Laura Riley: Oh, this is my favorite. "Pregnant women need
to eat twice as much." Absolute myth. Don't do it. You really actually only need
about 200 extra calories a day over a normal American diet. And that's assuming that
you're starting pregnancy at a normal weight. "Sex during pregnancy hurts the baby." Well... Dena Goffman: "Cocoa butter
prevents stretch marks." This is a myth. I'm Laura Riley. I'm a high-risk OB at New York-Presbyterian
Hospital/Weill Cornell. I'm Dena Goffman. I'm a high-risk OB at New
York Presbyterian/Columbia. This is so exciting, wondering what's gonna come next. Riley: I know, I know. Goffman: Oh, my favorite. "It's OK to drink a glass of
wine when you're pregnant." We know that the recommendation
in pregnancy is that you really should not consume any alcohol. Unfortunately, there is
no safe amount of alcohol nor a safe time in pregnancy
when we can be sure that alcohol won't affect
a developing fetus. Riley: Also, I think it's important to add that we don't think it's safe to drink while you're breastfeeding, either, because the alcohol does
get into breast milk. And as Dr. Goffman said, we don't know what the safe
amount is, and that safe amount may actually change for different women. Goffman: "Your belly
reveals the baby's gender." We certainly hear patients
coming in to see us and having heard or
having family members say that they can tell whether
you're having a boy or a girl based on how
the woman's belly looks. And we know that there
is absolutely no evidence that the shape of your belly can tell us this type of information. Riley: The other myth that
goes along with gender I think is the heart rate is high or low. My patients always say that,
you know, they come in, oh, it's 160, it must be girl. Like, no. If it's 160, it
means the kid's moving a lot, and if it's sleeping it's going to be 120. So it doesn't tell you
whether it's a girl or boy. Goffman: "Cocoa butter
prevents stretch marks." This is a myth. While cocoa butter is something that many patients like to use, we don't have any
evidence that cocoa butter or anything else that we can recommend will prevent stretch marks. Riley: It's probably
genetic, and, essentially, if you gain too much weight in one spot, i.e. your pregnancy gets really big, you're more likely to get
stretch marks, unfortunately. But it's not worth spending a ton of money on expensive creams,
because it's not gonna work. That was cheery. "You can give a cold to
your developing baby." This is a complete myth. Your baby is not gonna get the cold. Although your baby can get sick if you get something like the flu, which is why we tell
you to get a flu shot, to prevent your baby
from getting really sick. There are some illnesses you can transfer to your baby, but probably not a cold. I think people get the
cold and the flu confused, which is unfortunate because the flu can make you really sick in pregnancy. Goffman: "What you eat during pregnancy can influence the baby's palate." Riley: I don't think there
is a shred of evidence to support that. I think that what you eat
during pregnancy is important because it does sort of, you know, set your baby off to a good start in terms of its overall
nutrition and good health. But it's probably not gonna
change the baby's palate. Goffman: We always talk about
nutrition and food choices and healthy weight gain, which really can have long-term impact on your baby's development,
but not specifically the palate or what they have a taste for. Riley: "Pregnant women
shouldn't drink coffee." That's a myth. You can drink coffee. This is one where moderation
is the most important thing. In the first trimester, having
excessive amounts of coffee have been associated with a
higher risk of miscarriage. Once that first trimester is over, should you go crazy with the coffee? Probably not. But it's not gonna harm anything. Goffman: "Pregnant women
shouldn't eat hot dogs." So, this is a myth. I think the concern
with hot dogs are a few. You want to make sure
that they are well cooked to avoid infection risk. And there used to be a
fair amount of conversation about the amount of nitrites in hot dogs, but I think the evidence suggests
that unless you're eating really excessive amounts of hot dogs, that it's probably OK to enjoy one. I think there are probably things better than hot dogs
to eat, nutritionally, but I think if people
enjoy one once in a while, I don't have a problem with it. Riley: You're way nicer than I am. I'm not sure why anybody's
eating hot dogs, frankly, but, you know, you can
have one in pregnancy, but I think it's really important to make sure that it's cooked, because the concern about
listeria is a real concern. So, that includes the hot dogs, the unpasteurized cheeses, the deli meats. All of those things are
things that we worry about. So I think, you know. Yeah, it's a myth that
you can't eat hot dogs, but you should be certain
that it's cooked well. "Pregnant women shouldn't
