The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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4} e While many experts recommend taking 400 micrograms (0.4 milligrams) of folic acid daily, the British researcher who demonstrated this B vitamin’s role in preventing neural-tube defects, such as spina bifida, and other problems, says the dosage should be increased about tenfold, recommending that all women start taking 5 milligrams of folic acid daily two weeks before trying to conceive and continuing that dosage for at least the first 12 weeks of pregnancy. “Taking 0.4 milligrams of folic acid will prevent
about 40 to 50 percent of neural-tube defects,” says Nicholas Wald, director of the Wolfson Institute of Preventive Medicine and professor of environmental and preventive medicine at Barts and The London School of Medicine and Dentistry.
“Taking 5 milligrams will prevent about 80 percent.” The American College of Obstetricians and Gynecologists (ACOG) recommends that women who have had a child with a neural-tube defect take 4 milligrams of folic acid daily and that others take 400 micrograms.
However, Wald points out that there are no risks associated with the higher dosage.
Folic acid is available either by prescription or over the counter. If you don’t have a prescription, find a folic acid-only supplement; taking higher doses of a multivitamin containing it could lead to ingesting toxic levels of other nutrients, such as vitamin A.
5} a Products such as hair dyes, perms and straighteners have not been shown to pose a risk to the average pregnant woman, Filkins says. (Women who work in the beauty industry and are therefore exposed continuously, and in larger amounts, to the chemicals in these products may have a higher risk of miscarriage.) To be on the safe side, wait until after the first trimester to have any of these treatments done. In addition, limit hair coloring to once every eight weeks. Switch from permanent color, which sits on your scalp, to highlights, as dye may be absorbed into the bloodstream through the scalp.
Nail polish and self-tanners also have not been proven unsafe, but limit unnecessary exposure. Some nail polish brands now offer formulas free of a suspect chemical, dibutyl phthalate (DBP), but not all list their ingredients. And choose a nail salon with good
ventilation. “The less ventilation, the bigger the exposure,” Filkins says. Self-tanners do not seep into the skin; still, it’s prudent to avoid applying these products to your belly while pregnant and your breasts if you are nursing. Acne medications are another story: Some can cause severe birth defects. “High doses of vitamin A should be avoided,” Filkins says. “Retin-A [a topical prescription], which contains a vitamin A derivative, poses a theoretical risk, but Accutane [an oral drug] is definitely dangerous.” To be safe, don’t use either.
In fact, you should stop using both at least one month before trying to get pregnant. Even riskier is Etretinate, a psoriasis medication.
“Etretinate stays in the body for a very long time—up to two years—so it isn’t a concern just during pregnancy,” Filkins explains. “It shouldn’t be used at all if you’re planning a pregnancy any time in the future.”
6} b Most women can have sex up until the day they deliver without fear of bringing on premature labor. However, if you have had preterm labor symptoms during this or a previous pregnancy, if your water has broken or if you have had problems with bleeding, your doctor may ask you to abstain from intercourse. “But that’s the exception, not the rule,” Berens says. Prolonged standing—working full time as a cashier, for example—is linked to preterm labor, as is contracting some vaginal infections during pregnancy.
Finally, the births of as many as 18 percent of preterm, low-birth-weight babies in the United States each year may be attributed to their mothers’ gum disease, according to the National Institute of Dental and Craniofacial Research. Scientists theorize that bacteria in tooth plaque send toxins into the mother’s bloodstream and then cross the placenta, interfering with fetal growth and development.
7} a If you’ve been choking down liver and onions for their supposed health benefits, or indulging in pât because you love it, you can—and should—take a breather. Because an average portion of liver can contain four to 12 times the recommended dietary
allowance (RDA) of vitamin A (too-high amounts of which can cause urinary tract and central nervous system anomalies in the fetus), some experts recommend avoiding this organ meat altogether in early pregnancy. Others suggest limiting your intake of liver
and liver products (such as duck liver pât s and some sausages) to 4 ounces per week during pregnancy.