Is It Safe? Common Pregnancy Concerns

Most pregnant people can look back at the early weeks of pregnancy and recall some type of risky behavior. For some, it's a headache tablet, dental X-ray, or hair dye that makes them wince. In my case, it was the wine tasting I attended the night I conceived. But as it turns out, these "slip-ups" are probably fine, at least according to medical experts. Most early transgressions do not put you or the fetus at risk.

That said, there are some things—and activities—pregnant people should avoid. Here, two top medical experts in fetal and newborn health, Craig V. Towers, M.D., and Urania Magriples, M.D., discuss which habits, foods, activities, and medications are safe for pregnancy people—and which aren't. Dr. Towers also discusses how risk changes over time. It doesn't just matter what you do but at what point in your pregnancy you do it.

After conception, for example, it takes five to seven days for your little bundle of cells to attach to the uterine wall. Only then does it start drawing nutrients and oxygen from you, making what you take into your body really count. Weeks four to 13 are particularly important; that's when the fetus is forming. Exposure to harmful substances at that time may cause birth defects or affect how a body part functions after birth, says Dr. Magriples, associate professor of obstetrics at Yale University in New Haven, Conn. However, few studies have been done on pregnant people, for obvious reasons. As such, when no good data is available and there's a suspected risk, experts tend to err on the side of caution.

Here's the rundown of what is known.

Alcohol

A safe level of alcohol consumption has not been determined, so many experts recommend abstinence. Heavy use during pregnancy can cause fetal alcohol syndrome—a serious, lifelong condition. But don't stress out about the glass of champagne you had before you knew you were pregnant. Your baby will be fine.

Cigarettes and Secondhand Smoke

Studies have conclusively proven that smoking and pregnancy don't mix. Babies born to parents who smoke weigh less on average. Doctors suspect the lower birth weight is due to restricted blood flow, which may also impair the passage of nutrients through the placenta to the baby. Carbon monoxide, which is present in cigarette smoke, can enter your bloodstream, thus reducing the amount of oxygen that reaches the uterus. For these reasons, doctors advise pregnant people quit and to steer clear of secondhand smoke.

Caffeine

Used in moderation, coffee and other caffeinated foods and beverages are not a problem. However, consuming more than 300 to 400 milligrams of caffeine a day (the equivalent of three to four 8-ounce cups of coffee) increases the risk of miscarriage, according to Dr. Magriples. When tallying your daily caffeine consumption, remember to count colas, iced tea, and chocolate.

Cold and Flu Medications

Antihistamines, such as Benadryl and Chlortrimeton, are generally considered safe, as are most cold remedies—though you may want to try to relieve your stuffy nose with saline spray instead.

When it comes to the flu, most experts agree Tamiflu is the way to go. "Tamiflu is thought to be safe for pregnant people, and the risks of skipping it are far greater than taking the meds," says Alane Park, M.D., mother of two sons and co-author of The Mommy Docs' Ultimate Guide To Pregnancy and Birth. "That's because the baby's temperature is always going to be a degree higher than yours, so if you have a high fever it may cause birth defects during early development stages and pre-term labor during later stages of pregnancy."

Diet Soda

Even though saccharin and aspartame have been found to be harmful in animal studies, moderate amounts haven't been proven harmful in pregnancy. A diet soda or two will not put you or your baby at risk. That said, diet sodas are best avoided. They are filling and allow less space in your stomach for important nutrients. Many also contain caffeine, another no-no when used in excess. Drink milk or water instead.

Exercise

While exercise is generally considered safe during pregnancy, you should consult your doctor before beginning any workout routine. Some pregnant people are at higher risk, some activities are more "dangerous" than others, and since overheating and dehydration can easily occur, you should drink plenty of fluids before, during, and after your workout. Stop immediately if your heart starts racing, you feel faint or short of breath, your uterus begins cramping, or you experience any vaginal bleeding.

Herbal Remedies

Both Dr. Magriples and Dr. Towers advise pregnant people to exercise strong caution when it comes to taking natural supplements. "Many people don't think herbal remedies are a big deal because they can get them at health-food stores," says Dr. Magriples. "But a lot of this stuff is very potent. Herbs are not regulated and could be toxic in pregnancy." It is probably prudent to avoid herbs; if you are already using them, inform your doctor as soon as possible.

Pain Relievers

Aspirin can affect blood-clotting in the fetus, a concern at delivery time, and while acetaminophen (Tylenol) is the generally considered safe, a recent study found that "prenatal exposure to APAP might alter fetal development, which could increase the risks of some neurodevelopmental, reproductive and urogenital disorders." For this reason, you should talk to your doctor before taking any pain reliever.

Radiation

Radiation is everywhere. You can be exposed during X-rays and airplane travel, or when using cell phones or lying on the beach. Don't panic. "It takes a fair amount of exposure before harm is done," says Dr. Towers. But a concentrated high dose to the pelvis (as with a barium study) or repeated exposures to small amounts (something a flight attendant might experience, for example) should be avoided, if possible.

Lifting

Moderate lifting is not a problem in a normal pregnancy, but proper body mechanics—lifting with your legs, not your back—are more important than ever. Because your center of gravity shifts and your ligaments are looser, it's easier to get injured. Be safe. Be mindful, and go slow.

Sushi and Other Raw Delectables

The risks of eating raw fish, shellfish, or other meats include bacterial infection, hepatitis, and parasites. Eating rare or raw red meat, such as carpaccio, can also cause toxoplasmosis, a parasitic infection that mothers can pass on to their babies. It can impair growth and brain development. To be perfectly safe, eat only well-cooked foods.

Hot Tubs

According to the American Pregnancy Association, hot tubs should be avoided during pregnancy, as they can cause hyperthermia—or an abnormally high body temperature—and this can put both you and baby in danger. Stick to a warm bath instead.

Vitamins

In high doses, some vitamins can cause birth defects. Megadoses of vitamin A, for example, have been linked to defects of the brain, face, and heart. Vitamin E poses a blood thinning risk, and high-doses of other vitamins have the potential to be problematic. For this reason, the American College of Obstetricians and Gynecologists recommends that pregnant people do not take more than 5,000 international units of preformed vitamin A per day or exceed the recommended dietary allowance of 10,000 micrograms of vitamin E.

Travel

The second trimester is the best time to travel. There is a higher risk of miscarriage in your first trimester, and in the third, you'll want to be close to your doctor or midwife. Wherever you go, know the locations of the closest medical facilities. Dehydration and stress often go along with traveling, and both are unhealthful for pregnant people. Drink plenty of fluids, try to relax, and move around as much as possible when traveling by plane, as pregnancy puts you at higher risk of developing blood clots.

Winter Sports

The risk in skiing and ice skating is falling. This isn't so bad in the first trimester, but after 20 weeks, when the uterus extends past the pelvis, falling on your abdomen could cause premature labor, separation of the placenta from the baby, or a fetal injury. Talk to your doctor before engaging in any winter activities.