Pregnancy and birth

Pregnancy and birth

Facts verified by Dr Raewyn Teirney and Dr Scott Dunlop.

During pregnancy, there are some obvious things to avoid – smoking, recreational drugs, any of the foods that are linked to listeria, salmonella and toxoplasmosis and caffeine (see the Hazards and precautions article). But there are lots of other things that are said to be safe and unsafe depending on who you talk to, and it can make some pregnant women too nervous to do anything. When in doubt you should always ask your doctor or contact the Mothersafe organisation on www.mothersafe.org.au or by phone (02) 9382-6539, but here is a general guide to what’s safe, what’s not and why
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Beauty treatments

SAFE:

- Hair treatments
Generally getting perms, hair colours and chemical straightening hair treatments during pregnancy is considered to be safe because the chemicals used for these treatments are only lightly absorbed into the skin and are rinsed thoroughly from the scalp so that they can’t reach the baby. Some medical professionals suggest waiting until the first trimester has passed before making an appointment for any of these treatments but this is just a precaution. For women who work as hairdressers and perform the treatments, they should ensure they use gloves and work in a well-ventilated area so they can minimise breathing in the chemicals as much as possible.

- Fake tanning
Spray tan solutions are also perfectly safe to use (tanning beds are definitely not) but pregnant women should be aware that beauty treatments may not work in the same way during pregnancy, with the presence of pregnancy hormones altering the normal structure of the hair and skin.

- Essential oils
Essential oils are created as highly concentrated plant extracts to be used used in conjunction with complementary therapies such as massage and aromatherapy, and are absorbed by being breathed in or rubbed into the skin.
They do have the potential to cross the placenta but are often diluted before being used so they are quite safe, except for certain essential oils that have been associated with triggering early contractions, increasing blood pressure, encouraging abnormal cell development and even instigating bleeding in some cases, including cinnamon, nutmeg, rosemary, basil, cedar, jasmine, sage, peppermint and juniper berry. Because you may sometimes be exposed to essential oils without realising it, such as when going in to get a treatment at a beauty salon where there are essential oils used in oil burners for example, you should inform the beauty therapist that you are pregnant so she can provide a safe environment.
 
UNSAFE:

- Teeth whitening
There is very little information available on the impact of the main chemical used for teeth whitening (which is peroxide) on pregnant women and for this reason, doctors advise pregnant women to wait until after giving birth before getting their teeth whitened at the dentist or by whitening their teeth themselves using at-home kits.

Medical procedures

SAFE:

- X-Rays
The exposure to radiation when getting a standard X-Ray is not enough to harm a foetus, as the amounts are usually very low but most doctors will still only order X-Rays for a pregnant woman if they are related to an immediate medical situation like a broken bone rather than general X-Rays such as mouth X-Rays for a dental check-up. So there’s no need to worry if your doctor refers you for an X-Ray at any time in the nine months of your pregnancy, provided there is an appropriate indication.
Similarly other non-urgent elective procedures like laser eye surgery and cosmetic surgeries like Botox, that aren’t necessary for health reasons will usually not be performed by doctors on pregnant women.
Some pregnant women worry about airport X-Ray screening machines for the same reason they worry about X-Rays but these machines actually produce electro-magnetic fields (not radiation) and are safe for pregnant women to walk through. The machines that scan carry-on luggage for dangerous items do use radiation but only by actually putting a part of the body inside the machine would there actually be any radiation exposure.

UNSAFE:

- Blood donation
The Australian Red Cross Blood Service states that women are temporarily deferred from donating blood during pregnancy to avoid placing any stress on the mother's and baby's circulation and iron levels, and this extends to after childbirth as well, where another nine months from the date of delivery has to be allowed in order to allow adequate time for iron stores to be replenished. So giving blood isn’t allowed for any reason during pregnancy.

Exercise

SAFE:

-Sit-ups/abdominal crunches
These are considered safe during the first trimester but in the second and third trimesters pregnant women could experience a drop in blood pressure when doing sit-ups, due to the weight of the foetus on the vessels carrying blood back and forth from the heart, when women lie flat in their backs with nothing underneath them, such as a pillow. However most women won’t find abdominal exercises to be easy enough to do in the later stages of pregnancy anyway.

- Weight training
This is safe provided women don’t try and lift weights that are too heavy for them but most trainers would suggest using resistance bands instead of weights that provide the same type of tension on the muscles without the risks.

UNSAFE:

- Horseriding
Because of the simple fact that it’s always possible to be thrown from a horse, no matter how experienced a rider you are, most doctors suggest all women do not ride horses at any time during pregnancy, and agree that the risks double in every trimester, as the uterus expands upwards and there is less space around the baby, making a foetus more vulnerable to any force or injury the mother may experience as well as placental abruption – where the placenta separates from the uterus, with very serious health implications.