eat smoked salmon." That's a myth. You can eat smoked salmon if you like it. I'm not a lover of salmon, so. Goffman: I love it. You can eat smoked salmon. This gets into concerns
around fish consumption in pregnancy, which is a huge topic. And we talk to our patients about the risk of various types of fish. So, we want to avoid fish
with high mercury content. So typically that would be
avoiding excessive tuna, choosing chunk-light, canned tuna, and also limiting the number
of cans of tuna in a week. There is also some concern
about some of these oily fish, I guess, about the potential for toxins. And so I would say salmon
in general may fall into that category, but
smoked salmon I think is safe for pregnant women to eat. Riley: The whole fish story is a little blown out of proportion. And I think people get really crazy about this whole mercury thing. I would say it's important
to also recognize, though, that fish has great
nutritional value to it that pregnant women and
babies need and want. So it is unfortunate that
somehow the fish story has resulted in people thinking,
"I can't have any fish." It's really the large steak fishes where you're worried about the mercury. But then, don't forget
that something like salmon is gonna give you the
DHEAS, which you want. Goffman: "Pregnant women
shouldn't pet cats." This is a myth. This would be terrible
if all pregnant women in the world couldn't pet
their pets, their cats. There is a concern with
pregnant women caring for cats in terms of the litter box, and really the risk is toxoplasmosis. And the risk of exposure
isn't with interacting with your cat, but with
changing a dirty litter box. Riley: It is actually
fairly rare in the US for women to come into
contact with toxoplasmosis. The more important thing
about sort of the cat stories, everyone worries about the
cat and the kitty litter; the most common exposure that women get to toxoplasmosis is actually not the cat or the liter even. It's not washing your garden vegetables, because it's the cat that has the toxin that poops in your garden and then you pick that up and eat it because you don't wash it or whatever. So, gardening without gloves are things that we tell pregnant women to avoid because of that particular infection. The cat's got a bad rap, unfortunately. "Pregnant women shouldn't fly." Total myth, get on the
plane, have a good time. That said, there are a few things to think about when flying. I think one of the major
issues is that pregnant women are at increased risk
for getting a blood clot either in their leg or their lung. When you fly, the air is dry. You're also more likely just to be sitting for a prolonged period of time. And that just further increases your risk for getting a blood clot. So I always tell pregnant
women, be happy, go ahead. Go on those trips. But you should hydrate before you go. You should wear support hose or at least, like, you
know, running tights or something that gives
you a little bit of support in your legs. You should get up and walk
around every hour or so. People worry about the air pressure, which makes no sense because
it's a pressurized cabin. That doesn't do anything, you're not gonna break your water. And they also worry about going
through the screener, right? Everybody's worried about the radiation going through the screener, but in fact the radiation
exposure is actually higher when you're in the sky
in the plane than it is when you're walking quickly through the security. Goffman: "Exercise during
pregnancy can strangle the baby." This is a myth. Exercise is actually strongly
recommended during pregnancy. All of our professional organizations, all of us as providers talk to patients about maintaining physical activity, maintaining exercise
throughout the pregnancy, really unless there's a medical situation that comes up that changes
those recommendations. So, exercise is not dangerous. And in fact, the opposite. It's really important. Riley: I think also this
whole strangling thing comes from this crazy nonsense
that if you get yourself into certain yoga positions, your baby can strangle itself. You don't have any control over the position your baby gets into. The baby is floating in a pool of water. And it doesn't matter whether
you're doing a headstand or you're just, like, chilling. "Sex during pregnancy hurts the baby." Well, that's a big myth. And it also helps to understand sort of the anatomy a little bit. I think this is where patients
get a little bit confused. The baby is floating
inside a pool of water, a big balloon bag. And that balloon bag is
surrounded by thick muscle, which is the uterus,
surrounds the entire bag and has, actually, a thicker
portion at the bottom. So there's just no way that sex is gonna get even near the baby. Goffman: Dyeing your hair
is harmful for the baby. This is another big myth. And we get phone calls about it. Lots of questions. There is no evidence, and again, we keep coming back to evidence because that's what we
