The Don’ts and Don’ts of Pregnancy

Have you ever noticed that when a person announces her pregnancy, after the “Congratulations” she gets a whole lot of unsolicited advice? It likely happened to you! And most of that advice comes in the forms of things to avoid? “Don’t do this, don’t do that…” It often comes from well meaning, yet uninformed friends and family.  It can even come from those “in the know”- doulas, doctors, midwives, prenatal yoga instructors- as well!

Slapping so many don’ts on pregnancy is problematic for a few reasons:

1. Upholds a culture of fear surrounding pregnancy. A little bit of fear is a good thing when it informs our personal safety, but too often, it is not based on reality and gets in the way of living a joyful life.  Consider the person living in an average neighborhood who misses out on the benefits of taking a walk- the fresh air, the exercise, the opportunity to connect with neighbors- because of the fear that they may be attacked along the way, even though this kind of crime in their neighborhood is virtually non-existent. Analysis of police reports and community data may show that taking a walk is generally a very safe activity, but news reports that focus on fluke criminal activity make many of us believe it is not safe to leave our homes.

In this culture of fear, pregnancy is perhaps The Queen of Scary Things. When women are constantly told that they should avoid things, the risk of whatever it may be starts to grow into something huge and looming, often creating a bigger problem than the initial risk. Nobody is ever told the risk of laying on her back during pregnancy- they are just told not to do it!  If I had a quarter for every time a student has told me she is losing sleep because she is not supposed to sleep on her back, but it’s the only way she feels comfortable, I’d be a rich woman! It’s nuts that so many women are experiencing very real risks of losing sleep and creating unnecessary discomfort in their bodies when the true risk of laying on the back- compression of the inferior vena cava- would create a sensation that would force them to change position anyway!

When fear informs our decision making, we often are unable to weigh the true risks and benefits and may end up with an undesired outcome. It may be as trivial as the expectant mom who suffers in a hot room because she was told raising her arms above her head to reach the thermostat would get the baby tangled in his cord. (I hope I don’t have to mention there is zero science to support this claim.) Or it may be way less trivial as in the all-too common example of what “might” happen if a healthy, low-risk mom goes past her due date. I regularly hear about doctors insisting on induction as early as 40 weeks for no other reason than dates. I quite literally never hear about doctors warning of the risks of induction. There are a bazillion studies that have looked a the issue of due date and induction and I don’t want to oversimplify any of them here, but I will say that discussing risks of going post-dates without discussing risks of induction does not paint a clear picture for moms.  I will also say that the number of moms I personally know who expressed feeling pressured into medically inducing labor and then regretted that decision afterwards is rather high. Time and time again I hear, “I was scared into it.”  For a clear picture of what the research says on the issue of due dates and induction, I highly recommend Rebecca Dekker’s article Evidence on: Due Dates. (It’s long, but thorough and well worth the time.)

 Highly Recommended Reading!

Highly Recommended Reading!

Living in a state of fear keeps us from being in the moment, one of the ultimate goals of yoga and meditation practice (which of course, has been shown in numerous studies to reduce stress and increase overall health.) As Nancy Bardacke points out in her awesome book Mindful Birthing, fear exists in the future. If we are always anxious about “what might happen,” we miss the beauty and joy or simply the mental clarity of the present moment.

Every time a mom hears she needs to avoid something in pregnancy, it maintains the status quo that pregnancy and birth are terrifyingly risky and must only be experienced with extreme caution! Where is the joy in that!? Or the reality, for that matter? As birth photographer Harriet Hartigan says, “Birth is as safe as life gets.”

2. Profuse don’ts undermines and disempowers moms.  While advice in pregnancy is generally coming from an authentic concern for the expectant mother, telling her to avoid a bunch of things is basically telling her that she can’t figure it out on her own or that she shouldn’t trust her own knowledge and instincts. As the first step in a long journey raising a child, the last thing a mom needs is to feel disempowered. Raising a child takes courage and strength! Reinforcing that she is smart enough to navigate the experience, worthy of making her own choices, and her body is strong enough to grow and birth a human is a more effective way to show support.

No matter what your credentials are (doctor, doula, friend, grandma...), if you must give the mom some advice, make sure you know what the sources are for your recommendation, and be able to be clear behind the reasoning. Then support her in making the choice even if it’s different from what you would do in the same situation.

