Pregnancy - risks
pregnancy; pregnant; risk; alcohol; smoking; caffeine; coffee; listeria; toxoplasma; toxoplasmosis; food; eating; miscarriage; stillbirth; SIDS; flying; fly; aeroplane; plane; travel; airline; liver; kangaroo; meat; smoke; cigarette; tobacco; listeriosis; mercury; fish ;
Contents
During your pregnancy it is very important to avoid some things that can harm your developing baby. Here are some of the risks in pregnancy that you need to be aware of.
With every pregnancy all women have a 3 to 5% chance of having a baby with a birth defect. Some behaviours, medicines and drugs increase this risk.
- Harm to a developing baby happens when a mother drinks large amounts of alcohol often.
- Health experts are not able to tell you what a safe level of alcohol is during pregnancy. Some harm may occur to some babies even when they are exposed to a small amount of alcohol but the risks are higher when more alcohol is drunk.
- When you drink alcohol it rapidly crosses the placenta into the baby and can act as a poison affecting your baby's brain.
- Babies affected by alcohol can be smaller at birth and have physical problems such as heart problems. They might also have problems with learning, speech, attention span and hyperactivity.
- It is best to avoid drinking alcohol during pregnancy as far as possible.
- See the topic 'Alcohol effects on unborn children' for more information.
"Courtesy of 'Tanberg and the Australian Medical Association'".
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It is best not to smoke during pregnancy. |
| Women who smoke during pregnancy are at least twice as likely to have a miscarriage as non-smokers, and their babies do not grow as well as babies who are not exposed to smoke before they are born. |
Problems that have been found to be caused by smoking are:
- lower birth weight of babies
- death of the baby before birth happens more often (miscarriage or stillbirth)
- sudden infant death syndrome (SIDS) happens more often (at least twice as often)
- babies have more breathing problems.
How is the developing baby affected?
The poisons in tobacco and tobacco smoke such as nicotine and carbon monoxide cross the placenta into the baby. These affect the oxygen supply to the baby. They can also affect how well blood can flow through the placenta, and affect how well the baby is fed. There may be some damage to the genes of the developing baby.
It's not easy to quit - but there is help
You have a better reason to quit smoking than at any other time in your life. There is help out there - in South Australia phone the QUIT Helpline on 131 848. The staff are helpful and supportive and understand that it is not easy to give up smoking.
Note for non-smoking partners
Non-smoking partners can make it more difficult for someone to quit smoking by not realising how hard it is to give up. Do not:
- yell at your partner about smoking
- 'police' her over her smoking
- use spy tactics - count cigarettes etc.
You can be supportive and encourage her to get in touch with help from an independent source which is more neutral. (See our topic 'Passive smoking')
- Caffeine is a stimulant found in many foods and beverages.
- Drinking high amounts of caffeine may make it more difficult to become pregnant and high levels may make miscarriage more likely.
- In humans, even large amounts of caffeine do not cause an increased risk of birth defects. However, it is best to limit the amount of caffeine that you drink each day.
- Caffeine containing drinks include coffee, tea and cola drinks.
- Too much caffeine affects your nervous system and can make you irritable, nervous and unable to sleep.
- Try to limit yourself to two weak cups of coffee or 4 cups of tea or a litre of cola drink each day. If your cola drink has extra caffeine (like some 'energy' drinks), drink even less than 1 cup (250mls).
- If you take any medicines regularly, talk about them with your doctor before you get pregnant if possible, or as soon as you know that you are pregnant.
- Only a few medicines have been proven to cause harm to developing babies, however many more have not yet been proven to be totally safe.
- Usually it will be better for your baby if you keep well by taking the medication you need, so it is very important that you continue to take medicines that you have been prescribed for conditions such as asthma, diabetes, depression, epilepsy and many other conditions unless your doctor advises you to stop or change your medication.
- Some medicines such as some acne treatments should be stopped well before you become pregnant.
