By Dr Monique Robinson
Pregnancy brings with it some level of risk. There is no getting around that. Of course, women want to do the best for their baby, but there is no recipe for the perfect baby and sometimes issues arise that we can't predict and for which we don't know the cause. Ultimately, pregnancy is about accepting a level of risk will always be there, but minimising those risks we know about, and simply getting on and enjoying the amazing experience.
Most mums-to-be already know the major risks to a healthy pregnancy. We want expectant mums to focus on enjoying a healthy pregnancy rather than worrying about everything that can go wrong, but being aware of those risks that are relatively easy to avoid makes sense.
For example, we know that for women who are pregnant, not drinking is the safest option. Although there is a lot we do not know, the weight of evidence suggest the most sensible and best advice is to avoid alcohol from the time you find out that you are pregnant, or considering trying to get pregnant.
Similarly, we know that smoking damages your health - whether or not you are pregnant. Still, some 12 per cent of women in WA continue to smoke cigarettes during pregnancy, despite links to poor pregnancy outcomes. Women sometimes feel quitting will be too hard, but it is worth it and never too late to quit. Even if you are a regular smoker when you fall pregnant, research at The Kids Research Institute Australia shows women who quit by 18 weeks of their pregnancy avoided the same level of risk as those women who continued smoking.
A little bit of coffee in pregnancy is okay. The recommended level for caffeine consumption is 300mg per day, or no more than around three cups of coffee a day. Remember that you may also be ingesting caffeine from tea, chocolate, soft drinks and some energy drinks.
Other known risks to unborn children are not as obvious. Toxoplasmosis is caused by a parasite you are most likely to encounter from cat litter or even while gardening. A few simple precautions will reduce your risk and many cat owners will already have some immunity.
- Avoid changing cat litter if possible. If no one else can perform the task, wear disposable gloves and wash your hands with soap and warm water afterwards.
- Ensure that the cat litter box is changed daily. The Toxoplasma parasite does not become infectious until 1 to 5 days after it is shed in a cat's faeces.
- Feed your cat commercial dry or canned food, not raw or undercooked meats.
- Keep cats indoors.
- Avoid stray cats, especially kittens. Do not get a new cat while you are pregnant.
- Keep outdoor sandboxes covered.
- Wear gloves when gardening and during contact with soil or sand because it might be contaminated with cat faeces that contain Toxoplasma. Wash hands with soap and warm water after gardening or contact with soil or sand.
Listeria is a relatively rare bacteria that can cause Listereosis, a serious infection caused by eating food contaminated with the bacteria. The disease affects primarily pregnant women, newborns, adults with weakened immune systems, and the elderly. If you are pregnant, you are advised to avoid consuming unpasteurised dairy products, processed meats, soft cheeses, and soft serve ice cream. Contrary to popular opinion, it doesn't live in these foods all the time, but occurs in rare outbreaks which quickly attract national attention. The reason we advise pregnant women to avoid these foods is so they are not the first to ingest the bacteria in the event of an outbreak. Other foods to avoid include raw fish and sushi, due to potential contamination with E. Coli and pate, due to its vitamin A content.
Diet soft drinks, which typically use artificial sweetener Aspartame are generally considered safe in moderation. However, if you have the inherited disorder phenylketonuria (PKU; a disorder that prevents the metabolism of phenylalanine and is diagnosed at birth), you are advised to avoid artificial sweeteners and diet soft drinks.
The risks of anti-depressants in pregnancy are also commonly over-estimated and the dosage and type of antidepressant can differ widely amongst women. If you are already prescribed anti-depressants you should seek advice from your doctor, but should never just stop taking them without consultation. The benefits you may get from continuing medication could well outweigh the risks - particularly when you consider that untreated stress and depression are also linked to pre-term birth and some behavioural problems. Seeking support and managing your stress is important and you should seek support from the many services available, including your doctor.
It is common for pregnant women to experience a deficiency in Vitamin D, which has been recently linked to pregnancy complications. The good news is getting out in the sun - especially important in winter months - for as little as five to ten minutes a day will ensure your Vitamin D levels are maintained. Although this must always be considered within sun exposure safety guidelines.
It is easy to feel overwhelmed - but try to remember that most of the time what you are doing is right. There is plenty of support available for individuals and please make sure you take advantage of all the resources offered to you. Remember, you can't eliminate all risk, but if you can accept that and try to minimise those risks where you can, you will hopefully be able to enjoy your pregnancy as much as you can.