Blog Every Day in May: Soapbox

Day 22: Rant about something. Get up on your soapbox and tell us how you really feel. (a pet peeve, a current event, a controversial topic, something your husband or roommate or neighbor or boss does that really ticks you off)

(Rubs hands together in quasi-gleeful manner)

I get incredibly irritated at a subset of pregnant women who choose to turn gestation into the Martyrdom Olympics. They remind us constantly of what they CAN’T eat and what they CAN’T drink and what they CAN’T do. They flaunt their (largely self-imposed) restrictions like merit badges.

Most of these women rely on the internet, instead of their obstetrician, for the long (and ever-growing!) list of prohibitions, and then insist on demonstrating to their peers that they are the Valedictorians of Sacrifice. These are women who, before getting knocked up, lead reasonably healthy lives – they exercised, ate well, and didn’t take stupid health risks. But introduce a zygote, and they decide to totally overhaul their lives. Add baby, remove reason. They end up confused and stressed and filled with contradicting “facts.” (See, “How to have the Best Pregnancy Ever,” by Tracy Morrissey)

Give. Me. A. Break. Women have been reproducing for thousands of years without worrying about their lunch meat, their alcohol consumption, or the lead content of their crystal glasses.

Causes of The Panic

This near-hysteria over Every Little Thing has several root causes. In part, it is the result of the staggering liability exposure for obstetricians. They pay the highest premiums for malpractice insurance of any field of medicine – juries are very sympathetic to dead or injured babies, and many parents are more than willing to blame the doctor when they have one. OBs must cover their own tails more than any other doctor – hence the long lists of things to avoid.  Another part is a media machine that targets women at their most vulnerable. Parenting magazines must sell copies, web sites must get hits, and publishers must move books – and what sells better than scare tactics? Not much! When’s the last time a headline like, “Relax, Everything’s Going to be Fine!” caught your eye? A third culprit is the rise of internet forums and mommy listservs, which are supposed to be safe communities but can become playgrounds for adult bullies who are more than happy to tell you You’re Doing Everything Wrong.

The Risks are Small

Most biological processes involve risk. Hell, getting out of bed every morning involves risk. Most of the time, we look objectively at a situation and decide for ourselves if the risk is worth taking. The risks to pregnant women seem to fall into two broad categories – birth defects in the baby and agents that will cause illness/death to either the baby or the mother.

According to the CDC, 3% of babies born in the US will have some form of birth defect. The most common birth defect is Down Syndrome, which is genetic and therefore not affected by the mother’s behavior while pregnant. In fact, some reports indicate that only 10% of birth defects can be traced to a specific environmental agent, while 20% are genetic, and fully 70% are of unknown origin. So all this fretting is to prevent something that occurs in less than one percent of live births.

Think of it another way – when you had your wisdom teeth removed, your oral surgeon told you that there was a small chance that the removal could end in your death, because that is true. Did you still have the surgery? Of course you did. You accepted the risk.

Yet when your OB says that if you eat deli meat while pregnant, there is a small chance you could get sick, what do you do? AVOID LUNCH MEAT LIKE THE PLAGUE BECAUSE IT WILL KILL YOUR BABY, OMG. Suddenly any risk, no matter how small, is unacceptable.

About that Deli Meat

The lunch meat prohibition is probably my favorite example of the pregnancy panic that has stolen the logic from many of my peers. Pregnant women are advised to avoid deli meats, unpasteurized cheeses, and some cold-smoked fish because they might contain listeria, a bacteria that can make you sick. When I was pregnant in 2003, the deli meat prohibition was brand new – in fact, I didn’t read anything about it until my pregnancy was almost over.

This article, published by the National Institutes of Health in 2008, gives a good overview. Bottom line – yes, listeria is a very dangerous bacteria, but your chance of getting it, even while pregnant, is very small. Like 0.00012%. There were 800 lab-confirmed cases of listeria in 2007 (the CDC’s current count is 1,600 cases per year), out of US population of 314 million. The study says, “In the 222 cases of maternal infection reported in the literature and reviewed by Mylonakis and colleagues, 94 infants were infected. Of these, 59 (62.8%) recovered completely, 23 (24.5%) died, and 12 (12.7%) had neurologic sequelae or other long-term complications.”

Now put that in perspective. As a pregnant woman, you have a 0.00012% chance of getting listeria. If you do, your baby has a less-than-50% chance of getting it as well, or 0.00006%. And if your baby gets it, he or she has a 63% chance of totally recovering. That means that the chance of your unborn child dying because you had a hot dog is 0.00002% or less.

Also? The last major listeria outbreak in the US was in 2011, and the culprit was cantaloupes. In fact, the NIH article referenced above says plainly, “Epidemiologic investigations have demonstrated that nearly all types of food can transmit Listeria….creating guidelines that will prevent exposure to Listeria is nearly impossible.”

This is just one example. There are countless others. 

In My Humble Opinion

I think that the long lists of prohibited items give pregnant women the illusion of control. Pregnancy is a very weird time, when your body is doing things all by itself and has possibly been invaded by alien beings. It may be comforting to imagine that if you just follow these rules, your baby will be born healthy and safe. And if a few rules are good, more rules are better. Look, I’m not advocating that we all start shooting heroin into our eyeballs when the stick turns blue (or whatever it does these days), but I’d appreciate a little common sense. The internet is not a substitute for your obstetrician, and it will always tell you exactly what you want to hear if you look hard enough.

Pregnancy is not some sort of aberration; it’s a perfectly normal condition. I think if we all treat it as part of regular life, instead of a nine-month vacation from reasonableness, we’d all be a lot happier.

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5 Comments

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5 responses to “Blog Every Day in May: Soapbox

  1. Krista

    Preach. I don’t know how I managed to give birth to my first two kids without the internet telling me all the ways I was endangering their lives. Good grief.

  2. Rebecca

    I loved my ob. His message was always: you’re healthy, the baby’s healthy, everything looks normal – so use your judgment and some common sense, but relax.

    That was so refreshing to hear – especially coming from my actual doctor and not the internet. Stress and worry are far more dangerous than cold cuts.

    I understand the tremendous responsibility a pregnant woman feels to do everything she can for her child. But there’s a point where you get diminishing returns and a stressed-out, bitter mom, and that’s not good for anyone.

  3. Quyen

    I asked my OB about the deli meats–his response was that I could also slip and fall in my bathtub, but he wasn’t about to tell me to stop showering. God bless the man–he was fine with everything from coffee to sushi.

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