Should pregnant women avoid non-vegetarian food and sex? A doctor explains
A 30-year-old friend of mine was enthusiastic and determined about "going natural" during her much awaited first pregnancy. She questioned the need for regular antenatal check-ups and believed that doctors did more number of unnecessary ultrasound scans which would harm her baby (ultra "sound" is innocuous sound wave, unlike radio-frequency waves in X-rays or CT scans).
When she was diagnosed to have increased blood pressure in the seventh month of pregnancy, she stopped consulting that doctor and started trying out "natural" ways to decrease the blood pressure.
She was not uneducated or uninformed and was fortunate to have uninterrupted access to the internet, unlike the majority of pregnant women in our country. When her feet got swollen and failed to shrivel even with rest, she kept them dipped in warm saline instead of consulting a doctor. (Age-old traditional wisdom of saline as an answer to swelling was tried with conviction). She felt triumphant when she delivered a healthy baby girl.
Her zeal did not last long because she went into cardiac arrest due to uncontrolled blood pressure following delivery. With the effort, wisdom and courage of doctors who practised "evidence-based medicine" (not to be imprudently equated with "allopathy", "western medicine" or "modern medicine"), she was revived! For the rest of us, she was reborn!
By the time I recovered from the shock of this incident, various media reported the release of a document titled “Mother and Child Care” by the Central Council for Research in Yoga and Naturopathy (CCRYN), an autonomous body under the ministry of Ayush with the aim of "taking the well known benefits of yoga and naturopathy to pregnant mothers".
My response to the above document is not different from the wonted reply I provide to patients in daily practice. Many of the patients with chronic diseases I counsel ask about the benefits of alternate systems of medicine as therapeutic options.
With due respect to their concern, I deliver a standard answer that I am not qualified in any other system of medicine to give a verdict on the efficacy of that regime, but I am trained to provide scientific information based on existing evidence on any condition pertaining to physical and mental health.
I am not the right person to talk about the merits of yoga and naturopathy in pregnancy and delivery, but I am qualified and authorised by the law of this land to provide evidence-based information on pregnancy and antenatal care.
Strangely in our country, opinions are provided by people who are the most ineligible to do the same. (Politicians give health advice to people, media personnel teach history, "pseudoscientists" discourse on religion and what not!)
Such futile opinions serve only to cloud the understanding of the public and deny them the opportunity to avail ethical and science-based healthcare.
The American Congress of Obstetricians and Gynecologists (ACOG) is an organisation dedicated to the advancement of women’s healthcare and has published guidelines and statements on issues pertaining to women's health, which is freely accessible on their website for professionals and the public.
I revisited the ACOG guidelines to understand the strength of evidence for dietary modifications and sex during pregnancy as these were the most controversial statements in the “Mother and Child Care” document.
Is there evidence for a vegetarian diet affecting the outcome of pregnancy?
Based on the recommendation by ACOG, a normal weight pregnant woman needs additional 300 calories in the last six months of pregnancy. This can be derived from vegetarian or non-vegetarian sources depending on local custom, easy availability and prevailing social practices.
Ensuring adequate and appropriate supply of carbohydrates, proteins, fat, minerals and vitamins is key to a successful pregnancy. Dietary restrictions and food faddism imposed by the family, society or the government without any rationale will adversely affect the future of this country by preventing adequate nutritional supply to the baby in the womb.
Is there evidence for avoiding sex during pregnancy?
The Ayush ministry has clarified that their document does not mention any rule for sex during pregnancy. (After all, who is bothered about the sexual needs of a pregnant woman?!)
The ACOG has not been reluctant in addressing the sexual needs of a woman during pregnancy. If there is no contraindication in an individual patient due to preterm labour, low lying placenta and bleeding, there is no harm in having sex during the entire period of pregnancy, provided both partners are comfortable with the idea and method. Whatsoever, the baby remains protected inside the womb in a see-no-evil, hear-no-evil and speak-no-evil world!
I wonder why "suggestions" and "code of conduct" specifically target women more than men. I yearn for a day when politicians, policymakers and governing bodies come up with a modus operandi for partners of pregnant women and I would like to incorporate the following suggestions.
Some guidelines and evidence-based suggestions for men to be of aide to their pregnant partners:
- Stop smoking, as it has been shown beyond doubt that passive smoking affects the baby's growth and has been implicated as a risk factor in Sudden Infant Death Syndrome (SIDS).
- Do not hesitate to give a hot warm bath to your pregnant partner and massage her legs and back. Pregnant women are prone to muscle cramps and lower back pain.
- Cuddle more often with your pregnant partner and put her to sleep. Hormonal imbalances in pregnancy causes sleep disturbances in your partner and the best effective treatment for sleeplessness is not sleep medicine but a good sleeping partner. (If you cuddle more, there will not be any need to drill your wall to "hang good and beautiful pictures in your bedroom". Courtesy: Ayush ministry).
- Help your partner in household work or rather give her adequate time to rest. Pregnancy is a time when the female body demands adequate rest. (Then your partner would always be in "good company" as advised by the ministry.)
- Be kind to your pregnant partner; then she can stop seeking kindness and solace in the "lives of great personalities", as prescribed by the Ayush ministry.
My intention is not to ostracise people like my friend who negate rational thinking and end up in trouble pursuing alternative therapeutic options, because I believe in their freedom of choice.
But I ardently wish people are not denied the right to scientific information before making informed choices that essentially concern their lives.