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Dr. Denise Willers: Hey, everyone. This is Dr. Denise Willers. I'm an OB-GYN physician, obstetrician gynecologist for St. Louis Children's Hospital. And I'm a mom doc.

Melanie Cole: Hey, welcome to Mom Docs, the podcast from St. Louis Children's Hospital. And today, we're learning about the truth behind 10 of the most misunderstood pregnancy myths. So pregnant ladies and those who love them, listen up because we are going to clear up some of these myths. And I know as someone who had two babies, when you're pregnant, there's a lot of worries. There's a lot of things that go on in your head and you've got hormones. So we're going to clear some of those up so you can have a worry-free and wonderful pregnancy. Dr. Willers, I'm so glad you're joining us today. So let's just start with one of the most popular ones. Pregnant women need to eat for two.

Dr. Denise Willers: So you're eating for two, but one of you is very, very tiny. Pregnancy does require more calories, but not much and mostly at the end. So, during the first trimester, you might burn an extra a hundred calories per day. So if you think about those little bags of Oreo, like the a hundred-calorie packs, that's literally how much more food you need in the first trimester.

Some women feel nauseated if they're not eating, so they'll consume more than that extra 100 calories just to keep the nausea at bay. And then in the second trimester, it goes up to about 300 calories. So I think about that as like an extra bedtime snack, like a peanut butter and jelly is about 300 calories or so. So you can just divide that throughout the day.

And then in the third trimester, you really need about 500 calories more. So you may need more of those snacks. Big meals start to seem like less of a good idea as the baby takes up more space. So I feel like women who are in the third trimester often just graze throughout the day to try to get enough calories.

I feel like for most women though, the increased needs regulate themselves and you don't really need to count calories, just eat when you're hungry, make good choices for the types of food that you're eating. And then, when your family's like, "Well, we really want to do something to help the pregnancy, so we made you a pie or extra ice cream," or "You better feed that baby," you can just listen to your body and maybe not your mother-in-law or your family.

Melanie Cole: Boy. I know that feeling because that's definitely what happens. Okay. So moving on. Exercising while pregnant can hurt your baby. And as an exercise physiologist, Dr. Willers, I know this one to be not true and actually completely contradictory. However, there are caveats, right?

Dr. Denise Willers: Yeah. So exercising during pregnancy doesn't increase the risk of miscarriage or preterm delivery or low birth weight. And being active during your pregnancy really decreases the risk of diabetes and high blood pressure during the pregnancy. And also there's a lot of benefit to how you feel during pregnancy as well. So stretching and working out can decrease lower back pain, help your joints and then it also can help you keep weight gain at bay during pregnancy to an appropriate level. And then, staying fit during your pregnancy can also help you lose the pregnancy weight afterwards.

So really, I like women to maintain fitness during their pregnancy because when you're pushing, some women have to push for a couple of hours to be able to get their baby out. So the default for pregnant women is exercise is good. Listen to your body. This may not be the time to start running a marathon though. You know, I think you want to be in what we call an aerobic range of exercise. So that would be being able to talk while you're doing the exercise. You can be out of breath, but you don't want to be really dizzy or so red faced or feel like you just can't go on. It's not the time to push quite that hard.

When I think about this, sometimes we go by heart rate. And so getting up to 80 or 85% of your max heart rate might be a little bit much, but for some women that's okay. So I think kind of going by how you feel is good for exercise.

And then there are some pregnancy complications like preterm labor or bleeding, where your doctor may tell you to lay off the exercise or, if you have high blood pressure, they may tell you less is better at that point.

Melanie Cole: That's definitely one of those. You listen to your doctor and it's not the time, as you say, to start running a marathon. But certainly, it is good for you. Now, how about seafood? We hear that avoid eating seafood while you're pregnant because mercury or all sorts of reasons. What about seafood?

Dr. Denise Willers: The truth about seafood really is that you should do your research and eat the right types of seafood during pregnancy. So you're right about the mercury. So fish is sometimes contaminated with mercury and that's the thing we know the most about. But also farm chemicals can be an issue as well, especially here in the midwest.

So a good rule of thumb is that the seafood lowest in mercury, such as wild-caught salmon, tilapia, other white fish and then some of the shellfish, this is what I like the most like shrimp and crab and scallops. Those are the lowest mercury and they can be consumed by pregnant women about twice a week for like a normal serving.

