A realistic view on pregnancy health guidelines

Pregnant women are given a long list of health guidelines to follow during pregnancy, lets take a closer look at these guidelines and get an idea on what you should and shouldn’t consume while pregnant.

Interestingly enough  many of the guidelines are arbitrary and differ from country to country.  This is a huge red flag that many of these guidelines may not be based on any actual science.  Ok so what are the guidelines?  If you live in the United States you’ll be told to avoid anything unpasteurized like milk, yogurt, juice, cheese, etc., but also raw eggs, lunch meat, sushi, soft cheese, liver, alcohol, smoking, limit fish and caffeine, and always eat your steaks well done.

However in France soft cheese and wine is commonplace and even smoking while pregnant isn’t seen as taboo but in the United States if someone lights up while pregnant you’ll be lucky to leave the smoking area without someone telling you how terrible of a person you are.   The French are also advised against eating raw vegetables as well which would exclude eating salad while pregnant. In Japan sushi is eaten during pregnancy without restriction yet they somehow manage not to kill off their unborn fetuses at an alarmingly high rate.

So sushi, cheese, and wine are ok in other countries but are a threat in the United States?  Interesting. Before I go into detail about all of these guidelines the main thing that comes to my attention is that there is no mention of added sugars or refined carbohydrates.  In other words the foods that are at the top of the list for chronic illness and physical degeneration are completely fine but you’re supposed to avoid some of the healthiest foods in the world like raw fish, liver, and other raw foods that have a very high nutritional value.  Then of course stick to pasteurizing anything that has healthy raw enzymes.  I’ll go into more detail later about the benefits of raw foods but first lets break down each of these guidelines.

Listeria hysteria!

So the main reason for the recommendations to avoid lunch meat, raw vegetables, unpasteurized dairy, and unpasteurized juice is fear of getting listeria monocytogenes.  Which is a bacteria found in these foods.  If you were to get this while pregnant this could lead to miscarriage, premature delivery, infection to the newborn, or possibly even death (roughly 1 in 5 women who get listeria will lose the baby).  Pregnant women are roughly 10 times more likely to get listeria.  Also, the mother may show no signs of it while the fetus can contract the bacteria.  Sounds pretty scary right?

Ok now with the good news.  The odds getting listeria while pregnant-roughly 1 in 33,000.  Let’s put this into perspective, here are some other odds comparable to this.

The odds of dying in a car accident: 1 in 18,585.

The odds of being murdered: 1 in 18,000.

The odds of picking a 4 leaf clover on the first try: 1 in 10,000.

The odds of winning an academy award: 1 in 11,500.

And again, just so that you can read it one more time, the odds of getting listeria while pregnant: 1 in 33,000.

This comes straight from the CDC based on a report using data from 2009-2011 (1).

So you’re almost twice as likely to die in a car crash or get murdered than you are to get listeria, and you’re roughly 3 times more likely in your lifetime to win an academy award or pick a 4 leaf clover.

By these standards maybe doctors should start advising pregnant women to avoid getting in a car, or maybe even to avoid leaving the house for fear of getting murdered.

The other interesting part of the study showed that people in general who contracted listeria were already high risk. Most of the people who contracted it were over the age of 65 with an immune compromising condition.  It didn’t go into detail on the health of pregnant women who contracted it.  The actual causes of listeria during this 2 year period according to the Center of Disease Control:

Soft cheeses labeled as made from pasteurized milk were implicated in five outbreaks: four implicated Mexican-style cheese and one implicated both chive cheese and ackawi cheese (a white brine cheese). An aged, blue-vein cheese made from unpasteurized milk was implicated in the sixth outbreak. Two raw produce items, pre-cut celery (an ingredient in chicken salad) and whole cantaloupe, were implicated as listeriosis outbreak vehicles.” 

So this is where France gets the whole no salad thing, but why are pregnant women not advised to avoid celery and cantaloupe in the United States?  Raw produce caused 2 of the outbreaks, more than unpasteurized cheese caused.  In other words listeria can come from any raw food, which if followed strictly would cut out an incredibly important part of your diet.


Next lets talk about this whole salmonella issue.  Which means avoid raw eggs and sushi.  The main difference between this and listeria for pregnant women is that if you get salmonella poisoning it will effect you and potentially your baby (although most of the time it won’t effect the baby), so you will notice if you get it since it will effect you. Symptoms of salmonella poisoning include nausea, vomiting, abdominal cramps, diarrhea, fever, chills, headache, and blood in your stool.  If not treated this could potentially lead to death.  Again, scary stuff right?

However the truth is that if you want to reduce your risk for salmonella one of the best ways to do this is to buy higher quality food.  Buy from organic farmers that produce high quality food and the risk is drastically reduced.  Even if we look at conventional eggs sold from the grocery store the odds of getting a salmonella infection are roughly 1 in 20,000.  Which again means you’re more likely to die in a car accident than get salmonella. If you’re purchasing high quality organic eggs the risk is virtually non existent.

Sushi if prepared properly also has very low risk for getting salmonella or a parasite for that matter.  Sushi restaurants take certain steps in handling and preparing their fish.  A required step involves freezing fish at temperatures of -4 degrees Fahrenheit (-20 degrees Celsius) for seven days, or frozen at -31 degrees Fahrenheit (-35 degrees Celsius) for 15 hours, which kills any parasites.  Another important thing to know here is that salmonella is more likely or just as likely to be found in raw nuts (2), and can also be found in raw produce; yet again there is no warnings against these food items in the United States.


