Updated October 2018

Really? No lunch meat or sushi during pregnancy, and I can’t touch kitty litter??

There are TONS of rules about what you should – and shouldn’t – be doing during your pregnancy. Perhaps you’ve already been admonished by an annoying coworker about eating sushi during pregnancy, and the dangers lurking inside your turkey sandwich.

The truth of the matter is that the majority of miscarriages, stillbirths and birth defects occur from reasons that are totally outside of your control. This will either give you comfort or totally freak you out; hopefully it’s the former.

As it turns out, many of the rules of the pregnancy police come not from actual data or studies, but from the “why-take-a-chance” philosophy that pervades American medicine, no matter how infinitesimal the actual risk. (Why not install a meteorite-guard on your house???…)

First, a biology lesson.

Mr. (or Ms.) Fetus

For moms carrying your own egg, only half of your tiny peanut is identical to your own biology (the other half belonging to your inseminator — otherwise known as your husband, boyfriend, guy at the bar that night, or, actual sperm donor).

Fetus: nooo, don't attack meee!! sushi during pregnancy
Because of this dissimilarity, your little ball of baby cells would normally be rejected by your body’s own immune system (much like with a transplanted organ). Thankfully, our immune systems have evolved and know NOT to attack the developing fetus.

Essentially, your whole immune system lets down its guard for the duration of your pregnancy. As a result, pregnant women are more vulnerable to nasty stuff. This also explains why you’ll get every strain of cold under the moon during the 3rd trimester, even if you are normally quite healthy.

So, which of the rules are justifiable and which aren’t? Let’s have a look.

Listeria Hysteria

Listeria is the big bad bacteria that you want to avoid during pregnancy, mainly because it can cross the placental barrier and infect the fetus, which can result in miscarriage or fetal death.

True, pregnant women are about 20 times more likely to get listeria than the non-pregnant, but EVEN SO, it is EXTREMELY rare, infecting about 50-100 per million (or, 1 in 10,000) for those with a bun in the oven (3 to 5 per million without).

For the sake of comparison, your lifetime chance of dying in a car accident is about 1 in 500.

It should also be noted that most listeria infections in pregnancy occur in the 3rd trimester, when suppression of Th1-mediated immunity is at its maximum.

The highest risk foods for listeria are preserved fish (lox and stuff), cheese from unpasteurized milk, deli meats, pâté (pa-TAAAAAY), and undercooked hot dogs. Stuff like that.

Bottom line: With those kinds of odds, you should worry more about your driving than your turkey sandwich.

Sushi During Pregnancy

Most American OBs say, “No sushi for you!” However, if you look at the data, 85% of seafood illness comes from eating raw shellfish – that’s right, bivalve mollusks, namely, raw oysters and clams.

If you remove those foods from the equation, the risk of falling ill from eating seafood is 1 in 2 million servings. [By comparison, the risk from eating chicken is 1 in 25,000.] So…can we agree that we won’t eat raw oysters and clams? I mean, really? Millions of Japanese women are not wrong (and yes, with some of the best public health officials in the world, they’ve looked into it).

Furthermore, fish eaten in a sushi restaurant in the US is almost always flash frozen before it gets to the restaurant, so any parasites or bacteria in the fish would have been killed during the process.

Salmon-ella, ha! sushi during pregnancy

Bottom line: No raw shellfish, but your salmon roll shouldn’t be any more scary than your chicken sandwich.

Freddy Mercury

“You should eat lots of fish when you’re pregnant.” No wait… “You should avoid fish when you’re pregnant.”

Well, which is it?

“Between the warnings about parasites in sushi and about mercury in certain species of fish, pregnant women are being scared off fish altogether. And that’s bad news, since the fatty acids in fish are the ideal nourishment for a developing baby,” said Steven Shaw, a former food writer for The New York Times.

Furthermore, researchers found that greater maternal intake of omega-3 fatty acids in fish was associated with better fine motor development, more pro-social behavior, and better social development.

So is there a “too much”? All researchers can do is guess at it, but many suggest that the warnings against seafood consumption are dramatically overblown.

In fact, a study in the Seychelles [a high fish-eating population] showed no link between the children’s development over their first six years and the levels of mercury contained in their mothers’ hair during pregnancy, which is a measure of the amounts to which fetuses were exposed.

Bottom line: Common sense would tell us to limit consumption of fish that are high in mercury, such as shark, swordfish, king mackerel, and tilefish (sorry, no shark for you this week [snort]).

The Truth About Kitty Litter

Toxoplasma gondii is a parasite whose only natural host is the cat. Reeeer.

The truth is, if you’ve had an indoor/outdoor cat for years, your chances of being immune from a previous exposure are fairly high – perhaps as high as 90%.

Studies show… of the 10% of pregnant cat owners that are susceptible, about 2% of those are exposed to toxoplasmosis during pregnancy. Of those (now 0.2%), only 30% of the 0.2% become infected. If infected (this keeps getting better, huh?), only 30% of those are “clinically infected,” meaning their newborn will be impacted in some noticeable way.

Where are we on the math? About 0.0018 (or, 1.8 in 100,000) of the fetuses of pregnant cat owners will get sick from toxoplasmosis. You can see why doctors really don’t see this very often.

Should you tell your husband or partner that this really isn’t a threat after all?

Hell-to-tha-NO! Let him think it’s highly lethal for, like… the rest of your life (come on, you can’t get drunk for the next few months, the least he can do is scoop some kitty crap, yeah?). It’ll be our little secret. 😉

Conclusion: Ladies, I’m not saying you can’t get sick from things like listeria, sushi, and kitty litter. I’m just saying they’re fairly unlikely (k, so don’t sue me). The beauty is that everyone can decide based on their own risk tolerance. I love ‘dis country!


Related

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  • Registry cheat sheet, for reference
  • Did you miss? Great Pregnancy Books.