The site 'Motherisk' (see below) has extensive information about this.
- Before you take any medicine, including herbal preparations, check with your pharmacist, midwife or doctor to find out if it is safe.
- Many products that are available from pharmacies, health food shops or even supermarkets may not be safe for a developing baby.
- For pain, paracetamol is safe, but other pain killers such as aspirin and ibuprofen should be avoided.
- Many cough and cold medicines, laxatives and herbal preparations should be avoided.
The site 'Motherisk' (see below) also has extensive information about this.
- Many drugs such as cocaine have been shown to have effects on the growth and development of an unborn child.
- Cocaine exposed babies have up to 5 times the rate of intellectual disability (problems with thinking and learning) compared to babies that were not exposed to cocaine.
- Using cannabis during pregnancy may cause problems for a developing baby. More of these children seem to have learning or behaviour problems when they are older.
Some foods are not always safe during pregnancy especially those which can lead to listeriosis and toxoplasmosis (conditions which can affect the unborn baby).
Liver
On the whole, any foods that are bought fresh, stored safely and well cooked are safe in pregnancy, and this includes liver.
- However liver pate is a particular problem because of the extensive processing it goes through, which gives lots of opportunities for contamination and growth of bugs.
- If you buy a fresh liver from a reputable butcher, cook it well and eat it straight away, this should be fine.
- You can even make your own pate, as long as it is eaten within a few hours.
Kangaroo meat
- Kangaroo meat, like any other meat, should be well cooked, ie. not too rare, for safety in pregnancy.
- Listeriosis is an infection which may cause a flu like illness, but most people with the infection are not sick at all.
- Listeriosis can harm an unborn baby, causing an increase in miscarrages and stillbirth. This is a rare problem, but the risk can be made even lower if you take care with the food that you eat.
- Listeria bacteria may come from eating foods which contain the germ such as dairy products (especially soft cheeses and unpasteurised milk), unwashed fruit and vegetables, pre-packaged salads, raw meat, processed meats (including pates), smoked seafood, and smoked shellfish.
- There is no need to avoid hard cheeses, cream cheese, cottage cheese or yoghurt.
- Wash fruit and vegetables well. Freshly made salads are safer than ones that have been made ahead of time.
- Thoroughly cook raw meat, and keep uncooked meat away from vegetables and cooked foods.
See the topic 'Listeriosis' for more information.
Toxoplasmosis is another infection that can harm an unborn baby, but effects from toxoplasmosis are rare.
- Most people who get toxoplasmosis get it from raw or undercooked meat.
- Although cats have been thought to have been another source of the infection, recent research has suggested that they are not the main source. We still advise pregnant women to avoid young cats and handling kitty litter.
- To reduce the risks:
- Do not eat or handle raw meat. If you do need to handle raw meat use plastic gloves if possible, wash hands with soap and warm water, and wash tools and cutting boards very well in hot water afterwards.
- Fully cook all meat eaten (meat cooked until it is no longer pink inside should be hot enough to kill the parasites). Freezing meat also kills the parasite.
- Wash fruit and vegetables if they could have soil on them.
- Wear gloves when you do any gardening or anything outside that involves handling soil, and wash hands very well afterwards. (Cats and other animals may have used the soft soil or sand for a toilet).
- See the topic 'Toxoplasmosis' for more information.
Mercury in fish
High levels of mercury in a pregnant mother's diet can harm the brain of a developing child. The following information is advice for Australian women only. Mercury levels in fish in other regions may be higher.
- Mercury occurs naturally in the environment, and it accumulates in the aquatic food chain, including in fish. All fish contain some mercury, and for most people, fish is their main source of mercury.
- The level of mercury in most fish is very low, but in large, long living fish (which eat a lot of other fish), their levels will rise during their lifetime. These fish include billfish (swordfish, broadbill and marlin), shark (flake), orange roughy and catfish.