And then there are some that are a little bit higher though. So tuna is a good example of a once a week recommendation because it is just a little higher in mercury. And if you really like tuna, know that the cheapest canned tuna is lower in mercury than like a yellowfin or a big tuna steak. And then there are some that are really high. So anyone who hasn't completed their families, they're still planning more pregnancies or they're breastfeeding, they should really probably stay away from shark and swordfish because those are really quite high in mercury.

The FDA has a really good handout that you can find if you Google just FDA advice about eating fish and it gives the list of all of these different types of fish. And it's actually for young children as well to kind of limit those mercury fish.

And then we go fishing and have a cabin up in Minnesota and from Illinois and I looked at both of the local statewide environmental protection agency information guides about fish. And they list sometimes by certain lakes rivers and whether it's safe to eat the fish out of those rivers. And sometimes they'll give a limit. So you can have one bass or one catfish per week or per month if they're a little higher in contaminants.

Melanie Cole: Wow. That's really interesting. And that's great information and ways to look that stuff up. So, so important. Now, another big one, you should never have caffeine or drink a glass of wine while pregnant. And I know that this has been controversial. Can you have one off the record, on the record you know, if it helps with stress? But really, no alcohol is the answer. Correct?

Dr. Denise Willers: Yeah, that's the answer. So I'll say this one's partially true. Caffeine, that's my go-to. But the alcohol, we just don't know where fetal alcohol syndrome-- we don't have enough data about it. So we really feel like we can't tell pregnant women how much alcohol is safe. So really in the United States, we recommend no alcohol during pregnancy. They'll say, 'Oh, it's New Year's eve. Have a drink of your husband's drink or your partner's drink." One drink, that's probably okay. But not even a glass of wine is really recommended.

And then caffeine on the other hand, really has this history a woman being told it's just not safe, causes miscarriage and other things. And, over the last five to 10 years, we've really figured out that caffeine can be consumed very safely in moderation. So about 200 milligrams per day is the cutoff and we all have to sort of look up what that means.

But usually a couple of servings of caffeine drinks per day, so a couple of cans of soda or six to eight ounces of coffee. If you're going to Starbucks and getting the big one, then that's probably more than one serving by itself.

Melanie Cole: Okay. We got a lot of these to get through, but what an interesting topic this is. I love when we bust up myths like this. Okay. So sleeping on your left side, is there a problem with rolling around or sleeping on your back?

Dr. Denise Willers: There are a lot of options for sleeping. So in the beginnings of pregnancy, before the uterus is very big, any sleep positions are fine. So I have a lot of stomach sleepers and I tell them, I'm like, "When it starts to feel like you're sleeping on a volleyball, then you probably don't want to sleep on your stomach anymore."

And then at about 22 weeks, we start telling you not to sleep flat on your back. The reason for that is that the uterus gets big enough that it can compress the vena cava if you're flat. So the vena cava is the vein that sort of collects all the blood from our legs and takes it back up to our heart. And if the uterus presses on that, then changes the blood flow back to the heart and also could impact the blood flow to the uterus as well.

Now, pregnant women are still going to wake up flat on their back during the pregnancy, and it usually doesn't cause direct harm, but we do try to favor not sleeping flat on the back and not laying on your back to do sit ups or not laying flat on your back to watch TV on the couch. So there are several options left though. If you're watching TV or sleeping or anything, you can sleep all the way on the right side, all the way on the left side or what I really did during my pregnancy, and I think this is a good option for women, is you can put a little pillow underneath one of your hips to turn yourself to the side a little bit and move the knees to the side as well because even just being tilted can take that uterus off of the vena cava, improve blood flow. Anybody who thinks you can sleep on your left side for your whole pregnancy is mistaken, because if you haven't been pregnant, hips hurt. you get uncomfortable, you wake up and you feel like you can't move at all. And you really need to have more than just that one option.

Melanie Cole: That's great advice. And I remember that myself. Now, some of these are funny that we got here, so maybe we can do a couple of them at the same time. Dying your hair when you're pregnant can hurt your baby and spicy foods will induce labor. I'd like you to hit both of those.

