Tuesday, May 10, 2011

The controversy over EVERYTHING during pregnancy; tylenol, wine, highlights?

[caption id="attachment_245" align="alignleft" width="300" caption="No, this wasn't my beer. "][/caption]

~* written from my perspective; pregnant for the first time, nervous, and hormonal; take these posts with a grain of salt please *~
Written partly in early April, partly today May 10th, 2011.

It’s still really weird to call myself a mom; I can write it, but saying it out loud is hard and knowing I am responsible for someone is even harder and the responsibility starts during gestation by the choices you make.  So, now comes the gray area of every mom-to-be; how do you handle your pregnancy, how do you choose from all the conflicting advice and evidence even in the medical community regarding what is safe and not safe during pregnancy?   I think there are more gray areas during pregnancy then there are statistics showing actual evidence one way or another; here is what I mean.  Is it okay to take Tylenol or  Benadryl when needed or highlight your hair, what about having a glass of wine, or an albacore tuna sandwich, get a manicure/pedicure, drink herbal tea, take herbs, etc., etc., and the list goes on and on.  I am sure some of you said 'yes' and others said 'no' to each of these things. 

Once I found out I was pregnant, I bought a book written by two doctors, one of the reasons I bought this book was because it had lists of things, like medicine or food that you could and couldn’t have during pregnancy.  I showed this list to my family practitioner at my pregnancy consult, and she disagreed with several things on the list.  When I asked my midwives who are caring for me during pregnancy what they thought about the lists, they offered conflicting advice as well.   So, when the medical community doesn’t agree on tylenol, fish or wine, how are you, the newly pregnant person, supposed to make an informed decision?

Let me first say that I work in medicine, oncology specifically. I work as a cancer registrar and part of my job is collecting and analyzing trends in cancer.  For example:  Why is my hospital seeing more stage 4 colon cancer patients this year than in years prior?  Could it be because a new hospital opened down the street and more patients are going there for treatment; or because some insurance doesn’t cover colonoscopies for high risk patients every 5 years anymore, they moved it up to every 10 years; or because more people without insurance moved into the demographic area hence those patients without insurance get avoid getting checkups due to costs and come in for higher stage diseases, or because of the increased amounts of processed foods people eat regularly?    Well, the answer is yes to 3 out of 4 of those examples.   One of our physicians says that you can use statistics to prove anything.  I agree with that statement 100%.  My point is that I am not a newcomer to analyzing statistics and conclusions.

[caption id="attachment_247" align="alignright" width="300" caption="One of the many beers in The Florida Keys this winter "][/caption]

At first, I would ask friends what they would do, and I found that many friends erred on the side of caution; ‘when in doubt go without.’  If I didn’t get the answer I wanted from them, I would do some research and almost always found evidence that was conflicting.   Then I had to deal with whatever judgment people would make based on that decision.  This wasn’t working for me, I wanted to get highlights in my hair and I needed to take Tylenol to take the edge off the bad headaches I was getting.  I wondered who would to do the study on pregnant women who get or don’t get highlights in their hair; no-one; there are much more important things to study and so we don’t have an actual definitive answer.   Of note, I did ask my midwives about both the tylenol and highlights and she said both were OK during pregnancy.  (with limits of course)  Recently, I went out to lunch with friends and saw a tuna melt on the menu that sounded delicious, but it had albacore tuna in it; I asked a pregnant friend who said ‘don’t eat it, its bad for the baby, no mercury is good.’  So, I didn’t; but went home and looked online at the FDA’s website, and it said to limit albacore tuna to one 6oz meal per week; and I certainly hadn’t had any during my entire pregnancy at all, so the sandwich would have been totally fine.  Obviously, I should have used one of the many I-phones at the table to come to my own decision, but I didn’t want to be judged.

One friend said recently that we judge our pregnant women way too much during their pregnancy and she is right.  We judge women for eating the right things, drinking the glass of wine, highlighting our hair, we even judge women after they have the baby for breastfeeding or not, or breastfeeding in public, etc.  The list goes on.  But more and more I think people judge because they think they know all the answers.  But so many things are controversial that there isn’t solid evidence for much at all!

