Pregnancy: Is It Safe?

I will be the first to admit that pregnancy safety can be difficult to discuss with just the right balance. On one hand, no one wants to stress out an expecting mom, causing her to worry about every single thing that she eats, breathes, and puts on to her skin; and truthfully, the individual risks of eating a cold deli sandwich or using a face cream with salicylic acid are probably very low.

On the other hand, this is not your mother’s pregnancy. Today, moms-to-be have to be the EPA, USDA, and FDA, as the laws that regulate over 80,000 new and existing chemicals in our environment are ineffective and out of date. Note: The primary law for chemical safety, the Toxic Substances Control Act (TSCA), called toss-ka by people in the know, was passed in 1976. It provides the U.S. Environmental Protection Agency (EPA) authority to regulate new and existing chemicals used in commerce. When TSCA was enacted, all existing chemicals were grandfathered into the system and considered safe for use.

What does this mean for an expecting couple? It is my opinion that current legislation, government programs and food labels are not protecting your unborn child (rates of autism, asthma, food allergies, etc. are not decreasing), and who knows what these chemicals are doing in combination with one another?  

Over time, we have learned that toxins do pass through the umbilical cord during pregnancy. Just as nutrients and fluids from a mother’s body are transported to baby, everything else from the environment flows there too. In a 2004 umbilical cord study, doctors found a total of 287 industrial chemicals circulating through the bodies of newborn babies (through analysis of cord blood), including mercury, fire retardants, and pesticides. Of the 287 chemicals, 217 were known to be toxic to the brain and nervous system, 180 were identified as cancer-causing, and 208 were cause for birth defects or abnormal results in animal testing.11

Adults have tight connections between their blood, brain, and cerebrospinal fluid (CSF). This is called the blood-brain barrier. However, embryos and newborns have immature, permeable, and “leaky” connecting points, making them critically susceptible to drugs, toxins, and chemicals in the environment.

Why Babies are so Vulnerable to Toxins

Babies and young children, whether in the womb or swaddled in a blanket, are not little adults. Adults have tight connections between their blood, brain, and cerebrospinal fluid (CSF). This is called the blood-brain barrier. However, embryos and newborns have immature, permeable, and “leaky” connecting points, making them critically susceptible to drugs, toxins, and chemicals in the environment. These chemicals can disrupt and alter the way our genes work together, causing developmental defects.12 This vulnerable group also does not have the ability to metabolize, detoxify, and get rid of toxins, as an adult does, because the kidney and liver systems are still developing throughout gestation and after birth.

Doubts about Pregnancy Safety

Early in my first pregnancy, I knew that certain foods and chemicals were bad or off-limits, but I didn’t really understand the potential long-term consequences of my choices. Others new to the pregnancy scene may have similar doubts or misgivings, such as:

  1. I wasn’t planning on smoking or drinking whiskey, but aren’t modern parents a little bit too paranoid about pregnancy dos and don’ts?
  2. I don’t want to be one of those over zealous helicopter parents. I had a childhood full of unsafe things, and we turned out okay.
  3. I was born into a world full of chemicals, and my doctor says that I’m healthy.
  4. Haven’t they already done away with DDT, lead, and all the really bad stuff?
  5. My obstetrician hasn’t said very much about environmental toxins.
  6. Isn’t baby wrapped up in a protective bubble called the placenta anyway?

After nearly six years researching these topics, I want to share a few things with you as a mom.

