nuts during pregnancy may sensitize a fetus to develop a peanut allergy after they are born. A recent study suggests that is not true. Dr. Broder says it is something you need to think about when making dietary choices.
 
"There is definitely reason to think that women who eat peanuts during pregnancy are more likely to have a child with a peanut allergy. In fact, it's one of the theories about why there is such an increase in the number of kids with peanut allergies over the last few years. So I think it might be worth avoiding during pregnancy, unless you're a vegetarian and that's a primary source of protein, and then again I think you just have to weigh, weigh the risks and benefits."
 
Okay now you know what you can and can't eat, but can you microwave that food? Yes.  Yes, you can.
 
"I think the reason people are even concerned about microwave is because the idea that it is microwave radiation and it's the word 'radiation' that is scary, but microwave radiation is radiation the same way that from your light bulb comes radiation, called infrared radiation. So radiation just means the transmission of energy through the air and it's not the same, it doesn't mean like nuclear radiation or ionizing radiation like what you get from x-rays. They're just different animals and the similarity is just that we're radiation. So a microwave oven would be dangerous if you got inside it and heated yourself up you know until you were cooked or your baby was cooked. Other than that it is not producing anything more dangerous than in your light bulb."
 
Pregnancy is a time when lots of mommies-to-be who are also mommies-to-cats silently cheer because they know they will not have to clean the litter box for the next several months. And in fact, I have not cleaned the litter box since I found out I was pregnant, and my daughter is several years old now. But -- and I won't tell your partner if you don't -- that's not necessary. Dr. Broder says you can safely clean the litter box.
 
"The bottom line is that you can change the cat liter if you want to be super safe you probably ought to use gloves. But other than that it's really not a particular danger but again we don't have to tell your husband."
 
But toxoplasmosis is something you need to think about, particularly if you garden.
 
"Where the toxoplasmosis is most likely to be found and transmitted to you is from dirt. So if there are animals, wild animals in your yard, things like that they can in their feces transmit this organism and you can get it if you're gardening without gloves. So gardening with gloves is probably a good precaution to take while you're pregnant. But the reason it is not a big issue with cats is, if you're a cat owner, two things might have happened already.  First you might have been exposed to toxoplasmosis many years ago and it is something, that as humans, it's really only transmissible to the fetus the first time you get it. So if you have a new infection during pregnancy then it is dangerous. If you had toxoplasmosis years ago, you can't get it again during your pregnancy and transmit it to the fetus. So that's one reason. The other is that cats, if they get toxoplasmosis, they probably only shed it once in their lives when they first get their infection. So if you have a house cat and it got infected it might have been able to transmit the infection only when it was first infected and if you've had that cat for years then it has probably been infected for years."
 
Another thing you might try to pass off on your partner is cleaning those cleaning products can't be good for baby, right?
 
"Anything that makes you feel bad when you are around it is probably not so good to be around but other than that you know just wipe things dry or things like that. They're pretty safe."
 
So most cleaning is safe, but as always during pregnancy, listen to your body. This also goes for preparing your nursery, I know you are loving getting your baby's room ready for them and that may include painting the walls pink or blue or yellow or green.  Dr. Broder says that's fine.
 
"I think the most important thing here is just keep a well ventilated room if you're painting or varnishing or doing that kind of thing. You know if it smells funny or you feel bad then you should probably stop and get some fresh air. The paint and those kinds of things are not really toxic in the way that you'd get them if you're painting you baby's room. If you're a house painter for example you might be getting exposed to some things during pregnancy that you don't want to be but in terms of painting a room in your house it's absolutely safe."
 
Now, a lot of women worry about their hair.  They stop dying it the moment they find out they're pregnant. They've heard somewhere that highlights or lowlights or full color will hurt their baby and Dr. Broder says there is some science behind this myth.
 
"There was a study done more than 20 years ago now that showed an increased spontaneous abortion among women who worked applying hair dyes at more than 20 hours a week, that was their job. And so from that people took that well the hair dyes themselves must be dangerous and therefore you don't want to put them on your head when you're pregnant, but I think later studies haven't shown that and even that early study you're talking about women who were getting this gunk on their hands all day long for 20 hours or more a week and the amount of exposure of any chemical that you get from that is so much greater than you would get applying to your hair which really doesn't absorb anything.  It's really the scalp where you'd absorb it. You know, even if you're getting your roots done, there's not much that is being absorbed really in the scalp. So for all of those reasons it is really completely safe there is just not really a shred of evidence to say that you should avoid dying your hair."
 
So there is no reason not to be pretty while baking a baby.
 
Some moms-to-be who have not been active previously have convinced themselves it is not safe to start exercising while pregnant. Dr. Broder says, on the contrary, that is the best thing that you can do for yourself and your baby.
 
"Increasing your level of activity during pregnancy reduces your risk of gestational diabetes and it also makes you fit for delivery and this is sort of an old joke but why do you think they call it labor, you know, it is a lot of work to have a baby and the more you've prepared for that work the easier it is. And being physically fit is about the best thing you can do to prepare."
 
