What to avoid during pregnancy

Most pregnant women are understandably keen to avoid anything which could potentially harm them or their baby. Minimising risk factors and knowing what to avoid during pregnancy are some of the ways to reduce the likelihood of problems, but there is a limit to how much you can control.

In all women, the incidence of having a baby with some form of birth defect is 3-5%. But this increases when mothers are exposed to factors which are teratogenic (causing birth defects) to a developing baby.

Keeping informed and knowledgeable about what you can do is important. It may seem while you are pregnant that every horror story soon finds its ways to your ears. Filtering what you want to hear and what you d rather not takes some energy and you'll find it's not always possible to block out what you d like to. It is common during pregnancy for mothers to worry about all the what if's which can happen and how they would deal with them if they did. It makes good, common sense to eliminate or at least reduce potentially hazardous influences in life generally, but especially during pregnancy.

Diet

A diet high in folic acid is important, especially in the first trimester. Low folic acid has been linked with babies having a higher incidence of neural tube defects, for example, spina bifida. A good quality pre-natal vitamin supplement which contains 0.5mg or 500 micrograms of folic acid is the daily recommendation. Foods high in folic acid are green leafy vegetables, good quality cereals, fortified cereals, liver and grapefruit.

Listeria

Some foods are considered too risky for pregnant women to eat and they are advised to avoid them. This is because of the chances of contracting an infection with Listeria, which can lead to stillbirth and other complications. Listeria is a food-borne illness which can be transferred in soft cheeses, pates, cold deli style meats, coleslaw and sushi. Refrigerated foods which have not been stored correctly or cold enough, soft serve ice-cream, unpasteurised milk and products made from unpasteurised milk and ready to eat seafood are also risky. Check the Victorian Government Health Information site for more information about listeriosis.

Fish

Some fish are potentially risky to eat during pregnancy. High levels of mercury are found in some fish species and when a developing baby is exposed to high levels of mercury they can have problems with their nervous system. Those which are higher in the food chain and are predatory such as shark, marlin, southern blue fin tuna, orange roughy and swordfish are best avoided. Check the NSW Food Authority Food Authority for more information.

Alcohol

The current recommendation regarding safe alcohol consumption in pregnancy is that there is no proven safe amount. The placenta does not completely filter out alcohol and a percentage still makes its way to the baby. If you had been drinking alcohol when you conceived try not to worry. The important issue is that you abstain for the remainder of your pregnancy. Check the Victorian Government's Better Health website for more information.

Medicines

If you have been prescribed medication by your doctor and they are aware you are pregnant, do not stop taking them. There is a risk to your own health if you do stop suddenly. If you are in any doubt double check with your doctor and a pharmacist. Most large public hospitals have drug and medication hot lines which you can phone to speak with a pharmacist.

The general guidelines around medication use in pregnancy are:

• Avoid taking anything unless you have to. Do not self prescribe and assume something is safe just because it is labelled as natural .
• Although a medication may be considered safe for you to take as an adult, to a forming baby with only a few hundred cells it may be very dangerous.
• Consult your doctor or pharmacist if you are at all unsure.
• If you do take a medication make sure you take the right dose, at the right time and how it is recommended, i.e. on an empty stomach or otherwise.

Complementary Medicines

There are associated risks with taking some herbal or natural therapies during pregnancy, particularly in the first trimester when the baby is forming. Again, check with your doctor or pharmacist regarding what has been proven to be safe and what is potentially toxic. Just because something is labelled as being natural is not a sign of quality control or safety. Many complementary medicines have not been tested rigorously and don t have the scientific evidence to back up their claims. So it is important to be cautious and always check for a comprehensive list of contents and dosage in what you are considering taking.

Caffeine

The current recommendation is for pregnant mothers to limit their caffeine intake. The safe limit for caffeine is considered to be 200mgs/day. An average cup size of filtered coffee contains around 130mgs, so even a couple of flat whites or cappuccinos a day, would be too much. Two cups of weak coffee per day or 4 cups of tea is considered safe. Cola drinks need to be limited to less than 1 litre a day, preferably unsweetened, and energy drinks to less than 1 can per day.