  1. Protecting your unborn child from environmental toxins, infections, and diseases should never be confused with paranoia. If someone wants to makes fun of you for being cautious, then so be it. Decisions that you make during pregnancy can have lifetime consequences for your child.
  2. Being over-protective of your body while pregnant should not be confused with an over-protective parenting style, such as helicopter parenting. The globalization of food production and the manufacturing of goods that has occurred in the last 10-15 years requires parents to think twice about the food they eat and the products they buy. You’ll have plenty of time to worry about over-parenting later.
  3. The world has changed since you were in utero. Due to extraordinarily low production costs in China and other countries, it is cheaper for food to be grown and goods to be shipped halfway around the world than to be grown or made down the street. That’s why a toddler in the middle of Washington State is likely to be sipping on a juice box with apples from China (85% of apple juice in the U.S. is imported with the vast majority from China). That’s why half of the fresh fruit Americans eat comes from outside the country, too. The problem is that a developing fetus or young child cannot process the pesticides and preservatives used on those foods, as adults do, and the developing brain and nervous system are particularly vulnerable.
  4. DDT, lead, and other chemicals may have been banned for certain uses in the U.S. However, these substances still linger in the water, soil, and older buildings, and they are readily used overseas. For example, DDT is used today to fight malaria in tropical areas, while paint with higher levels of lead is one-third the cost of paint with lower levels of lead in China. Search “lead paint recalls” to see just how prevalent this neurotoxin is in favorite toys and children’s products on the shelves today.13
  5. Your obstetrician has probably not discussed a long list of environmental toxins with you for various complicated reasons. Based on a survey examining the subject, she is likely to be limited on time. She may also sense that you are already anxious, and she does not want to cause more anxiety, especially with questions she is not prepared to answer due to uncertainty about the evidence. She likely wants to discuss environmental health more openly with her patients, but does not have extra time to dig into the research. She also tacitly worries what might happen if she starts the conversation about toxins with all of her patients. 14
  6. Not too long ago, scientists thought that the placenta shielded a baby from toxins like a big invincible bubble (the placenta is a blood-filled structure that attaches to the wall of the uterus, while the umbilical cord arises from it and attaches to baby.) Today, we know that alcohol, caffeine, nicotine, medications, and most toxic metals have the ability to readily cross the placenta, enter the fetal bloodstream, and harm unborn babies.15

In light of loose regulation of toxins used in our food and everyday products and a pandemic of chemicals linked to autism, attention-deficit hyperactivity disorder (ADHD), dyslexia, diabetes, cancers, and other childhood diseases, I recommend a conservative approach to safety in pregnancy. “If there is a doubt, there is no doubt.”

“Is It Safe?”

Alcohol

  • No. The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) agree that pregnant women should avoid alcohol.
    • If teetotaling is not possible, try a few occasional sips of wine. Bottom line: Don’t waste your time and energy quarreling over whether sips, or even a small glass of wine, will hurt your baby. The underlying issue is that if a respected syndicate of physicians, such as ACOG or AAP, gave the green-light to “very seldom sips of alcohol,” it would likely lead to more ingestion.
  • What if I drank a small amount of alcohol before I knew I was pregnant?
    • Although it is true that no amount of alcohol use is safe during pregnancy, serious harm from this kind of use is unlikely. The important thing is to not drink any alcohol for the rest of the pregnancy.

Drinking alcohol during pregnancy is a leading cause of birth defects. Alcohol can harm a fetus throughout pregnancy. Even moderate alcohol use during pregnancy can cause lifelong problems with a child’s learning and behavior.

Coffee/Caffeine

  • Limit to one cup per day or less than 200 mg of caffeine, including coffee, tea, soda and chocolate. ACOG maintains that moderate caffeine use of less than 200 mg per day and miscarriage are not linked.16
  • Calibrate your cup. Not all brews are the same.
    • Starbucks venti 20 oz. cup has 415 mg.
    • Starbucks grande 16 oz. cup has 330 mg.
    • Starbucks tall 12 oz. cup has 260 mg.
    • 20-oz. bottle of Diet Coke has 78 mg.
    • 8-oz. cup of black tea has 40 mg.
  • Consider cutting out caffeine altogether.
    • A study of 60,000 pregnancies in Sweden found that babies’ birth weight decreased 21 to 28 grams and gestation period lengthened by five hours for every 100 mg of caffeine consumed per day.17

Unpasteurized or Fresh-squeezed Juice

  • Do not drink fresh-squeezed juices from restaurants, juice bars, or farm stands. This seems counter-intuitive at first, but fresh juices are not pasteurized to protect against harmful bacteria, such as salmonella and E. coli. Bacterial infections can cause serious illness in those with weakened immune systems, such as pregnant women, the elderly, and young children.18

Sushi

  • Do not eat raw sushi or shellfish, which can harbor parasites or bacteria. You can eat cooked sushi or vegetarian rolls; however, stick to cooked seafood low in mercury, such as wild salmon and occasional shrimp. The tuna used in sushi tends to be very high in mercury.4

Fish

Here’s the dilemma that every pregnant woman must face.