- There are several nutritional benefits from eating fish, such as:
- fish is an excellent source of protein and is rich in important vitamins and minerals such as vitamin D and iodine
- fish is high in unsaturated fat and omega 3 fatty acids.
- Food Standards Australia and New Zealand (FSANZ) recommend that pregnant women continue to eat a variety of fish 2 or 3 times a week, but limit their intake of the fish listed above. FSANZ advises that if pregnant women want to eat these fish:
- They should limit their intake of shark (flake), broadbill, marlin and swordfish to no more than one serve per fortnight with no other fish eaten during that fortnight.
- For orange roughy (also sold as sea perch), the advice is to eat no more than one serve per week, with no other fish eaten in that week.
- Canned tuna has very low levels of mercury because smaller and younger fish are used.
- Very little mercury passes into breastmilk, so the risk to a breastfeeding baby is much lower than to an unborn baby, but mothers may still prefer to limit the amount they eat of fish that have higher levels of mercury.
For more information have a look at Food Standards Australia New Zealand 'Mercury in fish'.
Pregnancy and flying
While in general it is quite safe for a pregnant woman and her unborn baby to travel on commercial planes, it is still important to discuss this with your doctor and with the airline. Airlines can have different policies. One recommendation is that women do not travel on International flights after 32 weeks of their pregnancy, or on local flights after 36 weeks, however other carriers may accept an expectant woman up to 39 weeks.
For a healthy woman, the drop in air pressure, which is normal during a flight, will cause very little risk to the unborn baby, but if the mother is anaemic the drop in oxygen to the baby might be a problem. Both pregnancy and sitting still can increase the risks of blood clots in the legs. Pregnant women are advised to:
- wear support stockings
- walk regularly during the flight (about half hourly)
- flex and extend their ankles frequently
- have plenty to drink (water not alcohol).
Check with your doctor to see if is safe for you in particular to travel by air, and get a letter from your doctor which includes the date that your baby is due. Check also with your airline before you book to find out their policy and also find out what papers you will need for them to accept you as a passenger.
Pregancy and hair treatments
- There are very few studies of hair dye use during human pregnancy.
- In animal studies, at doses 100 times higher than what would normally be used in human application, no significant changes were seen in development of the fetus.
- We know that only a small amount of any product applied to your scalp is actually absorbed into your system and therefore, little would be available to get to the developing baby.
- In addition, many women have dyed their hair during pregnancy with no known reports of negative outcomes.
This information, in combination with the minimal absorption through the skin makes hair treatment in pregnancy unlikely to be of concern.
Food Standards Australia and New Zealand Food Authority. 'Listeria and food':
http://www.foodstandards.gov.au/_srcfiles/Listeria.pdf
Food Standards Australia and New Zealand 'Mercury in fish'. December 2004:
Fact sheet
Gideon Koren, 'Caffeine during pregnancy? In moderation', Canadian Family Physician 2000, 46: 801-3.
http://www.cfpc.ca/cfp/2000/vol46-2000-pdfs/apr00%20pdfs/vol46_apr00_clinchal_1.pdf
Organization of Teratology Information Services - Fact Sheets
- 'Caffeine and pregnancy':
http://otispregnancy.org/pdf/listeriosis.pdf
- 'Hair treatments and pregnancy'
http://www.otispregnancy.org/pdf/hair_treatments.pdf
- 'Listeriosis and pregnancy':
http://otispregnancy.org/pdf/caffeine.pdf
Women's and Children's Hospital Pharmacy Department (South Australia). 'Drugs in Pregnancy and Lactation'.
Women's Health Information. 'Infections during pregnancy':
www.womens-health.co.uk/infect.htm
Yagev Y, Koren G 'Eating fish during pregnancy' Canadian Family Physician, 2002; 48; 1619-21 (published on the 'Motherisk' web site):
http://www.motherisk.org/index.jsp
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
This topic may use 'he' and 'she' in turn - please change to suit your
child's sex.