New York Times
May 23, 2004


By Alex Kuczynski

On Wednesday, at a lunch at Cipriani 42nd Street to benefit the
obstetric unit of New York-Presbyterian Hospital, a table of women in
their 20's and 30's hovered over chicken salad and engaged in the
polite conversation suitable for lunching ladies. Divorce, death,
social scandal -- that sort of thing.

But when they got to the subject of pregnancy, all that white-gloves-
and-tea-sandwiches politesse went out the window.

"Well, you know you can't wear an underwire bra," one young mother

"No thong underwear," said Cricket Burns, the style director of
Quest magazine and a mother of two.

"Or Botox," chimed in another young mother.

Mushrooms, said Jessica Friedberg, a mother of two perfect ZIP-
code-10021 children.

The warnings tumbled forth: Tanning spray. Hair dryers. Acrylic nails.
The J. Sisters. Cellphones. Then the waiters delivered dessert, a
gooey chocolate souffle with a mousse center and a side of crème

Ms. Burns looked down, and in a voice lowered to the tone a Norad
officer might use to announce the approach of nuclear warheads, said:
"And... no... chocolate... mousse."

To hear the women tell it, all of these things could harm unborn

Well, maybe. Thanks to an ever-growing body of scientific research and
an old wives' circuit thriving on the Internet, dozens of foods and
activities and procedures, whether their danger is overblown or not,
are now believed by some pregnant women to be threatening to fetal

The result is a kind of Pregnancy Paranoia.

"The list does seem to get longer every year," said Marion
McCartney, the director of professional services at the American
College of Nurse-Midwives in Washington. "I'm 60, and we never had to
face anything like this."

Tanning spray and acrylic-nail preparations? Might have toxic
chemicals. (They might, doctors said. Probably not enough to harm a
fetus, however.) Chocolate mousse, depending on how it is prepared,
might have uncooked egg whites. (Which can cause food poisoning, so
some doctors say to avoid the desert.) Manicures and bikini waxes
might cause infections. (Possible, experts say, but doubtful.) Hot
tubs and saunas might raise body temperature to dangerous levels,
harming the embryo or fetus. (Ditto.)

Mobile phones, computers and television sets could emit harmful
electromagnetic radiation. (Not true, according to the latest
research.) Underwire bras might damage milk ducts, depriving a baby of
proper nutrition. (No doctor interviewed for this article had heard of
such a thing.)

And thong underwear? Oh. It might just look really bad, Ms. Burns said
in an interview after the lunch.

On the serious side, in the last year, three alarm bells have gone
off, giving pregnant women reasons to pause.

An article in The New York Times in November reviewing the latest
research on the affect of alcohol on fetuses (like the possibility
cited in one study that even a glass and a half of wine could harm an
unborn child) ricocheted in and out of the e-mail boxes of pregnant

Two months later, the journal Science released findings that farmed
salmon contains levels of PCB's and dioxins higher than what is
considered safe by the Environmental Protection Agency. (The
chemicals, in high doses, have been linked to impaired mental
development and immune system function in developing fetuses. A Food
and Drug Administration official said that there was no health

And in March, the F.D.A. issued an advisory recommending that pregnant
women, nursing mothers and young children eat no more than six ounces
of albacore tuna a week because recent tests showed it had higher
levels of mercury than other types of fish.

Dr. Karen Filkins, a professor of clinical medicine at the University
of California at Irvine and an expert in teratology, the study of the
processes leading to abnormal development and birth defects, said that
she has detected a sense of unnecessary panic from the pregnant

"I think the concern about fish and mercury really raised the bar,"
Dr. Filkins said. "But I think we ought to put it back into some

But getting mothers-to-be to relax about the health of their fetuses
is like asking a Hollywood studio head to ignore opening box-office
numbers. One pregnant New Yorker, upon finding out that a piece of
farmers' market cheese she had popped in her mouth was not
pasteurized, refused to swallow it, holding it for 15 minutes until
she was able to spit it out and brush her teeth.

Donna Rodriguez, a public relations executive who is 30 weeks
pregnant, said that she was amazed that the most innocent activities
were suddenly classified as life-threatening, and that she might as
well have just sealed herself up in a plastic bubble.

"When you make a cake, you can't lick the bowl" because of the
uncooked eggs, Ms. Rodriguez, 33, said.

"Same thing if you're making cookies," she said. "No hot dogs.
Unless they've been totally boiled. It makes you think, 'What do I
have going on in my body when I'm not pregnant?' "

Dr. Khalil Tabsh, the chief of obstetrics at the University of
California at Los Angeles School of Medicine, said that women should
most certainly not abuse drugs or alcohol. Nor should they smoke or
consume excessive amounts of caffeine. (All may pose threats, if
abused, to fetal development and the woman's ability to carry the
infant to term.) They should monitor the amount of fish, and type of
fish, they eat, he said.