- Skiing
Just like horseriding, skiing provides an opportunity for mothers to fall and hurt themselves, especially because of their decreased sense of balance due to the extra weight they are carrying. The cold temperatures and high altitudes related to skiing can also affect how much oxygen reaches the baby in some cases, so it should be avoided during all nine months of pregnancy.

Household items

SAFE:
- Pest sprays and cleaning products
Ever since Kelly Preston suggested her son Jett’s Kawasaki Disease must have been caused by the toxins he was exposed to when the family home’s carpets were cleaned when he was a baby, people have worried about the link between householding cleaning products and genetic disorders and defects. Most household cleaners can be used safely provided a pregnant woman never mixes ammonia and bleach and cleans in a well-ventilated area with gloves. But with the array of natural cleaning products available these days, and the fact that vinegar and baking soda are both excellent at cleaning all sorts of dirt and mess, there’s probably no need to use them anyway.
Pesticides are also always tested to be safe for all people and pregnant women, although once again, alternatives like citronella are even safer.

- Paint
Most paints are fine for pregnant women to be around, although good ventilation is a must and sleeping in a room that has been painted is not recommended – women should try and sleep in another room. Lead paint is an absolute no, for all people really but especially pregnant women because it can cause a number of problems when it is breathed in, not just as paint fumes but also as dust from paint that has been chipped or sanded away.

Medicine

UNSAFE:
- Sleeping pills
Getting a prescription for sleeping pills while pregnant will rarely come about, because there aren’t any sleeping pills that have been proven as being completely safe for pregnant women to use and there is also the chance of the baby developing a dependency and suffering from withdrawal, when they are used by the mother. For women who already have an existing prescription they should stop using them and discuss other solutions for dealing with insomnia with a doctor, immediately upon finding out that they are expecting.

- Cold and flu medications
It is very unfair that at a time when pregnant women have an increased susceptibility to colds and flus due to the slightly lowered immunity that accompanies pregnancy, they are also unable to take most over the counter cold and flu medications, with flu shots also being out of the question. A GP will be able to advise which medications are suitable to use so pregnant women should never buy cold and flu tablets for themselves without speaking to their doctor or pharmacist about the medications that are not safe for ingestion during pregnancy.

Food

SAFE:

Vegan and vegetarian diets
Women who have followed a vegan or vegetarian diet prior to conception may want to continue these diets after falling pregnant and they can – but extra care will need to be taken to make sure they are getting enough vitamins, iron, folic acid, protein and calcium either by taking supplements or consuming sources of food that contain these nutrients and fall within their vegan and vegetarian diets. Doctors and dietitans will be able to help with identifying suitable foods and supplements but women must follow their instructions to avoid depriving their baby and themselves of these essential nutrients.

UNSAFE:

Energy drinks
Besides caffeine, which most women are advised to reduce their intake of, early in their pregnancies, the other ingredients in energy drinks (mainly taurine and guarana) are not safe either which is why they should not be drunk at all, even though it may be tempting for some women due to the fatigue that accompanies pregnancy, especially in the first and third trimesters. Most energy drinks will actually state this somewhere on the bottle or can they are sold in.

Other things

Hot and spa baths/saunas
It’s no to both of these things, because of the combination of the high temperatures of spas and saunas that can cause a pregnant women’s heart rate to increase and restrict blood flow to the baby, and the enclosed spaces in which they are usually located, make it more likely that a pregnant woman could faint, which could be even more dangerous if they are unattended.
Some women also worry about waterbeds and electric blankets because of this fear of overheating but the risk of overheating while lying on an electric blanket or water bed is not as high as it is when inside a spa or sauna because the temperature of these devices can be better controlled. So if pregnant women want to continue to use waterbeds and electric blankets during pregnancy they can do so, although it may be best to switch them off before falling asleep to be even safer.

Vibrators
For any women inclined to use vibrators during pregnancy, most doctors recommend they don’t because too much force on the vagina can cause internal bleeding and there is also the possibility of infection and even triggering pre-term labour.

Amusement park/Carnival rides
Rollercoasters, waterslides and drop rides from heights may be seen to be off-limits because of the fast speeds but other seemingly harmless rides such as dodgem cars and Ferris wheels also pose risks because of the potential for sudden stops and collision. Both types of rides could rupture the uterus, leading to haemorrhaging or placental abruption so no rides are safe to be ridden during pregnancy. Fortunately most theme parks will clearly state on signs what rides are and are not safe for pregnant women, in case there is any confusion.


Dr Raewyn Teirney is gynaecologist, obstetrician and fertility specialist and a visiting medical officer at the Royal Hospital for Women in Sydney and also consults from her private rooms at Maroubra and Kogarah.

Dr Scott Dunlop is a consultant paediatrician at Sydney Paediatrics, Woollahra.