Pregnancy and you blog

Pregnancy rules: Do they need rewriting?

By Mary M. Murry, R.N., C.N.M. August 27, 2013

If you're expecting, you want to do what's best for your baby. That means following some basic pregnancy rules — and there's no shortage of people and places recommending them. There are umpteen books, magazines, websites and blogs (including mine) full of pregnancy advice. Family, friends and complete strangers also are more than happy to tell you what you should or should not do during your pregnancy.

Why are there so many pregnancy rules? As knowledge about the human body and pregnancy has grown, so have the cautions health care providers recommend during pregnancy. We warn pregnant women about deli meat, hot tubs, caffeine, and alcohol. We encourage exercise, good nutrition and use of folic acid.

Do health care providers know for a fact that caffeine during pregnancy will significantly increase your risk of miscarriage? Do we have absolute proof that any amount of alcohol during pregnancy will harm your child? No, we don't. The ethics of performing research on pregnant women is tricky territory. Our knowledge largely comes from observations about what has happened in the past or animal studies. We look at previous pregnancies and deliveries. We examine children and what happened during their prenatal periods to draw conclusions. As a result, most of our recommendations are based on potential risks to moms and babies.

If a woman asks me if drinking a glass of wine will harm her baby, I have to answer that we don't know for sure. I can explain that the U.S. Surgeon General recommends complete abstinence because a safe level of prenatal alcohol consumption hasn't been determined. Likewise, if a woman asks about caffeine during pregnancy, I can tell her that studies show there is a relationship between high caffeine use and miscarriage — and that it's probably dose related. However, there aren't 'yes' or 'no' answers for most of these types of questions.

I believe we need more pregnancy research. Your body works differently when you're pregnant. Without research, we won't know if a medication or treatment will be as successful during pregnancy as it is otherwise. I also wish there were absolute rules in pregnancy so you could know that if you did everything just the way you were told, your baby would be born healthy. But I don't think we'll ever get to that point.

In the meantime, I believe it's our responsibility as health care providers to inform pregnant women and their partners about the risks, the likelihood of those risks and the leading experts' recommendations. Then, it's your responsibility to ask questions and decide what's best for you and your pregnancy.

Aug. 27, 2013