"These are potentially big things," Dr. Tabsh said. "More serious
than, 'Can I have a sauna? Can I go to a tanning salon? Can I have a
glass of wine?' "

Concerns over tanning beds (because it could raise body temperature),
or the glass of wedding Champagne, he said, are based on "some
evidence." But patients might extrapolate that one glass of Champagne
could lead to fetal alcohol syndrome.

"That is not going to happen with one glass of wine," he said.

If one must use hair dye, with its high chemical content, he said,
play it safe and stick to vegetable-based dyes.

"The bottom line is, 'If in doubt, don't do it," " he said.

And there's quite a bit of doubt out there. Google the phrase
"pregnant women should avoid" and 6,970 entries appear. On, a popular destination site for expectant parents,
message boards are overrun with questions about what a pregnant woman
ought and ought not to do.

In answer to a question about whether the site's members thought it
would be a bad idea to go to a tanning salon, someone posted: "You
mean like a tanning bed? You can't be serious? It gets HOT in there.
You're better off standing in a microwave!"

Some women worry that they will contract toxoplasmosis, an infection,
from their cat's litter, though doctors say most women have developed
an immunity to the disease, and chances of contracting it are small.
Other women worry about phthalates, chemicals found in many industrial
and cosmetic products, including hand creams, nail polish, perfume and
hair spray. In some animal studies, phthalates have been linked to
premature birth and certain birth defects.

Andrea Nagel, the health and beauty-aids editor for Women's Wear
Daily, said that when she was first pregnant she thought she pretty
much knew the basics, like avoiding sushi and unpasteurized cheese.
(The F.D.A. said that unpasteurized dairy products might carry the
listeria monocytogenes bacteria. In healthy adults, listeria infection
can cause a short-lived flulike illness that can seriously harm fetal

"But one leaflet from my doctor told me to avoid food with artificial
coloring, nitrates and MSG," Mrs. Nagel said. "Ha! How can one eat a
bagel without smoked salmon?"

The American College of Obstetricians and Gynecologists issues
recommendations about drugs to avoid, which include alcohol, some
hormone agents, some anticonvulsants, anticoagulants and antibiotics.
The college advises pregnant women to limit their vitamin A intake as
well as their hot tub (10 minutes) and sauna (15 minutes) use. Limit
exposure to harsh chemical environments and lead paint. But the
college does not issue guidelines on substances like self-tanners,
Botox or acrylic fingernail ingredients.

Dr. Laura Riley, the chairwoman of the Committee on Obstetric Practice
for the obstetricians' group, said that if women are worrying about
teeth bleaching or use of Retin-A, they might have a bit too much time
on their hands. (She said both are probably safe, but pregnant women
should discuss their use with their obstetrician.)

What about Botox?

"What is the probability that it might cause some damage?" Dr. Riley
said. "None. But has there been a study to prove that? No."

Self-tanner? She said she considered it most likely safe.

"But I'm black so I haven't really looked into it that closely," she

Dr. Riley, who is a maternal-fetal medicine specialist at
Massachusetts General Hospital, emphasized the dangers of certain
cheeses and of the prescription acne drug Accutane.

"You want to avoid blue-veined cheeses and uncooked deli meats
because of listeria," Dr. Riley said. "And Accutane can cause
horrible defects. Those things are not even in the same category as,
'Can I get my legs waxed or my hair dyed?' "

Members of New York's civilian population appear to be finely attuned
to the needs and limitations of pregnant women. At Artisanal, for
example, the Manhattan restaurant that features cheese in many of its
dishes, the influence of pregnant customers is such that the waiters
are trained to point out which of the 180 cheeses on the cheese menu
are safe for consumption by pregnant women.

Melissa Levis, the mother of a 7-month-old and author of an Off
Broadway play about getting pregnant called "The Joys of Sex," was
so paranoid when she was pregnant that she avoided cheese, deli meats
and manicures, and checked into the hospital several times during her
pregnancy, because the baby seemed, well, kind of lazy.

"He was not kicking all the time," Ms. Levis said. "I was so
paranoid. I would show up every week and say, 'The baby's not moving,
the baby's not moving!' I think they got sick of me."

Her son, Montgomery, is perfectly healthy, she said, which she owes to
the fact that she did not drink. She did not tan. She did not color
her hair.

"Although," she allowed, "that wasn't so much because I was worried
about the baby."

You notice the gray hairs, she said, and you're shocked.

"But then you notice that suddenly you weigh 35 pounds more than you
used to. And that so outweighs a few gray hairs. When you're pregnant,
you just have to pick your battles."

Copyright 2006 The New York Times Company