New Adventure

So, I’m 21 weeks pregnant.

What has been interesting so far has been the difference in advice that preggos get from British, Danish and American sources of information.

I get the Danish information at my medical appointments, British information online on the NHS website and from forums, and American information from the apps I’ve downloaded to my phone.

One would assume that as this is based on Science and all three countries are reasonably similar, that the advice for those in the family way would be the same.

Not quite.

The best book I read (and one that I recommend to anyone considering starting a family), is “Expecting Better” by Emily Oster. This is a text where an economist goes through the advice given to American pregnant women, examines the evidence for claims and presents the statistics. Some of the stuff we are told is based on practically nothing at all. The injunction against coffee, for example, might be a simple misunderstanding of cause and effect. (Women who cannot stand coffee in the first trimester tend to have better outcomes than women who don’t find its bitterness completely disgusting. So, was it the caffeine that harmed the foetus or was the pregnancy not viable which led to less morning sickness?)

This is how you can have regional variations. A lot of what we are told to Never Ever do is based on cultural standards and prejudices, rather than hard science.

One example: in Britain and the US, we are told to stay away from pâté. This is for two reasons:

  1. Liver pâté has high levels of animal-based vitamin A, an overdose of which is harmful to foetuses
  2. It may contain listeria which is particularly bad if you are pregnant

In Denmark, where liver pâté is a way of life, “Du kan godt spise leverpostej”. They even go as far as to say it has low levels of vitamin A.

What about alcohol? In the US and Denmark, the answer is “hell no, even if you don’t plan on getting pregnant but are having unprotected sex, no no no”, whereas Britain, the advice is “not in the first trimester. Take it real easy in the second. One or two won’t hurt.”

In the UK, they offer whooping cough vaccinations to women at my stage of pregnancy. In the US, they offer it in the third trimester. In Denmark, my midwife had to look up what ‘kighoste’ even was, and looked like I was asking about getting a smallpox vaccine. (Though she did say “it’s not really a thing here but if you’re going back to the UK with the baby before it has the standard vaccines, maybe it’s an idea to talk to the doctor about getting the vaccine here”)

Gestational diabetes in the UK is screened for if:-

  • your body mass index (BMI) is above 30
  • you previously had a baby who weighed 4.5kg (10lbs) or more at birth
  • you had gestational diabetes in a previous pregnancy
  • one of your parents or siblings has diabetes
  • your family origins are south Asian, Chinese, African-Caribbean or Middle Eastern

In the US, if you

  • Had a previous pregnancy with gestational diabetes
  • Had a baby born weighing over 9 pounds.
  • Are overweight or obese.
  • Are more than 25 years old.
  • Have a family history of diabetes.
  • Are African American, Hispanic, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander.
  • Are being treated for HIV

and in Denmark, if you

  • previously had gestational diabetes
  • have a family history of diabetes (type 1 and 2), in grandparents, parents, siblings or own children
  • had a BMI over 27 before pregnancy
  • had previous delivery of a large child (over 4.5 kg)
  • are diagnosed with polycystic ovary syndrome
  • are pregnant with multiples

The advice is similar but not identical. All this reminds me of the saying “The man with one watch always knows what time it is, the man with two watches is never completely sure.”

In some ways, it has helped me get through everything with less stress and guilt. Each government is trying their best to interpret what they know but for all their injunctions and pronouncements, they aren’t completely sure. This means if I inadvertently do something that is considered harmful in one territory, I can take the advice with a pinch of salt, and skip the guilt.

 

 

 

4 thoughts on “New Adventure

  1. Congratulations! I remember that difference between countries as well. UK? Hell no! No liver pate! Denmark? I suspect they thought pregnant ladies would kill them if they said no leverpostej ;).

    Thank you for the book recommendation! If I get pregnant again I will have a look at it. However, if you like more evidence-based books, one book I liked for the baby first years is the Brain Rules for Baby by John Medina. He’s a scientist, and the book presents the evidence as well.

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  2. Congrats! Having given birth in Singapore, I found this highly amusing/interesting/true. I like how the brochure says to avoid liver but go ahead and eat the leverpostej. Can’t give you advice on good books, because I never did find one I really liked, but you know, just search the internet until you find something that tells you what you want to hear and go with that :)

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