  • If you eat too much of the wrong kind of fish, you may end up exposing your unborn baby to excess mercury, a toxin known to impair fetal brain development.
  • If you eat too little fish, you might deprive him or her of omega-3 fatty acids, which are highly beneficial to brain development and fetal growth.

The American College of Obstetricians and Gynecologists
(ACOG) encourages pregnant women, women who may become pregnant, and breastfeeding mothers to follow the FDA and EPA’s revised advice to:


1) Eat 2-3 servings a week (8 to 12 ounces in total) of a variety of fish (See below – Best Choices);


2) Eat only 1 serving a week (no more than 6 ounces) of some fish, such as albacore (white) tuna and fish with similar mercury concentrations to albacore (white) tuna (See below – Good Choices);

3) Avoid certain fish with the highest mercury concentrations: shark, swordfish, king mackerel, marlin, fresh tuna (bigeye, ahi), tilefish, orange roughy, and fish from contaminated waters. (See below – Choices to Avoid)


Check for advisories for fish caught by family and friends and where no advisories exist, limit eating those fish to one serving a week and do not eat other fish that week.

For a printable, wallet-sized reference card for eating low-mercury fish, visit The Natural Resources Defense Council link at http://www.nrdc.org/health/effects/mercury/walletcard.pdf.

Fish: A More Conservative Approach

Consumer Reports issued guidance a few years ago for light canned tuna, indicating that while this fish is generally safe, occasional spikes of high levels of mercury have led the non-profit to advise women to skip all canned tuna throughout their pregnancy. After pregnancy, canned light tuna is the better, lower-mercury choice. Canned albacore/white and yellowfin tuna are higher in mercury, but still okay to eat in limited servings. If still in doubt, look for the Safe Catch brand for mercury-tested canned tuna and seafood. Note: Canned tuna is the second most popular seafood in the U.S. (shrimp is first) and is responsible for about 37 percent of the dietary mercury exposure. Canned albacore accounts for almost 20 percent of that.

Overall, Consumer Reports recommends focusing on the 17 fish that are lowest in mercury (see below), which is more conservative than than the government guidelines.

Did You Know?

That Sounds Fishy!

Today, more than 90% of our fish is imported, yet less than 1% is tested for fraud, such as mislabeling and fish substitution. Between 2010 and 2012, the ocean environmental group Oceana conducted one of the largest seafood fraud investigations to date, collecting over 1200 samples in 21 states. DNA testing found that one-third of the U.S. samples were mislabeled: grocery stores mislabeled 18% of samples, restaurants 38%, and sushi venues had a 74% fraud rate. Substitution of seafood is particularly alarming for pregnant women, since tilefish and other species on the “FDA Do Not Eat” list were labeled and sold as halibut and other “Safer to Eat” fish. Bottom line: Avoid eating fish from questionable sushi venues and unknown markets. Stick to seafood found in reputable national chains, such as Whole Foods, or trusted mom-and-pop fish markets with whole fish, which are more difficult to swap.19

Cheese

Due to a suppressed immune system and other factors, pregnant women are 20 times more likely to contract listeriosis, a bacterial, food-borne illness from eating unpasteurized soft cheeses, unpasteurized dairy products, hotdogs, and lunch meats unless cooked.20

  • Safely eat: Most cheese sold in the U.S., including soft cheeses, are made from pasteurized milk (mozzarella, cottage cheese, cheddar, etc.). The pasteurization process kills the listeria organism.
  • Do not eat: Imported soft cheese or cheese from raw milk, such as Brie, Camembert, Greek Feta, Montrachet, Neufchatel, goat, and queso fresco, may contain listeria. Listeria can also be found in unpasteurized semi-soft cheeses, such as blue, Asiago, Gorgonzola, Havarti, Muenster, and Roquefort.