look to as your physicians. And there really is no evidence out there that the things that we use
for hair-dyeing reach the baby or have the potential to cause harm. Riley: The other thing about the hair dye, frankly, I tell people, if it's
gonna make you feel better, that's really important
because, for a lot of us, how we look and how we present ourselves really has a lot to do with
our psychological state. And you want that to be as healthy as possible during pregnancy. "There are simple tricks to
overcome morning sickness." I think that that's a myth in the sense that none of those things
were probably simple. But I think there are ways to sort of decrease the
painfulness of morning sickness. The first thing is that
the morning sickness can last all day, so the whole "morning" thing
is a myth in and of itself. But that said, some of the things that you can do to help it: Try and start the day with
something really simple, like soda crackers, the
minute you get out of bed. Saltines, something really bland. Stay away from the smells, the smells are going to make you sicker. I think the biggest
thing that I've learned over the course of my career, and had personal
involvement with this one, is we tell people to stay hydrated and so they go after the water bottle. And stay away from the water. The water makes you sick,
I don't understand it, but it makes you sick. So, what I tell patients is put
everything over crushed ice. That way you'll get the water but you're not actually
drinking it and gulping air as you're drinking out of a water bottle. The things that I would put over ice, I would say lemonade, and ginger ale, letting some of the fizz
out, will help as well. Lemon Popsicles, lemon
slush, lemon Italian ice. The reason I say lemon is because lemon helps cut the nausea as well. I think the other critical thing for morning sickness is it's important to go out every day. I think sometimes what happens is you feel a little bit nauseous, then you feel worse, then
you start to feel depressed, and then you can't get yourself
moving because you're tired. And that's the worst thing you can do is to sort of give in to it. I think it's important to
get outside, walk around, even if it's just down the block and back. Goffman: "C-sections are always necessary for breech births." So, this is a myth,
although I think most of us think C-sections are the most common and the safest way to deliver a singleton. So, a single baby in
labor, especially at term. So there are certainly situations that we need to be able
to individualize for. Often we'll talk to patients with twins. If the second twin is breech, that may be a great option for them. And I think there are rare situations where a woman comes in in labor where we may recommend and or support a vaginal breech delivery for a singleton. Riley: I think in order to support a vaginal breech delivery, you need to have a provider
who has experience doing that. And, you know, the
reality is that in the US, the number of providers that
are able to do those safely is definitely diminishing, almost to none. I think the other option though, which I think we should
put out there on the table, is a version which is if you know the baby is
breech and you're at term, is coming in for a procedure where we, under ultrasound guidance,
turn the baby to head-down. "If you sit all day,
you'll have a breech baby." Total myth. If you sit all day, you'll
gain a lot of weight and you'll have back pain, but your baby will do whatever
your baby is gonna do. Most babies are not breech at full term. So, only about, is it like 3% of babies are gonna be breech at full term. Those babies are gonna turn multiple times until they get to around 36 or 37 weeks. And so it has nothing to do with whether you're running a marathon or you're sitting on your bottom. Goffman: "Pregnant women should
sleep on their left side." I think pregnant women should
sleep how they're comfortable, although we know that women,
as they get more pregnant into the second and certainly
in the third trimester, may not be able to sleep
flat on their back. And that's because as the
pregnancy grows, the fetus grows, the uterus grows, the
weight that the uterus will put on your blood vessels and some other structures may make that really uncomfortable and
not ideal for the baby. So women can sleep on their left side, they can sleep on their right side, they can sleep on their
back, tilted a little bit. But we usually aren't so strict as to say left side only. Riley: I think people
worry that, oh, my gosh, I woke up and I'm flat on
my back, did I kill my baby? You didn't kill your baby. If you sleep flat on your
back, as Dr. Goffman said, the structure we're most worried about is the inferior vena cava, so it's this big blood
vessel bringing blood back up to your heart and your head. And most people are gonna
get really nauseous, right? And light-headed and feel weird. And so you'll naturally turn, so you don't have to wake
