Before I got pregnant, I remember telling Steve that I thought it was cruelty to see a pregnant woman drinking a Coca-cola — the caffeine, the corn syrup, the chemicals. And I still wouldn’t drink a Coca-cola while pregnant, or at least I don’t think I would, but I have had Sprite maybe four times in the past four months. And I had hoped that I wouldn’t eat white bread, but sometimes I do, albeit local organic white bread.
Maybe because it took so long — because I began worrying about what food or drink went into my body over two years ago, trying and failing to get pregnant. Or maybe it’s because, now pregnant for 4 months, or 18 weeks, or 126 days, I can’t be all good all the time for even that long. The ideal rules have to bend to fit reality. I had hoped I wouldn’t breathe in toxic city air, but I was in Las Vegas and Philadelphia, and so were lots of other pregnant people and healthy children. In Las Vegas, I had to eat non-organic fruit, and so did lots of other pregnant people and healthy children. It forces me to turn to my intuition: this world was not created to be so weak that everything is destroyed in one small act. Damage occurs with an accumulation of small acts, or with one catastrophe. And the fetus was not placed in a precarious environment: it isn’t breathing in the air I breathe, and my body filters toxins for me before it reaches the placenta, which then double-filters for good measure before it reaches the baby.
This gets harder because the rules are vague enough that I am forced to use my intution. One book says that after week 16, I should not sleep on my back (something about blood flow cut off to the uterus). to quote: Please, do it for your baby: don’t sleep on your back. So I’ve been trying all this time to sleep on my side, but it involves wedging t-shirts under my waist and putting pillows between my legs — when sleeping on my back feels so good, which means I actually sleep, which means I’m less cranky, which means my quality of life is better, which means so is the baby’s. If it’s seriously harming the baby, how could I not know? A midwife knocked that book off the table at our most recent doctor’s appointment — she said I would know when I should start sleeping on my side because I’d be uncomfortable on my back. Doesn’t that make sense? / Another book says that I should not take a hot shower — keep it lukewarm or cool. Before pregnancy, I took the longest, hottest showers. I would stay in there and meditate and think and work through poems and life problems and just breathe. Once I became pregnant, the heat suddenly made it difficult for me to breathe in the thick air, so I’d keep the shower a little cooler and stay in for less time — but still it’s a hotter shower than Steve takes. For a few weeks I felt guilt, that I had scrambled my baby’s brains with too much heat. The midwife reassured me: if I’m not fainting, if it’s not too hot for me, my body is regulating the temperature well enough to keep the baby safe. Doesn’t that make sense?
Which brings me to wine. Before pregnancy, I would have a glass and relax while I cooked or read at night. Beginning in January, I didn’t have any. But the more reading I do, the more confused I become. One midwife says absolutely no wine, that she is told to say that because she works for the University and has to hold the party line. I understand that a lot of wine is bad, but none? Not a sip on my birthday? She said none. The recent midwife rolled her eyes and said that this culture is obsessed with alcohol-restriction, that she has to say no because of who she works for, but that a sip on my birthday is fine. Because wouldn’t I know? Wouldn’t the smell of it make me sick? How far can I trust my intuition and my own sense of logic and self-care?
When we were diagnosed with infertility and started on a pretty terrible emotional stretch, a doctor prescribed for me Lexapro, a small dose, one-quarter of a pill of the smallest dose the pharmacy offers. I had been through tricky life sequences before, but this one felt big enough that I decided I would finally try an anti-anxiety medication — to try skeptically, tentatively. I noticed within a few weeks that my anxiety decreased enough that one thing after another seemed manageable, and I could breathe. The doctors all told me to stay on the medication while pregnant, but I didn’t: there is a tiny-tiny risk of organ damage in a growing fetus in the first trimester while on Lexapro, and there is a tiny-tiny risk of other birth defects if the baby is conceived through IVF, and I felt these tiny risks accumulating, so I weaned myself off of Lexapro before we had the surgery to get pregnant, an eighth of a pill at a time. Furthermore, if the baby is born to a mother on anti-depressant or anti-anxiety medication, when they leave the womb they go into seratonin withdrawal, and the first few days of their life they’re more fussy. The doctors assured me that this was fine, but said that I could wean myself off of the medication in the month before birth and then get back on it after the birth if I didn’t want the baby to be fussy in its first few days. All the doctors made this symptom sound small, but to me it sounds horrible, for a baby to experience serotonin withdrawal so young, whether or not that’s happening in the womb or after.
In my recent doctor’s appointment, we talked about my anxiety, which for some reason has increased in pregnancy — most likely because I have reason to be afraid of losing the pregnancy after what we went through, and I have reason to be trying to cope with the trauma of the hormones and the surgeries. The midwife looked me in the eye and reassured me that if I wanted to go on Lexapro, everyone would support me and the risks were small enough to not be worth even talking about.