Hot Dogs and Deli Meats

  • Thoroughly cook hot dogs or deli meats, or heat to a steaming hot temperature in a microwave, to avoid listeria and other pathogens. This means that if your Costco hot dog just came out of the steamer, it should probably be okay for listeria. A Kirkland Signature hot dog does contain 20% of your daily salt intake and sodium nitrite.
  • Avoid nitrates and nitrites. Nitrate is used in inorganic fertilizers, and sodium nitrite is a food preservative found in cured meats, such as ham, bacon, and hot dogs. When cooked with high heat or broken down in the stomach, nitrites form nitrosamines, which cause cancer. Particularly vulnerable groups to nitrates and nitrites are pregnant women and young children.21-23

Pâté or Meat Spreads

  • Do not eat pâté or refrigerated meat spreads to minimize risk of listeria.

Raw Eggs

  • Do not eat raw eggs in cookie dough, batter, homemade Caesar dressing, and homemade desserts, including tiramisu, mousse, and meringue, if you want to be completely safe from salmonella.

Peanuts

There is a good reason for the confusion on this issue. The American Academy of Pediatrics (AAP) flip-flopped its position on eating peanuts during pregnancy in recent years. In 2000, the AAP warned that pregnant women should not eat peanuts or tree nuts while pregnant. In 2008, the group reversed its position, explaining there is not enough evidence to prove that avoiding peanuts and other allergenic food products while pregnant reduces allergies, eczema, and asthma. A 2014 study supports the claim that early allergen exposure (eating peanuts while pregnant) increases tolerance and lowers risk of childhood allergy.24

  • Talk to your doctor about eating peanuts, especially if food allergies are prevalent in your family.

Leftovers

  • Heat leftovers until steaming to kill bacteria. Do not ask for a doggie bag at a restaurant, unless you know that you’re heading straight home.

Artificial Sweeteners

  • Choose foods and beverages without artificial sweeteners. While there isn’t clear evidence linking artificial sweeteners and pregnancy, artificial sweeteners, including saccharin (Sweet ‘N Low), aspartame (Nutrasweet, Equal), sucralose (Splenda), and stevia (Truvia), prime the body for sweet tastes, promoting the consumption of more sweets to satisfy cravings. Opt for water, seltzer, or milk instead.
    • Note: To further clarify the “artificial” nature of these sweeteners, saccharin is derived from coal tar, aspartame is made from methanol and converts to formaldehyde after digestion, sucralose is chlorinated sugar, and even stevia often requires unnatural agents to reduce its bitter taste. Greater consumer awareness of these sweeteners may explain why diet soda sales are in freefall.

Exercise and Pregnancy

  • Exercises to do: Swimming, walking outdoors or on a treadmill, cycling on a stationary bike, pregnancy yoga, pregnancy calisthenics, and stretching routines. Stretching on all fours will relieve back pain and pressure, especially during your third trimester.7
  • Exercises to avoid: Waterskiing, diving/jumping into pools, horseback riding, downhill skiing, cross-country skiing >10,000 feet, scuba diving, bicycling on wet pavement or downhill paths (where a fall is likely), sprinting, or any high impact sports that could cause injury to mom or baby.
  • Jogging: Jogging is typically permitted with your doctor’s approval, as long as you are not a high risk pregnancy, such as preeclampsia, placenta previa, bleeding, etc. It is generally recommended that you keep the distance to under two miles per day on level terrain.
  • Mountain Biking: It depends. A benign trail ride may be okay early in pregnancy, but avoid bumpy, downhill rides with a risk of falling.
  • Weightlifting: Low impact weight training can be a great way to stay fit during pregnancy. However, most doctors recommend that you use lighter weights (5-10 pounds). You may not want to lift while lying flat on your back, as your uterus rests on the vena cava, restricting blood flow.