yourself up to do it. "Your hair and skin look
better when you're pregnant." Ha, I wish. Your hair might look better, I guess? Your skin probably won't
necessarily look better. Some women say they glow. I think that they're...[laughs]
they're dreaming. Unfortunately, the high
progesterone levels that you get when you're pregnant to support the pregnancy actually
can really bring out acne that you haven't seen since
you were 13 years old, and all the expensive creams in the world are not gonna fix that. So I wouldn't suggest that
you spend your money on it. Goffman: "Pregnant women get flexible." You know, we recognize there
are lots of changes going on in women's bodies when they're pregnant, but I wouldn't say that getting
flexible is one of them. There are certain things that happen in terms of your posture,
how you stand, and definitely some relaxation of
different parts of your body to prepare your pelvis to be
able to have a vaginal birth. But I don't think that sort
of traditional flexibility is what we typically see. "Eating spicy foods will induce labor." Riley: Ha! Goffman: So, if this were
true, that would be wonderful because we could help women
induce labor when we wanted to. Unfortunately, we haven't
been able to come up with any particular food or
physical activity or drink or supplement that
actually can induce labor. We have medications to
use to induce labor, but as far as we've been able to tell, there is no evidence
that any of those things that women may want to try
actually will be effective. Riley: I think people are
just looking for something to get out of Dodge at 40 weeks, which I can totally relate to. Goffman: Yeah. [laughing] It's not going to hurt. Riley: It's probably not going to hurt. The spicy food probably won't hurt. You can do whatever you want,
but your baby's in charge. Just remember that. Goffman: "Yoga can induce labor." We think there are a lot of benefits to potentially doing yoga and
participating in pregnancy, but inducing labor isn't one of them. Certainly more women are using yoga, which may help with relaxation,
may help with stress relief, may help with stretching. And so I think there are a lot of reasons why yoga may be a great
thing to participate in, but there's no evidence
that it induces labor. Riley: If only. "Yoga makes labor smoother." I think, overall, exercise probably gives you a better labor in the sense that it is
usually more efficient. But yoga itself, not
necessarily making it smoother. Goffman: There are some things
about yoga that are similar to other labor preparation or childbirth preparation things, right? Breathing, mindfulness,
I think are similar to some childbirth preparation things. So I think, in that sense, some
of those things may help you to be more centered, be able to focus, be able to use some of
those strategies to help, but certainly not make
labor itself smoother. "Natural births are better." So, this is a myth. There are certainly women who spend time thinking about what they'd like their
birth experience to be like. And I think for some women, natural birth, and the way we think about
that is usually birth without pain medication,
and for some women, this may be a wonderful
experience, but we all know that we need to individualize
the care for our patients. And for many women, a natural
birth may not be better. There may be real medical benefits, depending on the situation
and underlying condition, to having pain medication,
to having an epidural. Riley: I'm a huge fan of natural
childbirth, I have to say, but I do think that it
takes some preparation, and I think it takes mental preparation, and I think that it's not better or worse. I also think there's
another myth associated with natural childbirth, which
is that if you're induced you have to have anesthesia
because the pain is worse. The pain is bad whether we
give you the contractions or your kid gives you the contractions or it happens naturally, whatever. It's painful. And some people can cope better because they've practiced mindfulness or hypnobirthing or whatever. And then sometimes people
can just cope better because it's faster. But again, I think it's all about everybody can make
their own birth choices. I love this one. "There are ways to predict
your exact due date." When we give you your due date, it's plus or minus two weeks. And the reason is because
your kid's in charge of when you go into labor. We are not. Though, I have to say, are
much more precise in knowing what your dates are than we used to be because we use ultrasound,
early, early ultrasounds, so much more frequently. Obviously, there are those
people who have done IVF, and they know even more. But again, even if you
know when it all started, you do not know when it will all end. Because the person who
knows that is your baby and we can't at the moment
talk to that person. Goffman: This is so exciting, wondering what's gonna come next. Riley: I know, I know.