In the middle of writing this blog, I had an appointment for physical therapy.  My therapist is my age and has a 1.5 year old daughter; we have talked about the controversy over wine, back sleeping, eating seafood and more during pregnancy at length over the 3 year relationship.  She felt comfortable drinking wine throughout her pregnancy, stating the European Obstetric Community’s recommendations regarding alcohol, which basically says no more than 1 drink per night and no more than 4 drinks on a ‘binge.’  Europe, in fact, has a much lower infant/maternal mortality rates than the United States, meaning its much safer to be a pregnant mother in Europe than in the US.   My therapist today happened to have a student with her, he was a guy about my age, whose wife just happened to be pregnant and due in October, the same as me.  Without my persistence at all the three of us started discussing alcohol during pregnancy, the student stated that their OB and pediatrician said she could drink wine even nightly without harming the baby.  He had made the mistake of telling this to his mother, who said “Dr. Oz says you should just stay away from anything like alcohol”  to which he replied, “mom, Dr. Oz is a cardiologist, not an OB or pediatrician.”  He also mentioned they visited the Coors factory recently (a place I am very familiar with:) and even though his wife was drinking non alcoholic beer, she still had stares and glares from other people that made her feel uncomfortable.  Again, I go back to what my friend said, we judge our pregnant women way too much!

Another example for me was being sent to the ER 2 weeks ago for massive headaches by my midwife, the worry was a blood clot in my brain (I was having trouble seeing), the ER did an MRI of my brain (controversial during pregnancy) gave me a high dose of Benadryl to get me into the MRI machine due to my paralyzing fear of tight spaces,  (also controversial) and then shot me up with pain meds (more controversy) when they sent me home my head was spinning from the meds and they handed me a script for Percocet to take when needed.    I mentioned this to my sister, a nurse, who said I shouldn’t take Benadryl anymore and that she couldn’t believe they gave me pain meds.  So, what did this teach me?  If the medical community doesn’t have consistency, how are pregnant women or even society supposed to know what is right or wrong?

I am going to continue this topic in another blog post, there is so much to say on this subject and I would love to hear others opinions.


  1. We absolutely judge our pregnant women too much in this society! While I err on the side of caution, you also have to live your life. The occasional glass of wine or beer, tuna sandwich, tylenol, etc. isn't going to harm the baby (IMO). Great topic Jen!

  2. I ran my first half marathon at 12 weeks pregnant and couldn't believe the controversy on the internet about running. My OB was very supportive as were my friends and family. I think everyone is different and there is no way there can be enough research to definitively state whether things are actually harmful or not. Also, I haven't given up caffeine (though I did cut back) and I have no guilt over that.

  3. Noah read an article recently about how the infant mortality rate is measured in the U.S. compared to other countries. Apparently our rate is horribly because we could all miscarriages, or something like that. Other countries don't count miscarriages at all! So that huge bad statistic is kind of crap (but it's also "common knowledge").

  4. Erin, Infant mortality rate is defined as death after a baby is outside of the womb through 1 year of age. So, miscarriages, or early miscarriages are not counted in the stats. But what the article might have been saying (or trying not to say) is that more and more preterm babies are being born; we are scheduling c-sections, inducing mothers and not listening to the body of the mother. Those interventions create a higher infant mortality rate, as does the US pushing the envelope in fertility. Implanting numerous eggs into women, older women having children, etc. The bottom line is that pregnancy and childbirth is a natural process, the more money and medicine we put into births creates a higher mortality rate. And the dicey fertility doctors out there, pushing the boundaries of health in older women who want to conceive.
    In my line of work, oncology (cancer data), medicine and new technology work wonders in the setting of cancer; however, cancer is a disease; pregnancy is not. The more medicine and technology we throw at pregnancy/conception has not made pregnancy safer for women, but it has given many women the opportunity to have children that may otherwise have not. That doesn't make it safer for those who have normal pregnancy and births however.

  5. The studies comparing infant mortality and morbidity are flawed. You cannot compare such dissimilar systems. From diet, to exercise, to access to care, to defining mortality/morbidty...there are two few commonalities.

  6. And don't even get me STARTED on "Dr. Oz."

  7. Again, good, thoughtful post, Jen!