Practical Tips from Real Parents: Exercise

  • Prepare for labor and delivery like you are working up to a big race or big game, and you may be pleasantly surprised how your body reacts. I did this to better prepare for my second birth after the first one kicked my tail.
  • My favorite pregnancy exercise was to take my phone outside and do laps around the neighborhood while talking to friends and family. Stay close to home, though, because you may need to make a pit stop.
  • Prenatal yoga is the best pregnancy exercise. It helps you stretch, focus, de-stress, and prepare for labor. This is a good time to try yoga for the first time, too, because you don’t have to deal with snooty or super skinny yogis.

Air Travel

Flying is generally considered safe before 36 weeks, if you have a healthy pregnancy. “No later than” flying rules vary from airline to airline, and some domestic and international carriers require a doctor’s certificate or medical clearance between 25 and 35 weeks. Talk to your doctor before traveling.

When you fly,

  • Check your airline’s policies for pregnant women.
  • Ask for a “pat down” through airport security, especially if you travel frequently or have doubts about scanners.
    • TSA claims that x-ray machines and body scanners are safe for pregnant women since the kind of radiation you are exposed to doesn’t penetrate the body very much. However, there is no guarantee against machine malfunctions, and there is a safer alternative.
  • Choose an aisle seat to facilitate frequent bathroom visits. Buckle the seat belt below your abdomen.
  • Wear loose clothing and avoid tight pants. Stand and stretch often. Take walks up and down the aisle.
  • Drink lots of water. Spending hours in a low humidity cabin without fluid intake is a recipe for dehydration.
  • Program your doctor or midwife’s phone number into your cell phone, just in case. Make a contingency plan for obstetric care at your destination.

Seat Belts

  • Always wear a seat belt. Put the lap strap under your belly and across the hips. The shoulder strap should go between your breasts and to the side of your belly.

X-Rays

  • Tell your doctor and dentist that you are pregnant, even if it is obvious, and avoid all routine x-rays for dental and diagnostic work.

Smoking and Secondhand Smoke

  • Smoking: Most people know that smoking causes cancer, lung disease, heart disease, and other major health problems. Smoking while pregnant adds to the list, potentially causing miscarriage, problems with the placenta, prematurity, increased risk for Sudden Infant Death Syndrome (SIDS), and increased risk for birth defects, such as a cleft palate or cleft lip.25
  • Secondhand smoke: Secondhand smoke contains over 7000 chemicals. Hundreds of these chemicals are toxic, and roughly 70 are believed to cause cancer. One study shows that women exposed to secondhand tobacco smoke have an increased risk for adverse pregnancy outcomes, including stillbirth, miscarriage, and ectopic pregnancy.25, 26

Medications (talk to your doctor before taking any medications)

Rule of thumb: do not to take any medications, prescription or OTC, unless you absolutely have to take them to stay healthy during pregnancy with a doctor’s approval. Some medications may be required to prevent harm to you and your baby (i.e., for epilepsy, asthma, high blood pressure, etc.). For some women, OTC or prescription medications may be required to treat infections during pregnancy, such as a yeast infection, urinary tract infection, or sexually transmitted disease.27

  • Acetaminophen (Tylenol) is generally the preferred OTC pain reliever during pregnancy; although, two separate studies in 2014 (one aggregating over 64,000 pregnancies) linked acetaminophen use during pregnancy with ADHD and other behavioral disorders.28, 29
  • Talk to your doctor about medicines for cold and flu symptoms.
  • Continue allergy shots with your doctor’s approval, but do not begin new medications.

Household Cleaning Products

  • Go green! Phase out toxic cleaners. Make sure there is good ventilation in your cleaning area and wear gloves to protect your skin. Avoid mixing chemicals, such as ammonia and bleach, which can produce toxic fumes.

