Safety

Pregnant women often want to know whether something they do, eat, drink, take, or are exposed to could potentially harm their pregnancy.

However, searching for safety-related answers during pregnancy is difficult, as research into environmental agents is extremely limited.

Medications, chemicals, pathogens, and even specific foods are not often studied during pregnancy due to well known research hurdles. However, current existing data can help women avoid possible harmful agents and have more in depth discussions with their health care provider (HCP).

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Research and Pregnancy
It is important for women to understand how research is conducted in the field of obstetrics which can help explain why answers are sometimes hard to find and interpret.
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Teratogens (Safety Introduction)
A teratogen is a term for any outside agent or influence (medication, chemical, drug, food, bacteria, virus, heavy metal) that could potentially induce harm in a fetus through a pregnant woman’s exposure to that agent.
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Risks and Benefits
For many women, pregnancy will be a routine exercise in risks and benefits analysis – making mostly minor (and some major) decisions throughout their day that could potentially positively or negatively affect their pregnancy.
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Medication Overview
Very few medications have been adequately studied during pregnancy, leaving women and their health care providers (HCP) to make decisions on whether to recommend/use a medication based on little to no data.
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Common Safety Concerns

Vitamin A (Retinoic Acid)
Vitamin A is both necessary and potentially harmful during pregnancy; however, the latter occurs mostly in the context of retinoid medications and supplemental forms – toxicity through food is very rare.
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Acetaminophen (Tylenol)
Acetaminophen (Tylenol®/Paracetamol®) is the most common pain-relieving medication used during pregnancy, with an estimated 75% of pregnant women in the United States using the medication, throughout all trimesters.
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Altitude
Most healthy women with uncomplicated pregnancies and no risk factors can travel to high-altitude locations without any major concerns.  However, certain considerations are warranted.
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Antiperspirant and Deodorant
The safety of antiperspirant and deodorant use in relation to their ingredients has not been studied in human pregnancy. 
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Bed Rest
Bed rest is a traditional method used by HCPs all over the world to avoid pregnancy-related complications that could be affected by a woman’s level of physical activity. However, current research greatly questions this practice.
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Cold Medications
Although data is limited, current available evidence suggests most over-the-counter cold medications are likely safe during pregnancy with proper and limited short-term use. 
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Exercise
Unless an HCP has deemed otherwise, exercise is not only safe during pregnancy, but highly recommended. Exercise offers many physical and mental health benefits and is well tolerated by the fetus.
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Fever
The impact of a woman’s fever on her pregnancy depends on the fever itself, when the fever occurs and for how long, the illness causing the fever, and whether the woman takes steps to adequately manage the fever and/or seeks treatment for the underlying illness. 
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Hair Dye
There is not enough information to determine whether hair dye is risk-free during pregnancy, or which type of dye may pose the least amount of risk. However, there are "risk reduction" steps women can take to lessen possible absorption and exposure.
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Heat Exposure
Hyperthermia (opposite of hypothermia) is emerging as a risk factor for potential negative outcomes regarding fetal development. 
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Hydration and Thirst
Proper hydration is critical during pregnancy to support additional blood volume, amniotic fluid production, energy needs, kidney performance, avoidance of pregnancy-related side effects, and fetal growth and development.
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Marijuana
Studies regarding the effects of smoking/consuming marijuana during pregnancy are not as complete as cigarette smoking, but the identification of serious adverse neurological effects in the fetus/infant is becoming more evident.
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Ondansetron (Zofran®)
The use of ondansetron during pregnancy is intensely debated due to its significant effectiveness in most women with NVP/HG, but controversial safety profile. 
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Prenatal Massage
Massage has tremendous benefits on stress levels, swelling, and general discomfort during pregnancy, may help reduce depression and anxiety, and may be very effective for some women during labor. 
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Radiation
It is possible that some women will require diagnostic imaging during pregnancy due to a broken bone or other injury, abdominal, back, or pelvic pain, or other symptoms that require ruling out possible diseases or conditions.
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Screening Tests
Various screening tests are recommended during the first and second trimesters that normally include ultrasound examinations and lab/blood work. These tests, taken together, can evaluate a fetus’ risk for one or more birth defects.
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Sex
There is no evidence sex is harmful for healthy pregnant women with uncomplicated pregnancies and no underlying health conditions, regardless of trimester.
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Smoking
Smoking – as well as exposure to second-hand smoke – during pregnancy increases the risks of many complications for both mother and baby. 
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Ultrasound
Ultrasounds are commonly used in obstetrics. Most women will receive two to three of these examinations during their pregnancy, sometimes more if monitoring is required. 
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Vaccines
Vaccinations during pregnancy can protect a baby even before birth through the passive transfer of the mother’s antibodies through the placenta.
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E-Cigarettes/Vaping
Electronic cigarette use is becoming more common during pregnancy, mainly because women falsely perceive it to be safer than tobacco cigarettes. 
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Food and Beverages

Food Index
While certain foods may carry higher risks of pathogens than others, women can consume almost any food they enjoyed prior to pregnancy with just a few exceptions and specific considerations.
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Alcohol
Based on what science currently understands about embryology, fetal growth and development, and the breakdown of alcohol, every ounce of alcohol affects the fetus.
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Artificial Sweeteners
There is currently no evidence by United States or European regulatory agencies that approved artificial sweeteners, when used in appropriate doses, are harmful during pregnancy.*
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Caffeine
Most current studies have shown that caffeine consumption less than 200 to 300 milligrams (mg)/day is not associated with negative outcomes during pregnancy.
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E. coli
There are two factors to consider regarding E. coli during pregnancy: E. coli infection due to foodborne illness, and infection passed to the newborn due to E. coli present in the genital tract near delivery. 
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Eggs
Eggs are considered a vital component to a woman's diet during pregnancy based on their nutrient content, which has been shown to be beneficial for fetal growth – especially the fetal brain.
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Listeriosis (Listeria)
Listeriosis is a very rare infection in the general population, with a much higher incidence in pregnant women. Although rare, the consequences of invasive infection in a pregnant woman can result in neonatal complications.
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Safe Food Handling
While most individuals with "food poisoning" will recover with only supportive management (i.e. fluids, rest), pregnant women may experience more severe illness, which can be prevented with proper food handling.
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Salmonella
Salmonella infection is a foodborne illness most often contracted through contaminated food such as raw eggs or contact with raw or live poultry (including backyard chickens).
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Seafood
Women should not avoid fish during pregnancy. Pregnant women can safely eat two to three servings/12 ounces per week of seafood species known to contain lower amounts of mercury.
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