Environmental Toxins

Lead, chemicals, X-rays and ionising radiation, paint fumes, pesticides and cleaning agents can all pose a risk to pregnant women and their unborn babies. Get used to reading the labels on all products and their precautionary warnings. If there is a chance you could be exposed to a potential hazard, ensure you are in a well ventilated room and are wearing a protective mask and clothing. If your working environment is risky, let your employer know you are pregnant and see if you can arrange for an alternative working location.

Cigarettes

Cigarettes contain nicotine and a host of other dangerous chemicals. Babies who are born to mothers who smoke are smaller than they would otherwise be. They are also at more risk of being born prematurely, dying from SIDS, developing asthma and other respiratory illnesses. Lactating mothers who smoke do not produce as much breast milk as they could and their babies can smell like cigarette smoke. Nicotine replacement therapies are not recommended during pregnancy so you will need to investigate other options. Visit the Quit Now site or ring the Quit Line (Australia) on 13 78 48.

Illicit or Recreational Drugs

Babies born to mothers who use recreational drugs are at increased risk of a range of complications. Miscarriage, placental abruption, stillbirth, prematurity, small birth weight and addiction are common problems. Most major public maternity hospitals run specialty programmes designed to support mothers with addiction or drug dependency issues. The staff within these units are highly trained professionals who operate from a strongly non-judgemental approach. If you are having trouble stopping your drug use and need support, search online for a support group. Speak with your midwife or doctor about withdrawal options.

Illnesses

It will be impossible to completely insulate yourself from the risk of illness when you are pregnant. Viruses and bacteria are not selective about whom they colonise; their primary focus is to look after their own interests and replicate in as many innocent people as they can. Just because you are pregnant does not mean you are exempt. Far from it in fact. Pregnancy can mean a lowered immune response which means you may be even more vulnerable than you usually are.

Become vigilant about hand washing. Avoid inhaling when other people are coughing and sneezing and if you happen to be unlucky enough to be in close vicinity with someone who is vomiting, hold your breath, at least temporarily. Many viruses are air borne and hitch a ride on air particles which are easily inhaled.

Two viral infections which can potentially cause complications during pregnancy are rubella (German measles) and Chickenpox. Cytomegalovirus, Parvovirus (B-19), Toxoplasmosis and some STDs such as Herpes Virus and Syphilis are also dangerous.

Hot Baths, Mineral Spas, Saunas and Spas

In the early months of pregnancy, the foetus is very sensitive to its mother's core body temperature. Any environment which causes this to rise and stay high can potentially cause problems with foetal development. A normal temperature range for humans is around 36.1-37.3 degrees Celsius. Mothers in the early stages of pregnancy are advised to reduce their chances of contracting a fever inducing illness. They are also advised to avoid remaining in an environment which elevates their temperature to above 39 degrees Celsius.

Cats

No need to take a trip to the pound with your adored cat just yet, no matter what you're told by other people. You will need to avoid your cat's droppings though, so if it uses a litter tray you d be wise to ask your partner to empty it while you are pregnant. A parasitic disease called Toxoplasmosis can be transmitted in infected cat's faeces and is easily transmitted to human hands and then the mouth.

If you need to dig in the garden, wear gloves and wash your hands well afterwards. Likewise, it's important to wash fruits and vegetables very carefully before eating them and avoid foods you're not sure about, such as garnishes on food platters.

Threatening or violent relationships

The incidence of domestic violence within relationships is thought to be vastly under-reported. Pregnancy is a time when it can peak, especially when the baby has not been planned, when parents are young and unsupported or there are additional stressors. Unemployment, homelessness, drug and alcohol abuse can all make violence worse.

If you, your unborn baby or other children, or even your pets are at risk, you need to get help. Contact support services in your area and speak with your midwife or doctor. Safe houses are usually available in cities and towns for women and children who are at risk. Think about developing a safety plan and establishing a safety network of trusted people who can help you if you need it.

For Australia: Call 1800RESPECT or 1800 737 732, a 24 hour national sexual assault, family and domestic violence counselling line for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault.

For New Zealand: Call Domestic Violence Crisis Line - 303 3939

Contact your local RSPCA for information on foster care for your animals.

Not Wearing Seatbelts

The safest way for a pregnant mother to travel when in a car, bus, plane or any other vehicle is to be restrained by an approved seat belt. Although it may feel uncomfortable, in the event of an accident a correctly applied seat belt could save your own, as well as your baby's life.