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When you find out you’re pregnant, it seems to change everything. Suddenly you’re thinking not just about yourself, but about the baby you’re carrying. You may have questions about what substances or environmental exposures may be harmful to you or your baby while you’re pregnant.
There’s the usual medical advice about avoiding alcohol or illegal or prescription drugs when you’re pregnant. Plus, it seems many people are much more aware of their environment these days and the products they use. If you’re pregnant, that adds an additional layer of wondering what over the counter medications are safe to use, and if chemicals or poor air quality could cause harm to you or your baby.
Jade Elliott spoke with Virginia Homewood, an OB/Gyn with Intermountain Healthcare on this episode of the Baby Your Baby Podcast to explain some of the substances to avoid, some obvious and some you may not be as familiar with.
Why is it important to avoid toxic substances when you’re pregnant or thinking about getting pregnant? Is it to protect you or the baby?
When we think about toxic exposures during pregnancy, some things can be somewhat harmful to mom, but often we’re typically more concerned about the effect of the exposures on the developing fetus.
What are the most important substances to avoid when you’re pregnant?
Alcoholic beverages – We don’t know if there’s a safe level you can consume when you’re pregnant, so the best advice is to not consume any. Fetal Alcohol Syndrome. Drinking alcohol has been linked to severe developmental issues, learning difficulties, attention deficit disorders, and other developmental problems that don’t appear until later in a baby’s life.
Illegal Drugs – There are so many types of illegal drugs and the effects are varied depending on the drug. With narcotics, we see addiction in the baby. Then the baby suffers from withdrawal symptoms. It can cause neurodevelopmental problems as well. Other drugs affect the pregnancy and can cause complications for the mother, like high blood pressure or preterm labor.
Smoking – Smoking cigarettes can increase your chance of miscarriage or preterm labor. It also can affect fetal growth, and increases the chances of Sudden Infant Death Syndrome or SIDS. Vaping during pregnancy would also be harmful, since e-cigarettes contain nicotine. E-cigarettes are less-regulated than regular cigarettes and that means the amount of nicotine or other substances in them is harder to determine.
What other toxins should be avoided during pregnancy?
Mercury – Pregnant women should limit mercury, which is found in some fish. Mercury affects neurodevelopment and the brain of the developing fetus. Limit your choices to low-mercury fish. Fish is an excellent source of lean protein and the fish oil found in fish is especially healthy, so it’s important to find the balance. A good goal is to eat two servings of low mercury fish per week. Lake fish and shellfish are safe to eat.
Avoid these types of fish if you’re pregnant:
King mackerel
Marlin
Orange roughy
Shark
Swordfish
Tilefish (from Gulf of Mexico)
Big eye tuna
Fish with lowest levels of mercury include:
Canned tuna,
Cod
Flounder
Haddock
Pollock
Shellfish
Salmon
Sardines
Tilapia
Trout (freshwater)
Whitefish
For more information see the U.S. Food and Drug Administration recommendations for pregnant women about fish.
Hair and nail salons
We don’t know if the chemicals to color or perm your hair or do your nails are harmful or not. If you can smell it, it’s probably not good. Skip the salon temporarily or make sure the area is well-ventilated.
The best strategy is to adopt the mindset that fewer exposures is better. Reduce your exposure to things that are harmful.
What toxic exposures might there be in your own home?
Chemicals used in plastics such as phthalates. BPA is example. BPA has been removed from most baby products, but it’s replaced with other BPP or other similar bisphenol molecules.
Be aware of plastics and use them safely. Don’t reuse disposable plastic bottles. Don’t re-heat food in the microwave in plastic, like Tupperware or plastic wrap. Heat food in a dish or in glass. Cover the dish with waxed paper or a paper plate. The plastics leach into the food. Especially avoid plastics marked #7 and #3.
Toxins in food or personal care products
Read packages and labels and understand what is in your food or beauty products. Organic food costs more, but is a good option if you’re concerned about pesticides. The Environmental Working Group has a list of produce that rates those highest in pesticides, called The Dirty dozen as well as a list of produce with low amounts of pesticides, called The Clean 15. They also have a page called Skin Deep that has information about the ingredients in personal care products.
Eating and preparing food
Pregnant women should make sure meats are cooked all the way through before eating. Deli-meats, need to be heated and not eaten cold. And if you’re pregnant, only eat dairy products that are pasteurized.
Keep your house dust free. Mop your floors. Use a HEPA filter on vacuum. This will help reduce toxins in your home.
Opt for natural cleaning products. You can create your own with vinegar. You can soak citrus fruit in it for a better scent. A lot of cleaners are not studied in pregnant women, so we just don’t know if they’re safe. When you are using cleaning products, keep the room well-ventilated.
Avoid flame retardants. Try to buy infant clothing without flame retardants, because they contain toxins. Flame retardants are common in pajamas, costumes, and furniture.
Are there certain over the counter medications that should be avoided during pregnancy?
Any medication has a potential for harm during pregnancy. It’s best to not take anything before you talk to your doctor or midwife. They can help you know if over the counter medications are safe and when it is safe to take them. They can also help review any prescription medications you have. For pain relief, Tylenol is preferred over Advil or aspirin for pregnant women.
Are there certain prescription medications that should be avoided?
Medications that should not be taken when you’re thinking of getting pregnant or during pregnancy would include the acne medication Accutane, ace inhibitors, and some blood pressure or diabetes medications.
If you’re taking medication and thinking of getting pregnant go in for a check-up. Many women have put off going to the doctor during the pandemic, but Intermountain has many safety protocols in place to protect you and your provider from COVID-19.
Does it matter what trimester you’re in as far as reducing exposure to environmental toxins or medications?
Generally, during the first trimester, in the early development stages, is when your baby is most at risk of being affected by exposures. But it varies, from medication to medication. Some are a concern later in pregnancy.
What about toxic exposures in the workplace?
Let your doctor or midwife know about your work environment. You’ll want to minimize your exposure if you work with cleaners or chemicals, whether you work in a factory, warehouse, dry cleaners, salon or in healthcare.
Where can women go for more information? Talk with your provider about any medications you’re taking or substances you’re concerned about.
Another great resource is Mother to Baby, the nation’s leading authority and most trusted source of evidence-based information on the safety of medications and other exposures during pregnancy and while breastfeeding. It’s a no-cost information service available to mothers, health professionals, and the general public via chat, text, phone, and email in both English and Spanish. It’s recommended by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration’s Office of Women’s Health.
The phone number for Mother to Baby is 1-866.626.6847.
The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.