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Food Fright

Today's pregnant women are afraid to eat sushi,
tuna, peanut butter, aioli, coffee, bologna, and
more. Was it always this way?
By Sara Dickerman
Posted Wednesday, Sept. 15, 2004, at 3:55 AM PT 


I've got to confess: I'm in my eighth month of
pregnancy, and so far I have sheepishly eaten
several slivers of air-dried Serrano ham, a few
crumbles of blue cheese, and one shimmering piece
of yellowtail nigiri. Then, there's the red wine.
It started with furtive thimblefuls (just to
taste a new wine at the restaurant where I work!)
but has spiraled out of control into a biweekly
half-glass. All of these items
are on the do-not-consume list for pregnant
women, but no one seems to be able to tell me how
much of a risk occasional lapses like mine pose
to my baby. Food, which has always been my great
delight in life, has now begun to freak me out. 

I'm clearly not alone. As Alex Kuczynski observed
in the New York Times, incessant warnings from
doctors, friends, and the Internet tend to give
the modern pregnant woman a nasty case of
"pregnancy paranoia." The list of sketchy
comestibles is almost comically
long. Alcohol is an obvious no-no even though
it's unclear whether or how moderate drinking
could lead to fetal alcohol syndrome or
miscarriage. We are also told to avoid deli meats
(listeria risk), sushi (parasite risk), coffee
(possible miscarriage risk), soft and blue
cheeses (listeria again), peanut butter
(allergy risk), tuna (mercury risk), liver
(retinol poisoning risk), aioli (salmonella
risk), herbal teas (untested medicinal effects),
and any meats cooked less than shoe-leather tough
(toxemia risk). It's understandable that modern
women think they live in a time when it's
particularly stressful to be pregnant.
But are the vigilance and anxiety that accompany
pregnant women to the dinner table really all
that new? 

As long as women have been carrying children,
they have received advice, often dour, often from
men, about what to eat and drink. Even Plato had
his rather common-sense saying: 
"Children shouldn't be made in bodies saturated
with drunkenness." But alcohol hasn't remained
off-limits throughout history: According to
historian Janet Golden, in the 18th and 19th
centuries, alcohol was prescribed to pregnant
women as a tonic to treat "deranged stomachs"
(the contemporary term for morning sickness).
Even though nutrients had not yet been
discovered, women were still directed to
eat or avoid certain foods. It was believed that
a mother who consumed sour, spicy food might
produce an ill-tempered baby, and mothers were
sometimes urged to eat "young meats" like lamb
and veal in the interest of their own young
offspring. 

Childbirth, of course, used to be a more deadly
business for mothers and newborns�one that may
have stoked apprehension in many new mothers but
may have also prompted a certain fatalistic
repose. In the 1880s German Dr. L. Prochownick
developed a high-protein, calorie-restricted diet
intended to help expecting mothers limit the
weight that they�and thus their fetuses�would
gain during pregnancy. The theory was that a
smaller baby would make for an easier delivery.
We now know, of course, that low-birth-
weight babies have a harder time surviving.
But low-pregnancy-weight gain remained a major
recommendation even as modern obstetrics
(prenatal consultations, C-sections, antibiotics)
helped maternal mortality rates shoot downward in
the midcentury. Doctors worried about the effects
of substantial weight gain on a mother's overall
health.
The low-weight-gain imperative was supported by
the spurious view, popular through the 1960s,
that the fetus was a "perfect parasite,"
siphoning off its nutritional needs from the
mother's body, regardless of her diet (a notion
that no doubt set a mother's mind at ease when it
came to her prenatal eating habits).