You say you can't exercise...
 
"Anybody can exercise, get up and walk around the block and the next day walk around twice."
 
You probably want to avoid exercises like skiing or tennis or anything where your changing center of gravity can throw off your balance or cause injury. Horseback riding, contact sports, they're out. Scuba diving is also a big no-no.
 
What else can't you do? Well this might go without saying, but Dr. Broder says don't smoke.
 
"If you smoke, quitting smoking is the single best thing you can do for yourself and for your pregnancy. There's no doubt about that, and smoking is probably one of the number one or two causes of preventable injury or illness in the country, with maybe overweight as the other one. So I can't say enough about how important it is not to smoke during pregnancy. I mean period not to smoke, but during pregnancy there are many things that are worse during pregnancy if you smoke."
 
If you can't quite cold turkey he says start heading in that direction.
 
"If you can't quit then cutting down is a good idea. Even a pack a day is better than two packs a day. So it's not that women who can't quit should consider the idea that even cutting down is worth doing. And if you can't do it on your own there are methods, patches, and things like that can be used to help and those are probably better in pregnancy than smoking."
 
Dr. Broder says quit as soon as you can.  It really is the very best thing you can do for your baby. We do have a podcast that offers some advice on how to do just that. I quit smoking during pregnancy, I know you can too.
 
Now, some of you may be planning a babymoon -- a special trip before baby comes -- and you may wonder if hitting the sauna or the jacuzzi is okay.  Well, it is, in moderation. The American College of Obstetricians and Gynecologists suggest sauna use of no more than 15 minutes and hot tub use of not more than 10 minutes.  Avoid uncomfortably high temperatures. What you want to avoid is raising your core body temperature too high.  That's not good for your baby, so be conservative.
 
And if your babymoon is in some exotic place, can you fly? Here's Dr. Michael Broder, the author of The Panic Free Pregnancy.
 
"There is solar radiation that you're exposed to when you're flying and the higher up in the atmosphere you are the more radiation you're exposed to but it's a very tiny amount and so the women that need to worry about it are those that are airline pilots or stewardesses. Other people, even frequent flyers, really you have to be flying in the neighborhood of 50-100,000 miles a year to be getting enough radiation to be of any concern."
 
So if you're having a healthy, normal pregnancy, go ahead and fly. You might want to pick a destination with good medical facilities nearby, and The American College of Obstetricians and Gynecologists recommends women don't fly after their 36th week of pregnancy. Certainly airlines have different restrictions; you might want to check with them before you head out. And if you're having any complications with your pregnancy, stay home. It's always a good idea to talk to your doctor or midwife before making plans like these, anyway.
 
Oh!  And if you want to have sex on your babymoon go for it. Unless your doctor tells you otherwise, sex is perfectly safe right up to the day your baby comes. Your partner can't hurt the baby. Someone once told me it's like parking a car in an attached garage. The car can't get inside the house. Your partner's parts can't hurt the baby, no matter how impressive they may be. ;)
 
The next thing we're going to talk about is a little controversial.  Caffeine. Doctors have long disagreed about the danger posed to a developing fetus by caffeine, particularly in early pregnancy. I, in fact, drank a ton of coffee in my early pregnancy because I didn't know I was pregnant.  I probably wouldn't have if I had. But a study published in The American Journal of Obstetrics and Gynecology found that caffeine can greatly increase your risk of miscarriage. Dr. De-Kun Li is that study's author.
 
"What we found is that for those who had a caffeine intake more than 200 milligrams a day the miscarriage rate was doubled."
 
200 milligrams is not very much.
 
Dr. Li thinks the reason caffeine is dangerous to a baby is because it crosses the placenta and is difficult for the fetus to metabolize. Li says caffeine can also increase blood flow to the placenta. Of course, caffeine comes in coffee and tea and soda and hot chocolate and chocolate you eat.  Coffee, of course, has the most caffeine. Dr. Li hopes the study will encourage The American College of Obstetrics and Gynecology to set some guidelines about the consumption of caffeine. But in the meantime...
 
"The general message is the less the better. If they can totally stop during the first 3 or 4 months of pregnancy that is best but they have to drink something the general message should be the less the better or they should limit it to less than one cup a day."
 
Okay, I know we haven't covered everything that is going to panic you during your pregnancy.  That is a fact. I remember having a meltdown after getting gas all over myself while pumping gas at the gas station, thinking I caused great harm to my baby. I didn't, she was fine. You can pick up Dr. Broder's book, The Panic Free Pregnancy, but also -- as always -- if you have any questions at all, talk to your doctor or midwife. That's what they're there for.
 
We hope you've enjoyed this Pea in the Podcast: What You Can and Cannot Do During Your Pregnancy. Please visit our website PeaInThePodcast.com for more information about our experts, to find links and transcripts and to register to get tailored week by week shows for each week and stage of your pregnancy. It's everything you need to know about your body, your baby and the big changes ahead in your life in your journey to becoming a mommy. For Pea in the Podcast, I'm Bonnie Petrie. Thanks for listening.