6 August 2008

I missed my period. Am I pregnant, and should I be on a special diet?

Hi, I missed my period last month. I am having doubts about whether or not I can eat non- vegetarian food in the initial stages of pregnancy and whether I can continue my job. I am a teacher. What precautions should I take?

Rimma Orenman

Hi Jiya,

Thank you for your question.

I would like to emphasize that missing your period does not necessarily mean that you are pregnant. People may miss their periods occasionally for no obvious reason or sometimes because of stress or rapid weight change.

So it would be important to take a urine pregnancy test (you may be able to buy it in a local store) and if you are indeed pregnant to see a trained midwife, nurse, or doctor. These health workers can follow your pregnancy to make sure that you and your fetus stay healthy. Nurses and midwives should also be able to refer you to a doctor in case they find anything abnormal. In general, a first visit to a health worker during pregnancy should include tests for sexually transmitted infections, for hepatitis B, a Pap test of the cervix, a urine test to check for a urinary tract infection, and a blood test to check your thyroid function and your blood type. It is especially important to see a doctor during pregnancy if you suffer from any medical conditions.

Fetuses can be harmed by certain infections that are common and and relatively harmless to children and adults. One of these is “Fifth disease” and is caused by a virus called Parvovirus B19. For this reason pregnant people are advised not to work with children.

For the same reason a doctor will take a blood test to make sure that the pregnant person is immune to rubella, a disease against which most people have been vaccinated. This disease, caused by a virus, causes a rash in children but they recover relatively quickly. However if a pregnant person gets rubella, the fetus can develop serious congenital anomalies. This is why pregnant people who are not immune to rubella should not work with children. Adults who are not immune to rubella can be vaccinated but pregnant people cannot be vaccinated because the vaccine is a “live-virus vaccine” which can also be harmful to the fetus.

Diet is an important consideration during pregnancy. A balanced diet is important as many vitamins and minerals present in fruits, vegetables, meats, poultry, fish, and milk products are essential for the healthy growth of the fetus. If a person is a vegetarian, it is possible for them to keep their vegetarian diet during pregnancy; however, it is important to ensure sufficient protein intake and they may find the advice of a dietician helpful. Vegan diets are not recommended during pregnancy.

Supplementing your diet with certain vitamins and minerals is also important. Many people need to take extra iron to ensure they do not develop iron-deficiency anemia as iron requirements increase tremendously during pregnancy. Folic acid supplementation is also very important prior to pregnancy and in the first 6 to 12 weeks during pregnancy since folic acid reduces the risk of neural tube defects in newborns. The recommended daily intake of folic acid varies depending on whether the person has had previous children with neural tube defects.

Pregnant people are also advised to avoid cheeses made from unpasteurized milk, uncooked hot-dogs straight from the package, non-dried deli meats and raw or uncooked fish, poultry and meats. All these products can contain Listeria which is a bacteria that is harmful to fetuses. Pregnant people are 20-times more likely than non-pregnant people to get listeriosis (i.e. become infected with Listeria). Symptoms may include mild flu-like symptoms like headache, fatigue, chills, and muscle and joint pain. Listeriosis during pregnancy can result in miscarriage or still-birth.

Pregnancy is not a time to diet. It is normal to gain between 11.5 and 16 kg (25 to 35 lbs) during pregnancy. Most importantly, pregnant people should aim to eat healthfully and sensibly.

It is important not to smoke cigarettes during pregnancy as this can result in miscarriage, premature birth, and low-birth-weight babies. Second-hand smoke should also be avoided. Consuming alcohol during pregnancy can cause fetal alcohol syndrome. There is no proven safe amount of alcohol that can be consumed during pregnancy and so many doctors recommend that alcohol should be completely avoided during pregnancy. The same is true regarding other drugs. If you are taking any medication, you should discuss with your doctor the pros and cons of continuing this medication during pregnancy.

I know this is a lot of information to take in all at once. I would suggest the following websites for good and detailed information on nutrition during pregnancy and other health concerns.

March of Dimes – Pregnancy
Guide to healthy pregnancy (Government of Canada)

And of course do not hesitate to write us again if you have any other questions.

Rimma, for Alterheros.