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I have become public property. Nine months ago I could not imagine that a stranger would smile at me, then reach out to tenderly pat me on my abdomen. But now strangers do, with no obvious sense of reticence or embarrassment – instead they just ask whether I know if it is a boy or a girl and am I resting enough?
I have come to realise that this typifies the experience that noticeably pregnant women can expect from people they know – and people they don’t. I can’t imagine asking a stranger much less intimate questions, such as what their mortgage repayments are, or what they earn. Even the question of whether or not you had “planned” the conception seems to be socially acceptable.
I might be tempted to write this off as just another irritating side-effect of pregnancy. But the ease with which individuals and institutions give out advice – and cause alarm about pregnancy – doesn’t stop with patting your tummy and asking how long you have been trying. There have been enough scare stories in the press over the past month about the “risks” of pregnancy that it is difficult to imagine how women ever managed to give birth before we had all this “advice”.
Take sunshine. Recently the Royal College of Obstetricians and Gynaecologists (RCOG) deigned to advise pregnant women that we should not sunbathe lest we overheat the foetus. As a GP, I read this and have no doubt that it is important – to women who are toasting themselves during sunny hours or living half-submerged in a hot tub.
To be fair to the RCOG, its advice concerns what to do in a heatwave. But the majority of those of us who are pregnant are tired and large. Melting in the throes of a tropical sweat does not float my pregnant boat. To keep myself comfortable I have to sit under a massive umbrella with ice on tap and someone kind to fan me. Isn’t keeping cool a matter of common sense? Is issuing guidelines to scold pregnant women into the shade when they are in a heatwave terribly useful?
I can’t but help feeling rather picked on, especially when much of the press translated the story into a general warning about the dangers of the sun in pregnancy.
The problem is the sheer amount of bad information about risk that pregnant women are meant to absorb happily (along with their folic acid and recommended antenatal exercise classes). Pregnancy is presented as a major feat to get “right”. Don’t drink (more of that later); don’t eat liver (too much vitamin A; no problem, it’s disgusting); don’t drink too much coffee/tea (caffeine), or eat too much chocolate (more caffeine); don’t eat unpasteurised cheese; don’t eat pâté; don’t eat coleslaw; don’t change your cat-litter tray; don’t eat raw meats or sushi; don’t gain too much weight; don’t put on too little. In case that lot is not enough to worry about, you also shouldn’t get stressed (it lowers the baby’s IQ, apparently).
I agree, some things do come with risk. However, the danger of most of the above is pretty small. Whereas the risk of becoming a nervous wreck at the thought of all the rules is, for me, quite large.
Let’s take a look at that list again. Caffeine: lots of people refused to make me coffee once they knew I was pregnant. Makes the baby small, they’d say, loudly. It made me feel like a criminal mother in the making. In fact lots of research suggests that you can have caffeine in doses of up to 300mg a day without undue concern, which is three cups of instant coffee, or six cups of tea, or eight cans of Coke, or eight bars of chocolate. Exceeding this is unlikely to be recommended for the nonpregnant, either.
Now the coleslaw risk: the man behind the till in the hospital canteen eyed me rather suspiciously when I tried to buy some with my baked potato. The reason is the risk of listeria infection. This bacteria can cause miscarriage and premature labour.
The Health Protection Agency says that in 2006 there were 25 cases of listeria in pregnant women in the UK. However, listeria does not just occasionally come in coleslaw, or soft cheeses, that we are advised to avoid, but has been found in sandwiches, chilled foods, cold meats and smoked fish.
If you want to try to abolish all risks in pregnancy it would seem a difficult if not futile task, especially if you want to eat.
Instead of treating women like sensible people who can think for themselves, we are in the midst of a feast of dramatic warnings about the risks of pregnancy. Do not forget the melodramatic recent announcement by not only the Department of Health but also the British Medical Association (BMA) that alcohol in pregnancy was to be avoided absolutely. (I am a member of the BMA and now thoroughly ashamed of it.)
The American prerogative of it being “acceptable” to tell a pregnant woman supping beer in a bar that she is a bad and undeserving mother will no doubt soon be happening here. No one thinks that binge drinking or getting drunk or imbibing every day is good for a healthy pregnancy – or for anyone else. But I have gone from being generally off alcohol on the grounds of heartburn and nausea to a profound feeling that I am fed up with being preached at – and want a half of Guinness. There is no research basis for saying that a little alcohol will do the baby harm; it’s the heavy intake and the binge drinking that is the problem (and are pregnant alcoholics going to listen anyway?).
My issues with the glut of advice being given about pregnancy are twofold. Instead of pregnancy being one of the happiest times of life, it is instead filled with well-meaning but mismatched advice that can seriously damage your health. And second, what happens next? Pregnancy results in a baby. The Children’s Society has quite rightly recently condemned the risk-averse attitude of parents who want to keep children wrapped in cotton wool and not allow them to work out or take risks for themselves. This risk-averse mentality is now starting in utero.
This is, of course, what you can expect of a society that regards the pregnant woman as its collective property. It is entirely logical – as well as nuts – that society should extend the same overinflated dangers of pregnancy and sentimental public ownership of the pregnant to a risk-averse way of regarding the newly born child.
I am rather afraid that a cheese-eating, Guinness-drinking pregnant doctor will be attracting the attention of her midwife – for all the wrong reasons, which is why I am writing this under a pseudonym.
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