It used to be that having a baby was only mildly interesting, as women routinely had ten, twelve, fifteen children. Now that we have birth control, and it’s in the hands of the women, most people have two or three, so they invest a lot in each child. As the mother of two young women in their mid-twenties, I can tell you they’re worth every bit of effort. Let's see what can be done ahead of time to insure healthy offspring.

Preparation

According to physicians Felicia Stewart, Gary Stewart, and Robert Hatcher, in their book Understanding your body: Every woman's guide to lifelong health, prospective parents should follow these precautions before pregnancy, and continue with them all the way until the baby is born:

• Avoid exposure to potentially toxic agents including alcohol, tobacco, caffeine, X rays, and illicit drugs
• Avoid taking any medications (prescription or over the counter) until possible pregnancy risks have been assessed
• Make a healthy diet a top priority, and avoid restricted or weight loss diets that could be lacking in either macro or micro nutrients
• Avoid elevating body temperatures through saunas, hot tubs, steam rooms, which may affect the quality of sperm and egg
• Minimize exposure to radio frequency, microwave radiation, and radiation from television and video display terminals. There are indications that these may have adverse reproductive effects, perhaps as the result of local heating effects.

Probably one of the more difficult aspects of our lives is that we live in increasingly toxic environments, and that subtle dangers to our offspring lurk in them. Both men and women may be affected by exposures to toxic substances at work, although how exactly they will be affected cannot be predicted with precision. One study links exposure to the following substances to sperm abnormalities, impotence, infertility, and/or increased miscarriage in the wives of exposed workers: alkylmercury, antimonide, anesthetic gases, carbon disulfide, chloroprene, ethylenes, inorganic lead, manganese, methyl chloride, organic solvents, synthetic hormones, styrene, acetone, welding operations, and heat. It is important to reduce exposure to these toxins and other chemical and environmental hazards as much as possible, including asbestos, garden sprays, insecticides, paint and solvent fumes, and agricultural chemicals.

Prenatal care

A prenatal care provider must be in harmony with or at least sensitive to the parent's culture, wishes, understanding, and needs. According to physician Keith Block, a clinical instructor at the University of Illinois College of Medicine, first you need to know what you want, what you think is best for you, and then to find a doctor or midwife who will both respect your wishes and converse in reasonable ways about your areas of concern. Prospective mothers may also want to look into hiring a doula, who is a woman whose sole job is to support and advocate for the mother while she is going through labor and delivery. Studies have shown that women who are attended by doulas have less medication, less cesareans, and recuperate faster that women who are not.

Good Food

The fact that pregnant women need to pay special attention to what they eat is recognized by practically all societies, including ours. The following are some findings that can round out our perspective on what women need to eat during pregnancy.

The issue of supplements

Because we believe that our modern food supply is nutritionally poor, there is now an over-reliance on vitamin and mineral supplements, both by mainstream and by "wholistic" health practitioners. These substances, which in the medical literature are classified as drugs, were originally intended for people with clinically determined nutritional deficiencies such as scurvy, beriberi, and pellagra. In such a situation, vitamin supplements are indeed very helpful. Now it is assumed that everybody is deficient, and the use of supplements has become routine, a situation that Steven F. Horowitz, MD, medical director of the Samuels Planetree Model Hospital Unit at Beth Israel Hospital in NY, has called "the other drug culture.". This is particularly true for pregnant women; prenatal vitamins are automatically and universally prescribed. Millions of women who would hesitate to take a drug while they're expecting, enthusiastically pop their daily supplement pills.

Supplements may be helpful for poor or malnourished women, and there may be many of those in our society; they are also helpful when for some reason the woman does not properly absorb nutrients from her food. But in general, women who follow an appropriate diet of some protein foods, whole grains breads and cereals, fruits and vegetables, do not need any vitamin supplementation. In fact, there are studies that show the adverse effects of supplements, particularly vitamins A, B₆, C, D, and nicotinic acid. Writing in the Journal of the American Dietary Association, J. Greger points out that "Current widespread use of supplements containing one or two nutrients may not only cause overt toxicity symptoms, but also adversely affect the bioavailability of other nutrients." For example, excess Vitamin C interferes with copper metabolism; excess zinc impairs immune function, depresses copper absorption, and induces anemia. An excess of Vitamin A supplementation has repeatedly been shown to cause birth defects.

While vitamin and mineral supplements may have some usefulness for malnourished women, they may provide an excess of nutrients when conditions are more favorable; when taken in large amounts, they may cause chemical imbalances that may lead to detrimental effects. Human beings are built with a lot of leeway, and are very resilient even in suboptimal situations. Reasonably healthy children are commonly born without difficulty under conditions that are not perfect, to mothers whose diet leaves a lot to be desired. On the other hand, I found it peculiar that a considerable number of my students, friends, and acquaintances, healthy women on good diets, frequently had difficulties at delivery time, even if they took excellent care of themselves during pregnancy. The difficulties were usually in the area of late or slow labor, failure to dilate, and failure of the baby to come out even at full dilation. Several times a c-section was the only solution, and it was quite clear that in these cases the intervention was justified.

Keping in mind my the basic notion that the body is extremely reasonable and knows what it's doing, I wondered -- why would these situations come up? It occurred to me that slow labor and failure to dilate could indicate a lack of flexibility in the tissues; I wondered if an excess of nutrients, particularly the body-building ones (calcium, iron, protein) could be at fault. After I began inquiring, I found that all the women with these type of problems had taken abundant vitamin and mineral supplements during their pregnancy.

I theorize here that in some cases the supplementation of the pregnant woman's diet with an excess of minerals might lead to slow, delayed, or unsatisfactory labor. If too much can be as damaging as too little, it is conceivable that the excess of nutrients in well-nourished women, in particular calcium and iron, would stiffen the tissues of the mother and make them less pliable and stretchable; these same nutrients could make the baby's bones thicker, including those in the skull. For easy birth, the bones in the baby's head must give a little so as to fit during the passage through the birth canal. If the high prenatal mineral intake has done its job, and thickened the baby's bones, we might expect a larger than normal baby, with a strong, round skull that won't give. If the mother's pelvis is a bit on the narrow side, it is not unlikely that birth would be difficult; it is even possible that the only way out for the baby would be through a c-section, the very thing the mothers were hoping to avoid by taking such good care of themselves. Thus I wonder whether the need for caesareans -- often resorted to in cases of "slow labor" -- may be secondarily related to the hypernutrition of supplementation. There may be other reasons as well, but it seems to me that our lack of trust in nature's ways and our over-reliance on technology sometimes backfire on our good intentions. I believe that the use of supplements during pregnancy is only justified in the case of demonstrable nutrient deficiencies; otherwise, they fall into the same category as unnecessary drugs, that is, they are best avoided. If you do wonder about taking supplements during pregnancy, be sure to check with an expert and take only those specifically designed for your own nutritional status. On the whole, stay away from calcium supplements as they can cause the most trouble.

And remember to chew well every bite, and to be awed and grateful for every day of this miracle of life.

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