Household Herbicides, Insecticides, and Pesticides

  • Buy organic foods in key food groups, wash food thoroughly, and avoid using chemical sprays to kill insects and rodents inside and outside of your home.30
  • Take your shoes off when you enter your home. Place a shoe rack by the door.
  • Avoid common household weed killers, such as Monsanto’s Roundup.

Glyphosate

Monsanto’s glyphosate-containing herbicide, RoundUp, has been making headlines, due to with its underestimated toxicity.31 RoundUp is a common household weed killer and the most widely used herbicide on wheat and soy crops in the U.S. Farmers use RoundUp not only to kill weeds but also to speed up the dry down process for wheat, such as reaching 20% moisture for harvest. Glyphosate has been strongly linked to birth defects and non-Hodgkin’s lymphoma, in addition to other diseases. Levels of glyphosate are now ten times higher versus decades ago, due to GMO, herbicide-resistant crops.32

Eat organic or non-GMO foods to minimize exposure to glyphosate.

Changing the Cat’s Litter Box (or gardening in soil with cat feces)

  • Have someone else change the litter box, and keep your cat indoors. Cats can become infected with toxoplasmosis as they ingest infected insects, birds, and rodents. Cats transmit this parasitic infection through their feces, which can cause birth defects, especially if contracted in the early stages of pregnancy. Also, garden with gloves if there is a chance of contacting cat feces in the soil.

Skin Care and Skin Care Products

  • Know that topical ingredients do get absorbed into the bloodstream. Agents or creams that injure the thick, outer layer of skin called the stratum corneum, such as strong acids, are absorbed quickly and more readily.
  • Avoid Retin-A/Retinol/retinoids (found in ROC Retinol Correxion, L’Oreal Revitalift, Neutrogena Age Intensives, and Oil of Olay Pro-x), tetracycline, and products containing salicylic acid and beta hydroxy acid/BHA (most OTC acne washes and creams).
  • Avoid prescription acne medications, similar to Accutane (the generic name is isotretinoin, sold under the trade names Amnesteem, Claravis, and Sotret).

Facials

  • Avoid Botox and spa facials that use unknown chemical ingredients, or peeling agents such as glycolic acid.

Manicures and Pedicures

  • Bring your own instruments from home if you are serious about reducing infection risk.
  • Ask your technician to be gentle or skip these altogether if you are worried about contracting nail fungus, especially with pregnancy pedicures. Pregnancy conditions–such as restricted blood flow to the feet, a suppressed immune system, and increased nail bed damage caused by swollen feet stuffed into small shoes–increase vulnerability to fungus.

Coloring Your Hair

  • While the American College of Obstetricians and Gynecologists (ACOG) suggests that minimal hair coloring during pregnancy is probably okay (only small amounts of dye are absorbed through the skin), schedule color appointments after your first trimester. If you must color, consider getting highlights, as opposed to full color, to reduce overall chemical exposure. If you are worried about salon chemicals, but early stray grays are driving you crazy, try a henna-based hair dye found in natural stores.2

Hot Tubs and Saunas

  • Avoid hot tubs and saunas while pregnant. Studies show that water >105°F can be damaging to developing cells and embryos. A study of over 1,000 pregnant women in California showed a twofold increased risk of miscarriage associated with the use of a hot tub or whirlpool bath after conception.33

Hot Baths

  • Keep bath water to < 100°F, or around your own body temperature. Avoid baths that raise your body temperature above 102-103 degrees.

Massage

  • Request a masseuse trained in prenatal massage, and ask for a special maternity table. If a table is not available, make sure that you are propped up on your left side for circulation.

Alcohol-based Hand Sanitizers

  • Prioritize washing hands with soap and water over hand sanitizers. The use of alcohol-based sanitizers has been questioned for pregnant women since alcohol may be absorbed through the skin. If used sparingly, this should not add up to detectable amounts.