As far as eating under cooked meat goes, this is for fear of getting a parasite called toxoplasma ghondii.  Again, the odds of getting this and having it lead to birth defects are roughly 1 in 33,000 pregnancies.  Most cases of toxoplasmosis are mild and in otherwise healthy people, doesn’t usually require treatment.  If you were to get infected it can be treated with antibiotics.

The ridiculous caution of eating liver

Beef liver is high in many vitamins including vitamin A, which is why women are told to avoid liver during pregnancy.  This advice can be traced back to a 1995 research paper published that followed 23,000 pregnant women (3).   Roughly 20,000 of the women consumed less than 10,000 IU of vitamin A and had a 1.5% rate of birth defects while the other 3,000 women who consumed over 10,000 IU of vitamin A a day had a 3% rate of birth defects.  So the advice to consume less than 10,000 IU a day of vitamin A comes from this single study.

However, not only are there flaws with this study but there are other studies that have shown vitamin A intake of up to 300,000 IU daily without increased rates of birth defects (4).  So the recommendations are only off by a measly 290,000 IU.   Looking at the bulk of studies done on vitamin A there is no reason to fear Vitamin A, it is not a cause of birth defects and actually can prevent birth defects.  The 1995 study did, however, show a correlation between synthetic vitamin A and birth defects.  It’s important to note that correlation does not equal causation and also the study did not look at vitamin A from real food.  Studies that included vitamin A from food show no correlation.


There is, however, some truth to all of this.

So above we’ve talked about the odds of getting these rare infections; however, more than likely we are exposed to bacteria and parasites much more often than we think.  For example, according to a study up to half of the world’s human population is estimated to carry a Toxoplasma infection (5).  However most people are asymptomatic because the immune system keeps the parasite from causing illness.

Also, a study done by the British government found that 23 percent of farms with caged hens tested positive for salmonella, while just over 4 percent in organic flocks and 6.5 percent in free-range flocks carried the bacteria.  (The healthiest form-pastured eggs, were not included in the study.)  Again, showing that it is exposed to us on a rather normal basis but getting sick from it is very rare.

With odds like these, why even take the risk right?

I mean why not just cook everything to a burnt crisp just to ward off any possible exposure?  Better safe than sorry.   The fact is though, that raw foods contain more vitamins and even contain good bacteria that our body needs.  If we are going to follow these rules we would have to do it with everything: nuts, vegetables, fruit, etc.


Some unconventional dietary suggestions

Since you are higher risk during pregnancy, the focus needs to be on keeping a strong immune system.  I’m not suggesting to completely avoid the concerns listed above, but to put them into perspective.  Instead of  freaking out if you had some rare steak, personally I wouldn’t even bat an eye or think twice about it.  The main thing to focus on is keeping a strong immune system.

Here is where some of these guidelines can be an issue.  For example, raw full fat milk from pastured grass fed cows is the healthiest form of milk you can drink.  Adding this into to your diet while pregnant is one way to add vitally important nutrients needed while pregnant.

Beef liver is one of the healthiest foods (if not the healthiest) on the planet, and should be encouraged while pregnant.  Eating liver once or twice a week would be ideal during pregnancy, and if from pastured grass fed cows then it could even be eaten raw.

However the odds of getting a woman to eat raw liver: roughly 1 in a million-and honestly  even eating cooked liver may be unlikely.  If this is the case then you may want to try supplementation that isn’t synthetic.

Not only should you be consuming the healthiest foods but you should also be avoiding foods that negatively effect your immune system.  These include: added sugars, fructose (not from fruit), industrialized grains, vegetable oils, and processed food.  Refined carbohydrates are detrimental to health, and should be avoided at all costs.  This is something that should be done anyways but while pregnant is even more important.  Avoid refined carbs like you would smoking, studies have pretty much confirmed they are as bad or at least nearly as harmful.

The point is to follow rules you would normally follow, why should we all of a sudden change what is healthy and what isn’t while you are pregnant?  For the most part the same rules apply; however, since you at a higher risk these rules should be adhered to even more so than usual.

More and more studies continue to show the importance of keeping a healthy gut microbiome in order to have a strong immune system and fight infection.  Supporting good bacteria and reducing bad bacteria in your gut comes from a healthy, real food diet that includes probiotics.  Raw foods that you may have been advised to avoid while pregnant can contribute to a strong immune system.

Should you supplement?

In an ideal scenario you could get most, if not all of the vitally important nutrients while pregnant from food alone.  However, with industrialized food being far from ideal most women may not be able to obtain all of the nutrients they need from food alone.  So in other words if you’re not able to follow a strict healthy diet you should probably consider supplementation.

Some suggestions would be a folate supplement (instead of folic acid), a prenatal supplement, vitamin D, cod liver oil, and vitamin K2.  Don’t worry vitamin K2 isn’t the same as the vitamin K they warn against.  Folate is something that while pregnant you need more of, the others are to ensure you’re getting vitally important nutrients that you may not get from diet alone.  The minimum recommendations for folate are 400-600 mcg.  Although a more ideal number to aim for would be 800-1200 mcg.  Although supplementation may be needed, try to get as much vital nutrients from food alone and supplement where you are falling short.  This means you may not have to supplement as much as the recommended  dose on the box if you are eating a nutrient dense diet.

Trying to do everything correctly while being pregnant can be a daunting task that sometimes can leave you feeling overwhelmed and stressed out, which isn’t good for you or your baby.  Hopefully getting a different viewpoint towards some of these pregnancy health guidelines will give you a more confident approach towards pregnancy.  Focus on real food and try not to stress out so much.





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