Which, to me, sets up an absurd comparison: I am encouraged to relax for the baby’s sake, but I am not permitted to relax with a sip of wine — of grapes that people have been drinking while pregnant since before Jesus was born — but I am encouraged to swallow a new concoction of chemicals that alter my brain. When the studies of alcohol were done in the US, they were looking at people who drank a lot, more than three glasses each day, and found that a very small percentage of them, 3 in 100,000, gave birth to children with a defect. And I’m sure that if people took 3 pills of Lexapro each day, there would be a similar statistic. Somehow our culture can rationalize that there are different doses of anti-depressants, but they cannot rationalize that there are different doses of wine. Here’s a quote from the March of Dimes: “Because of the fact that the effects of moderate alcohol intake during pregnancy are not known, the March of Dimes recommends that women who are pregnant or who can become pregnant avoid alcohol of any sort.” But the effects of moderate antidepressants are also not known, and we aren’t asked to avoid those. And the effects of moderate caffeine intake is known: while adults can break it down quickly, the fetus cannot, which means it accumulates, and it is known to affect the baby’s activity level and ability to absorb nutrients, a decrease in iron and calcium levels, and a greater chance of a preterm and low birthweight delivery — yet pregnant women are permitted two cups of coffee per day in the US. Why? Perhaps because caffeine increases productivity and is not considered a drug in our culture, although technically it is.
Sometimes I wonder if we even need studies: The US is notorious for its history of prohibition, of protestantism and the fear of alcohol’s effects: of losing control and the indulgence to get there. Europe is known for social celebration and moderation with alcohol. And England is known for the joyful indulgence of alcohol. Therefore, US studies conclude that alcohol is dangerous. European studies show that alcohol in moderation is excellent. And studies from England show that drinking each day is actually very good for the baby. The studies are predetermined by the culture in which they’re performed.
There are quotes for both sides of this issue, but here are some that interest me:
Dr. Michael Samuels of New York City’s Doctor’s Hospital says that the data has been “turned around for the purpose of frightening women”, and indicates that birth defects of any kind occur in 3 – 5% of babies born in the United States and only 1 – 2% of those can be related to the ingestion of alcohol. Based on the data of Samuels and other medical researchers, it becomes clear that less than 0.1% of all birth defects are related to alcohol, and that more than 90% of the affected children are born to women with a history of alcohol abuse.
More than this, not even one study carried out since the mid-1980s has shown a direct correlation between moderate alcohol consumption and birth defects. One study, of 33,300 California women showed that even though 47% drank moderately during their pregnancies that none of their babies met the criteria for Fetal Alcoholic Syndrome. The authors of this study concluded “that alcohol at moderate levels is not a significant cause of malformation in our society and that the position that moderate consumption is dangerous, is completely unjustified.” (link here to the article)
U.K. policymakers are shifting recommendations on consumption of low levels of alcohol and caffeine during pregnancy in reaction to two recent studies on the effects of the drugs, the Los Angeles Times reports. The studies — which were the “largest and most rigorous” to date on low-level alcohol and caffeine consumption during pregnancy — challenge the notion that alcohol should be avoided entirely during pregnancy and that light caffeine consumption has no effect on outcomes, according to the Times. The Times reports that the two studies suggest that “limited alcohol consumption is not so bad, while regular caffeine intake is worse than we thought.” (link here)
Here’s a British study that makes me laugh, it so vehemently contradicts everything we’ve been told:
Boys born to mothers who drank lightly during pregnancy are better behaved and score more highly in tests at the age of three than the sons of women who abstained, according to a study published today.
Researchers found there was no link between light drinking in pregnancy – defined as one to two units a week, or on occasion – and any behavioural or cognitive problems in children at the age of three.
Surprisingly, the University College London study found that some of the children of light-drinking mothers appeared to be doing better than the babies of those who abstained.
Boys born to mothers who drank lightly were 40% less likely to have conduct problems and 30% less likely to be hyperactive, even when the differences between social and economic circumstances were taken into account. They also scored more highly in vocabulary tests and were better able to identify shapes, colours, letters and numbers.
The study also found that girls born to light drinkers were 30% less likely to have emotional and peer problems, compared with abstainers, but in their case this could not be extricated from their family backgrounds. (link here)
I’m not saying that I know what I’m going to do or that I necessarily believe the studies on one side or the other. It just seems more and more apparent the further I get into this pregnancy that, like everything else, the choices I make are my choices, and they are, in the end, after all this necessary internal deliberation, based on my intuition alone.