An OB's Guide to Pregnancy: What you Can and Cannot do During Pregnancy

| Pregnancy |

Knowing what you can and can’t do in pregnancy can be as hard as knowing what dress to wear on that very important first date. It can be overwhelming (to say the least). From the moment you pee on that stick, you feel pressure. The anxiety begins to brew, and your mind starts to race. If you are a first-time mom, you are probably thinking, “Is this really happening?” You begin to think of all of the “bad” things you did over the past few weeks not knowing you were pregnant. The paranoia sets in, and you probably turn to your girlfriend, your Google, or your OB to ask what’s next. But here are a few basic tips from your professional OB girlfriends!


The period from your period to pregnant is the time when most of us don’t even know we are pregnant (especially if we’re not actively trying). We act like our usual selves…which for some of us is not always all that clean. While we are not here to lecture, we want to tell you that those first few weeks are considered the all-or- none period. If the insult or toxin does not prevent the pregnancy, then it will not have any impact on your baby.


What can I eat? I’m starving! Food choices in pregnancy can be complicated. In the beginning of pregnancy, you are often so nauseous that you will take whatever you can to keep down. As the weeks roll on, you can start to tolerate the sight of chicken and the smell of fish again. Go with what your body can tolerate—something is better than nothing! Once protein and healthy foods (salads, veggies, and fruits) look appealing again, go crazy. But don’t drive yourself nuts about what you missed for the first few months. A few bites to remember are the following: unpasteurized cheeses are unacceptable. Good news is that almost all cheeses that are served in this country are acceptable! However, if you travel during pregnancy, just make sure to check with your server before you order. Watch your mercury intake. Mercury is an element that is found in bodies of water; mercury can turn into methylmercury, which in high levels can be toxic to the developing nervous system of an unborn baby. Certain fish contain higher mercury levels than others and should absolutely be avoided in pregnancy. Those include tilefish, swordfish, shark, and king mackerel. Other than those mercury magnets, eating fish in pregnancy is totally fine and is actually recommended. The FDA recommends eating 8 to 12 ounces of fish low in mercury per week; this is equal to two to three servings of fish per week. Low-mercury fish include salmon (not farmed!), tilapia, shrimp, cod, catfish, and canned light tuna. Next, cold cuts (a.k.a. deli meats) are sort of getting the cold shoulder in pregnancy…if served cold! If you want to eat turkey or ham, you can most certainly do so, but make sure it has been fully cooked. This is because eating cold cuts can result in infection with a bacteria called Listeria (pregnant women are more susceptible to Listeria than non-pregnant women); Listeria is extremely dangerous in pregnancy.


And lastly, how should you dress your salad (if you are up for eating one!)? If you are partial to Caesar dressing, you are probably okay. The only sticking point when it comes to Caesar is that some restaurants use raw eggs when they whip this up. Raw eggs can bring with them some bad bacteria (a.k.a. Salmonella). Make sure to ask your waiter how the dressing is made. If the eggs are raw, then you need to go to salad choice B.


Although you can get there by planes, trains, or automobiles, the one that we OB/GYNS are usually asked the most about by pregnant women is planes. Is it safe to fly? Am I putting my fetus at risk by setting foot onto a flight? How much is too much travel? The good news is that, for pregnant women without any obstetric or medical complications, it’s wheels up. Air travel during pregnancy is pretty safe and does not appear to cause any increase in pregnancy complications. The exposure to cosmic radiation is negligible. While 36 weeks is usually when most airlines don’t let you past security, before this, it is smooth sailing. Just remember to make a few trips to the bathroom (not hard for a pregnant woman!). Moving around will decrease the risk of blood clots in the legs.


Caffeine has been deemed the culprit of so many of our problems. However, it’s also been the key to our success (how else could you pull all-nighters and turn that project in on time?). It is actually ok to drink a limited amount, be it coffee or another type of caffeinated beverages, in pregnancy. Just watch how much you take in. In general, we recommend selecting a drink with no more than 200mg/cup. If you are having an off day, are really dragging your feet, and go a bit above the limit, don’t freak out; just try to watch how much brew your baby sees on most other days of the week!