Dr. Denise Willers: All right. Well, I'm going to start with spicy foods. No, there are lots of anecdotes about people saying like, "Well, I eat something spicy and then I went into labor." But the truth is that women that are that close to the end of pregnancy go into labor anyway. So there's no data to say spicy foods will induce labor. If spicy foods sound great to you, have some. If they don't, you can stay away from it because it's not gonna make you have labor anyway.

And then hair dye generally is considered safe in pregnancy too. There's not lots of studies about this, but the amount of chemicals that absorb into your body during hair coloring is very low. Maybe a little higher from the hair coloring that goes right on the roots, as opposed to down farther on the hair strands. But really, it's considered to be safe.

If you were nervous about it and just in case there's some small danger, some people would recommend waiting till about 12 weeks and that's when the organs of the growing fetus are fully formed. So it couldn't cause a heart defect at that point or a brain defect. and maybe it's safer to wait a little.

The other thing I tell people is like, if you're really getting a lot of fumes from hair coloring or from permanents or other things, then they should turn a fan on and just get it ventilated well around you so you're not breathing in the fumes. But safe, no need to stop your beauty regimens because of because of pregnancy.

Melanie Cole: I love that. That's just great advice. Just a few more before we let you go, Dr. Willers. You should not have sex during pregnancy because it can hurt your baby.

Dr. Denise Willers: Sex is safe. So there are only a few medical conditions that make it unsafe. And your doctor's going to tell you if that's the case. If the placenta is too low or if the cervix is shortened, then we would recommend not having sex. But otherwise, sex is fine. It is important to know that there's a short-lived increase in contraction sometimes, especially late in the pregnancy, with sex or with orgasm. And then also that throughout the whole pregnancy, the cervix can be sensitive. And so sometimes women after intercourse, we'll see like a little pink or a little red spotting. If there's not heavy bleeding and you don't have any pain with it, then there's nothing to worry. about.

Melanie Cole: Okay. Just one more because this one really had to be one of my favorite ones. Heartburn during pregnancy means your baby will have a full head of hair.

Dr. Denise Willers: It's just not true.

Melanie Cole: We still got one more here. What you eat during pregnancy can affect your baby's food allergies. Is that true?

Dr. Denise Willers: So it's not actually. So, I have an anecdote about this one. So I had my first baby, December 26th. And my friend brought me a lot of Reese's and I was half plowing through half of the bag when the lactation consultant came in and said, "You should not be eating peanut butter while breastfeeding, because you might increase the risk of allergies to your baby." And so I stopped eating peanut butter for a year and a half while I breastfed. And by the time I had my second baby, they said, "You know what, we've disproven this. Really, that mothers who eat a wide variety of foods during pregnancy and during breastfeeding actually reduce the allergies in their children."

So, that's what we recommend. We recommend eating peanuts. As long as the mother is not allergic to it, that we recommend eating and exposing the baby to all of the things that you eat. And that actually reduces allergies.

Melanie Cole: What a great segment this is. Do you have any final bits of advice as an OB-GYN for women that are pregnant for those that love them? What would you like them to know about? I mean, I loved being pregnant, Dr. Willers. I enjoyed it both times. Tell mothers to be what you would like them to know about that time and being pregnant and really why not to worry, it's pretty natural.

Dr. Denise Willers: Yeah. So I actually really loved being pregnant too, but I think one thing to be aware of is sometimes that we fantasize pregnancy a little bit because many of us do feel pretty good about it, but that it's okay to not feel great all the time and to not be happy about it all the time, because it's a lot for your body to go through to make all of these changes. There's a lot of stress for some women sometimes. They don't feel well. They have nausea, vomiting. You don't have to be happy about it the whole time. And that doesn't mean there's something wrong with you. But it's okay. Just cut yourself some slack. Take great care of yourself. If you have questions or worries about things, feel free to ask your doctor. Don't take the old wives' tales too much to heart. Make sure you try to ask about those and really take care of yourself and enjoy what you do enjoy. And if you don't enjoy all of it, that's fine too.

Melanie Cole: Great advice. I just love doing podcasts like this. And parents and parents-to-be, share this show with your friends and family on your social channels, because we are learning from the Mom Doc experts at St. Louis Children's Hospital together and these are great ways to share this quality information that we can trust.

That concludes another episode of Mom Docs with St. Louis Children's Hospital. For more advice and articles, check out the Mom Docs website at childrensmd.org. I'm Melanie Cole. Thanks so much for listening.