“Will it hurt the baby?”

Every pregnant woman asks this question at least once during their 40-week journey. Pregnancy is a time when women become especially aware of their health and lifestyle, eating habits, physical activity, and other aspects of their lives. That hyper-awareness can range from legitimate concern to irrational angst.

So, here are some common questions that worried pregnant women ask regarding the health of their unborn children.

Can eating fish hurt the baby?

Fish is generally very healthy, rich in protein, and full of omega-3 fatty acids which are good for the heart. However, expectant mothers should be cautious about the types and amount of fish that they eat. Fish can be contaminated with mercury. If a mother’s blood has high mercury levels, her baby’s brain and nervous system can be affected.

Some vegetarians and certain cultures consume large amounts of fish. A recent study of Hispanic and Caribbean immigrants in a Brooklyn, N.Y., community found that exposure to mercury came mostly from consuming a high seafood diet.

Lead author of the study, Dr. Laura Geer, said, “we found that it was the fish consumption during pregnancy that was really driving the blood levels and the cord blood of their babies. High mercury levels can lead to development delays in children.”

Dr. Geer also notes that there are other sources of mercury exposure like skin lightening creams and dental fillings.

Certain fish are higher in mercury than others. The fish with the highest levels of mercury include marlin, shark, mackerel, and some tunas. Low mercury fish include whiting, trout, salmon, and tilapia. Expectant moms should consult with their doctors about their fish consumption and eat fish in moderation.

Will traveling hurt the baby?

Travel during pregnancy can cause major concerns for pregnant women. Whether by land, sea, or air, whether it be domestic or foreign, the traveling pregnant woman loses the security of knowing that she is in close proximity to her obstetrician. While the actual act of traveling is not harmful in pregnancy, certain precautions should be taken, including consultation with a doctor.

By land…
If traveling in a vehicle, pregnant women should always buckle up. In the third trimester, the lap belt should lay across the hips under the pregnant belly. For long trips, pregnant women can reduce the risk of forming blood clots in their legs by walking at least every two hours. If in a train or bus, walking the aisles while holding onto railings is an option.

By sea…
The notion of being out in the middle of the ocean can really make a pregnant woman feel vulnerable. Expectant moms should call the cruise line to inform them of the pregnancy and to confirm that adequate health services will be available on the ship as well as at the ports. Cruises are well known for viral outbreaks, so hand washing and good hygiene is very important.

By air…
While flight travel alone is not harmful to a baby, it does carry some risks. Very rough turbulence can occur, so holding on to seats while walking the aisles is highly recommended. At high altitudes, the fetus is exposed to cosmic radiation, which might be more than is recommended in pregnancy, especially for frequent flyers. Planes of major airlines are usually pressurized and allow for an adequate amount of oxygen to mother and fetus, unlike smaller unpressurized planes. Airport security scanners have not been shown to be harmful.

Foreign travel…
Traveling to foreign countries is relatively safe during pregnancy. Pregnant women should consult their doctors about any vaccines that are safe during pregnancy to protect against infectious diseases. Drinking bottled water and eating only cooked foods is highly recommended. Travel insurance is a good idea, whether pregnant or not.

Will medications hurt the baby?

A common myth is that all medications are harmful in pregnancy. This is simply not true. Many medications are safe in pregnancy. Especially in complicated pregnancies, some medications are needed to assure that the fetus remains healthy. For example, diabetic pregnant women may benefit from being on insulin if their blood sugars are hard to control with diet. Uncontrolled blood sugars can result in a stillborn baby or a comatose expectant mom.

Common medications taken in pregnancy are acetaminophen (Tylenol), antacids, and stool softeners. Medications that should be avoided in pregnancy include ibuprofen (Motrin), ace-inhibitors (for blood pressure), and fluoroquinolone antibiotics (like Cipro). Other medications pose some risk to a fetus, but the risks to the health of the mother have to be weighed against the risk to the fetus. After all, healthy babies come from healthy moms.Will an epidural hurt the baby?

Epidurals are commonly used for pain control during labor and are generally safe in pregnancy. Sometimes the epidural can cause the mother’s blood pressure to go down, which can affect the fetus’ heart rate. This often resolves without intervention, and is otherwise treated by giving the mother another medication to raise her blood pressure to an acceptable level.

Does exercising hurt the baby?

In a low risk pregnancy, exercise does not increase the risk of miscarriage. If a woman has been following an exercise regimen before becoming pregnant, she should feel free to maintain that regimen. If a pregnant woman wants to start exercising during her pregnancy, she should start slowly and listen to her body. Pregnancy is not the time to exercise for the goal of weight loss. So, starting a rigorous regimen for the first time in pregnancy is not recommended. Because dehydration is common in pregnancy, expectant moms should drink plenty of fluids.

Does sex hurt the baby?

This question is frequently asked by couples. Intercourse is generally safe in low risk pregnancies and actually encouraged once the pregnancy is full-term. Intercourse should be avoided in certain high-risk pregnancies, including history of preterm deliveries, placenta previa, short cervix, ruptured membranes (water is broken). Semen can cause the uterus to contract, although, there is no evidence that it can induce full-blown labor.

Pregnancy is an exciting, but uncertain, time. Any questions about nutrition, travel, activity, medications, or lifestyle should be directed at your obstetrician.

Renée Volny, DO, MBA is a practicing obstetrician-gynecologist, a graduate of Morehouse School of Medicine’s Health Policy Leadership Fellowship, a contributor to the Policy Prescriptions online forum, and participates in medical missions with the International Healthcare Volunteers.