Imbibing during pregnancy is not ok. While most do have a drink here and there without any negative consequences, there is no acceptable amount at which you can fall below and be in the clear. While most problems arise when large amounts are consumed on a frequent basis (medical term = fetal alcohol syndrome) and therefore a glass of wine occasionally is no harm, be careful with how much you drink. There is no recommended number of drinks or ounces that you can guzzle while with your girl or guy on board. So think of it as a good time to be the designated driver; we all need one! 


Oh no, everyone is going to know I am not a real blonde! Hair coloring in pregnancy is a frequent question that comes across our inbox. While there is a theoretical risk of the chemicals in the hair dye affecting your fetus, most of the data do not support this fear. Most colorists are cool continuing to color your locks. They usually recommend waiting until you are out of the first trimester. Furthermore, you may consider cutting down on the number of trips you make to the salon. While this may highlight your grays, it will definitely make your wallet heavier! Lastly, discuss the situation with your colorist; they may suggest changing the product and the formula to something gentler (vegetable dye).


Hair removal (waxing, plucking, tweezing) while pregnant is not something you need to remove from your beauty dos. You are not doing any harm by saying goodbye to that unwanted hair. Just remember that you skin changes with pregnancy. It is more sensitive, and therefore, something that never caused you pain before may cause you some discomfort now. Additionally, while you may have previously visited your favorite waxing place every four to six weeks during pregnancy, you might be seeing them much more frequently. The hair cycle changes during pregnancy as a result of hormones; this results in thicker and faster hair growth. That’s a major plus on the head, but not so much on the bikini line. And just because you are pregnant does not mean you need to change your style. I you like to go bare, go bare. Pregnancy does not mean you have to abstain from Brazilians (just remember to only visit clean and reputable establishments that don’t double dip!). Laser hair removal is a bit less clear, and as a general rule, we do not recommend it when pregnant.


Can your pants be too tight? Basically, do tight pants or everyone’s favorite tummy tucker Spanx hurt your baby? The answer is: no! While they probably hurt you (wearing pants that are too tight are never fun), they are not hurting your baby. And while we totally get trying to keep things sucked in, remember that a lot of what you are seeing is your uterus. No matter how tight the pants or the tights, they can’t flatten your uterus. Nor should you want this; take this time to let it go. You have the rest of your life to worry about how your belly looks in that dress!


Last on our list of most-asked pregnancy questions is nails, toes, and all things manicure. Let’s face it, who doesn’t like to have pretty nails and toes, especially during pregnancy? Your nails are probably one of the few areas that you are happy to see growing as your belly grows, and you want them to look good. Trust us, we get it. While some salon practices are probably best saved until the postpartum period, basic manicures / pedicures (clipping / filing / massaging / painting) are a go. Pamper yourself, relax, and take a load off those swollen feet because you deserve it! There is very limited data to suggest that the brief exposure to fumes and chemicals in a salon is harmful. Just remember to limit your spa services to select salons (those that are clean and reputable) to ensure yours and your baby’s safety! Make sure that they follow good hygiene practices (sterilization, gloves, license of certification, sanitization). UV and gel manicures’ effect on pregnancy has not been well studied. Theoretically, they should pose no problem to the baby growing in your belly. With that said, if you want to go clean and without polish during your pregnancy, we won’t judge you based on the state of your nails and toes!

Bottom line…pregnancy is the beginning of the Parenthood Land of the Unknown. It is only the start of not knowing what is right and what is wrong. But in many ways this is because pregnancy and parenthood is a lot of gray. So go with it. You may only do this pregnancy thing once. Relish this time (stretch marks, spider veins, swollen feet, and all) because it will be over before you know it!

Written by Jaime M Knopman & Sheeva Talebian

Friends and colleagues for more than ten years, Dr. Knopman and Talebian have both completed their M.D. degree at Mount Sinai School of Medicine, and Residency in Obstetrics and Gynecology at NYU School of Medicine. Their areas of medical speciality include: treatment of menstrual irregularities, assisted reproductive technologies, in vitro fertilization, oocyte cryopreservation, oncofertility, same sex reproduction, and third party reproduction. In addition to their love of medicine, they have a true passion for writing, and owns a blog Truly MD where they share their professional, yet heartwarming insights for new Moms and Moms-to-be.