Triclosan/Anti-bacterial Soaps

  • Be cautious using too many anti-bacterial soaps and toothpastes with triclosan. Not only is triclosan linked with bacterial resistance to antibiotics, but FDA is also reviewing triclosan for possibly altering endocrine function, hindering an enzyme linked to the metabolism of estrogen. Estrogen plays a critical role in fetal brain development and gene regulation.34

Scented Feminine Hygiene Products and Douches

  • Avoid douching, feminine sprays, and scented sanitary napkins because they can irritate the vagina and increase the risk of urinary tract or yeast infections.

Thong Underwear

  • Buy cotton underwear that you feel good in and skip the thongs (cue in Sisqó). Thong underwear is linked to a higher risk of urinary tract infections and bacterial vaginosis, and thongs can also irritate hemorrhoids. If you must wear thongs, try a cotton maternity variety and sleep in regular underwear. If you are prone to yeast infections, stick with moisture-absorbing cotton.

Sleep Position

  • Try to sleep on your left side to maximize blood flow, and avoid sleeping on your back after four months. Back-sleeping causes your uterus to press against your inferior vena cava, which returns blood from your lower body to the heart. The constriction can lower blood pressure and cause hemorrhoids, varicose veins, and swelling in the feet and ankles. If you wake up “feeling tingly,” simply roll over to your left side.35

Practical Tips from Real Parents: Sleeping While Pregnant

  • I had crazy insomnia while I was pregnant, all three trimesters. I would immediately get up to check work emails, or watch Netflix on my iPad, when I should have been listening to soothing music or doing something calming. Try your best to relax and get rest at night.
  • Getting up to go to the bathroom several times each night is really annoying. Try to cut back on liquids in the evening, and make sure the path to the bathroom is clear before you go to bed.
  • I could not have survived without my Snoogle! My husband was less than thrilled to haul that giant thing with us on vacation, but it kept me comfortable.
  • Eat your larger meal in the middle of the day, or else expect heartburn to keep you up at night.
  • Stretch before you go to bed if leg cramps are waking you.
  • You may want to wear a thin maxi pad to bed, especially in the third trimester. Every time I rolled over my belly pushed on my bladder.

Vaccinations

For pregnant women

Diseases such as rubella and German measles present serious risks to a fetus in the first trimester, and, ideally, women should be up to date with vaccinations prior to becoming pregnant.36  Also, a flu shot may protect your baby after birth. In a 2011 study, babies with mothers who had a flu shot while pregnant were nearly 50% less like to be hospitalized for a flu as infants than babies whose mothers were unvaccinated. 37 If you get the flu shot, be sure to request the shot, not the nasal spray, which is a live virus and not appropriate for pregnant women. 

Environmental Toxins Suspected of Causing Autism and Learning Disabilities

  • Lead
  • Methylmercury
  • Organophosphate pesticides
  • Organochlorine pesticides
  • Endocrine disruptors (ECDs), such as Phthalates and Bisphenol A (BPA)
  • Polychlorinated biphenyls (PCBs) or pre-1979 industrial chemicals
  • Automotive exhaust
  • Polycyclic aromatic hydrocarbons (PAH) or fossil fuel products
  • Brominated flame retardants (polybrominated diphenyl ethers, or PBDEs)
  • Perfluorinated compounds (PFCs) or Teflon and Scotchgard
  • Arsenic
  • Toluene
  • Manganese
  • Fluoride
  • Tetrachloroethylene or dry-cleaning chemicals