 Pretty sure someone told me not to do back-bends in pregnancy, but my body just couldn't get enough of them then!

Pretty sure someone told me not to do back-bends in pregnancy, but my body just couldn't get enough of them then!

Recently I saw advice offered up to an expectant mom on social media regarding yoga practice. The poster congratulated her, then immediately added “Make sure to avoid deep twists and inversions.” Then summed it up with “Listen to your body.” The middle statement was totally unnecessary, and could have been much more useful if it included the reasons why, had defined exactly what constitutes a deep twist or inversion, or cited a source proving it was harmful, so mom could make her own conclusions about what is right for her.  Better yet, all three!  (Okay, I’ll do it: deep twists are hypothesized to upset the implantation/ growth of the fetus and may also put additional stress on the linea alba and inversions may negatively affect mom’s blood pressure or blood flow to the fetus; deep twists are those that rotate the spine more than just turning to the side and firmly compress the abdomen and inversions are defined differently depending on who you ask- handstands and headstands are definitely inversions, while downward facing dog is debatable; unfortunately, there are no adequately peer-reviewed studies to support every pregnant mom avoiding these particular poses or any specific yoga poses or any other physical limitations in pregnancy, except for avoiding anything that will cause abdominal trauma, like contact sports, or anything that is likely to produce a significant fall- the latter being pretty subjective. Phew!) Most moms should avoid deep twists and certain kinds of inversions in pregnancy, but for others the benefits of these poses may outweigh the risks- it’s really up to mom to “Listen to her body!” Really, that’s all that needed to be said!

As a yoga instructor, I never give an adjustment or correction in my class without a word regarding why and seeing if it’s true for the mom. For example, if a mom is in a lunge with her knee past her toes, I let her know it could put strain on her knee and ask how it feels when she stacks her knee over her ankle. To this day, I have never had a mom say it felt better with the knee past the toes, but someday there just may be someone who prefers it that way! I owe it to every mom to ask what her body prefers. It’s a reminder that she’s the one in control of her body!

3. Likely the information is incomplete at best and down-right incorrect at worst.  There are all kinds of crazy myths out there about pregnancy that are propagated through years of misinformed, well-meaning advice. Some are easy to scratch our heads and laugh at, like the example of lifting the arms above the head. But others are not so obvious. How many coffee-drinking mothers get admonished for enjoying their morning cup?  Studies are inconclusive on the upper limit of caffeine intake and its effects on pregnancy and the fetus, but there is enough evidence to suggest a cup or two a day of caffeinated coffee has no significant negative outcome to mom or baby. Surely the fellow who comments as you pick up your Starbuck’s order has not read these studies.

With so many people giving well-meaning advice, it becomes rather challenging for a mom to sift through credible information. Even doctors can give orders with little or no supportive evidence. Take bed rest for example.  According to WebMD, approximately 1 in 5 mothers will be assigned bed rest at some point in her pregnancy. However, studies show that not only is bed rest not effective, it can be down right harmful. Assuming that everything an OB says is right for every mom may not be in her best interest. Expectant mothers have the right to ask questions and demand research to back up their doctors’ recommendations!

Of course, most mothers today want to be informed about their pregnancies.  It should be left up to them to seek out information, discuss their findings with whomever they choose, and not have unsolicited advice flung at them. They have a right to decide what’s “fake news” and what is not without a chorus of don’ts coloring their research.

Needless to say, it drives me nuts to witness pregnancy advice, particularly when it comes in the form of “don’t!” A very common reason I hear from my fellow birth educators and doulas for why they are motivated in their work is because they want to empower mothers and reduce fear around birth.  Yet we are so entrenched in a culture of fear that many of us don’t realize that saying, “Congratulations! Don’t (fill in the blank here)” does exactly the opposite! If you are an expectant mom reading this and feel frustrated by the people in your life telling you what you shouldn’t do, feel free to share this article with them. If you are a friend, family member, or work with expectant moms, I hope you will consider the power of your words. Don’t be a “don’ter”!  ;-)

Did you get a lot of unsolicited advice and don'ts in pregnancy? How did you react? Share your experiences in the comments.