Although eating too much was long discouraged,
the role of dietary nutrients became clearer
throughout the 20th century; doctors began to
recognize that a good diet could have a positive
impact on maternal and newborn health, even if
they did not agree on specifics. As the century
progressed, supplements and vitamin-rich foods,
like cod-liver oil and liver, became more
commonly recommended for mothers to be.
Moderate alcohol use was not forbidden, but
liquor was shunned as a source of "empty 
calories" not worth the potential weight gain. It
has only been since the 1980s or so that, in the
United States, the hazard of a malnourished baby
has trumped the potential complications of the
postpartum mother's being overweight, and women
are given more workable guidelines for weight
gain: 25 to 35 pounds for an average woman, 15 to
25 for an overweight one. (In the
midcentury the recommendation for an average
woman maxed out at about 20 pounds, and some
overweight women were even encouraged to lose
weight.)

But as weight became less of an obsession, the
relative safety of everything a mother consumed
became more of an issue. In the 1980s the popular
mothering-advice business exploded with the
publication of the best-selling What To Expect
When You're Expecting series. (WTEWYE itself has
sold over 10 million copies since its 1984
debut.) The books, which continue to be an
essential part of the pregnancy library, exposed
women to a wealth of information about pregnancy,
but they were also notorious for their
puritanical tone, particularly on issues of
nutrition. The WTEWYE "best odds diet"
demanded not only increased vitamin, protein, and
iron consumption from expecting mothers, but
urged them, while they were at it, to seriously
restrict salt and fat intake and to give up
refined flours and sugars.
The nutritional companion to What To Expect,
called What To Eat When You're Expecting,
scolded, "Nothing offers your baby less to grow
on than sugar. Every calorie refined sugar
supplies could better come from foods that yield
a nutritional return, which is reason enough to
offer it to your baby as rarely as possible." At
the core of this thinking is the overwhelming
notion that no action a mother takes is
without direct consequence for the baby. "Your
baby equals what you eat." (The times have
changed a bit: A recent third edition of What To
Eat boasts an "all-new (guilt-free!) attitude.") 

The WTEWYE books were not so much the cause of
pregnancy paranoia as the crystallization of a
trend that was already in the works. One reason
for the new parental vigilance might have been
the newly available images of unborn children.
Until the late 20th century, Americans had never
been so aware of the prenatal life of a fetus:
The spread of ultrasounds and amniocentesis in
the '70s and '80s gave women a glimpse of their
babies in utero while Roe v. Wade sparked the
legal movement toward what Golden calls "fetal
personhood." At the same time, childbirth
professionals became increasingly legally liable
for anything that went wrong with a child's
delivery, so instead of offering common-sense
advice, many health-care professionals were 
understandably inclined to tell women how to
avoid all possible risks. The surgeon general's
1989 warning about alcohol use during pregnancy,
for example, called for absolute abstention, even
though fetal alcohol syndrome develops almost
exclusively in the offspring of
alcoholic women. 

In the wake of WTEWYE's success, dozens of
pregnancy guides sprang up in print and on the
Internet, many with "don't" lists outnumbering
"do" lists. And this is a key problem with
contemporary pregnancy advice,
on culinary matters and otherwise�the emphasis on
fears of a poisonous environment, rather than on
positive steps that can help the baby's
development.
On babycenter.com, the massive Web site for
parents and parents-to-be, for example, the paid
content, which is presumably the site's most
desirable, consists largely of anxiety-focused
information: baby equipment recall alerts and a
long list of "Is it safe" questions and their
heavily qualified answers.

Before the window into the womb opened up,
pregnancy's anxieties stemmed more from a lack of
information than its overabundance. As my mother,
who was pregnant in the '60s and '70s, said: "We
certainly knew something could go very wrong, but
there was not too much we could do about it." A
woman who made the effort to eat
liver and onions once a week was pretty proactive
in those days. But thanks to a surfeit of
information, today's expecting mothers have a
sense of culpability about every bite they eat
and sip they take�even if they don't know
precisely how risky such behavior is.
As much as I wish some of the information
available were more conclusive, I have come to
accept that there will probably never be a
double-blind study on the effects of raw
yellowtail on fetal development. I do know I'm
looking forward to the sushi party I'm going
to have in celebration of my baby's birth. Or do
I have to wait until I'm done breast-feeding? 


Sara Dickerman is a cook and freelance food
writer in Seattle. 

http://slate.msn.com/id/2106463/




                
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