How to minimize exposure

  • Lead: have your pre-1978 home tested for lead, watch for chipping paint in older homes, don’t remodel while pregnant, filter your water
  • Mercury: eat fish and seafood low in mercury
  • Pesticides and insecticides: eat organic foods (prioritize The Dirty Dozen fruits and vegetables for buying organic to reduce up to 80% of pesticide exposure), wash fruits and vegetables under running water, scrub with a brush, minimize household weed killers and insect sprays, be mindful if you are living near a golf course, farm, or public space that is frequently sprayed with pesticides.
  • BPA: skip canned goods from the grocery store if not labeled BPA-free, use BPA-free plastics, limit drinking bottled water (Note: you can research which brands and which canned or bottled foods are packaged with BPA. For example, here is Trader Joe’s list of BPA-free canned goods and those packaged with BPA. Acidic foods, such as canned tomatoes and mandarin oranges, are likely to have BPA in the lining.)
  • Phthalates/Vinyl/PVC-plastics: drink from stainless steel or glass water bottles, use glass to heat and re-heat food, be plastics aware: lose #3, 6, and 7 plastics and choose #2, 4 and 5 plastics. Choose fragrance-free products (avoid the ingredient “fragrance” or synthetic fragrances/phthalates in cleaners, detergents, and personal care products.)
  • Brominated fire retardants/ polybrominated diphenyl ethers (PBDEs): throw away ripped items or replace decaying or crumbling furniture with foam padding inside (especially pre-2005), watch for PBDE dust when pulling up old carpet (PBDEs are found in the foam padding beneath carpets), don’t buy baby gear, mattresses, and household products coated in fire retardants
  • Polychlorinated biphenyls (PCBs): avoid eating fish skins and animal fat, eat wild salmon (not farmed); Catfish, buffalo, and carp usually have the highest PCB levels among freshwater bottom-feeding fish
  • Arsenic: get your water tested if you drink from a well, if you live near metal smelters where metal is made, or if you live near a garbage incinerator
  • Toluene: avoid inhaling or sniffing paint, paint thinners, gasoline, rubber cement, nail polish, and other solvents; if you smell fumes, leave the room
  • Manganese: check your well water for manganese levels, filter your water, do not feed baby soy or rice milk beverages in place of infant formula
  • Perfluorinated compounds (Teflon): keep heat at medium or below for non-stick cookware; opt for iron or stainless steel pots and pans, if possible
  • Toxic household cleaners: mix your own cleaning ingredients or use green cleaning products
  • Other chemicals brought into the home: use a door mat, take shoes off with a shoe organizer by the door, use a high-efficiency particulate air (HEPA) filter vacuum cleaner, dust with a wet cloth, use sticky pads and crumb cleanup for critters and not indoor sprays

For more information, read:

Exposure to Specific Toxins and Nutrients During Late Pregnancy and Early Life Correlated With Autism Risk: Mount Sinai study uses a unique source—baby teeth—to reveal that both the timing and amount of exposure can affect diagnosis

Source: Mercola.com Top Toxins to Avoid If You’re Pregnant

Sources

11.       Greene, A.R., Raising baby green : the earth-friendly guide to pregnancy, childbirth, and baby care. 1st ed. 2007, San Francisco: Jossey-Bass.

12.       Saunders, N.R., S.A. Liddelow, and K.M. Dziegielewska, Barrier mechanisms in the developing brain. Front Pharmacol, 2012. 3.

13.       Environmental Protection Agency (EPA) DDT – A Brief History and Status: Current Status. 2014.

14.       Stotland, N.E., et al., Counseling patients on preventing prenatal environmental exposures – a mixed-methods study of obstetricians. PLoS One, 2014. 9(6).

15.       Staud, F., L. Cerveny, and M. Ceckova, Pharmacotherapy in pregnancy; effect of ABC and SLC transporters on drug transport across the placenta and fetal drug exposure. J Drug Target, 2012. 20(9).

16.       Morgan, S., G. Koren, and P. Bozzo, Is caffeine consumption safe during pregnancy? Can Fam Physician, 2013. 59(4).

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19.       Oceana, Ocean Study Reveals Seafood Fraud Nationwide. 2014.

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34.       Huang, H., et al., The in Vitro estrogenic activities of triclosan and triclocarban. J Appl Toxicol, 2014.

35.       Dimmitt, B.S., Safest Sleep Positions During Pregnancy in Parenting. 2013.

36.       Harms, R. Is it safe to get a flu shot during pregnancy? 2014.

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