Runny Eggs and X-Rays: Defining ‘Risk’

I like to bake. Big cakes, cupcakes, cookies, brownies… you name it, I love making it. And eating the results. And, if I’m truly honest, eating the partially made product, otherwise known as licking the bowl clean.

The day that we found out I was pregnant, I’d planned to make Peanut Butter cookies – my favourite and my speciality. We’d made a special detour to a local shop to buy ingredients, where we also unsuccessfully tried to pick up a pregnancy test. Managing to buy one later, I took that before starting on my baking. Only once we’d got the positive, I couldn’t bear to bake anymore, not only because I was too excited but because I suddenly realised that I couldn’t eat the raw dough. Raw eggs are on the no-no list for pregnant women due to the increased risk of salmonella.

It was only over the following few days that I really began to think about it, and look in to it, properly. For starters, I realised that British eggs stamped with the Lion Mark come from Salmonella free, vaccinated broods. So the chances of getting Salmonella from raw or runny Lion Marked eggs really are very slim. Which made me think about all the other “risky” things we’re advised not to do when we’re pregnant.

The thing is: nothing can eliminate all risks entirely. Being alive is a risky business, given that the only certainty is death. Being pregnant is certainly a risky business too, and absolutely everything in pregnancy – what to eat, what activites to do or restrict, what medications to take and what treatment to have – are a balance between risks and benefits. The problem is that nothing at all, even just walking along the street, can be proven safe because unfortunately some babies will be born with problems and it will be really hard , if not impossible, to identify what actually caused them – if anything specific. Things which are known for sure to have harmful effects should obviously be avoided. Thalidomide is a good example. But other seemingly forbidden things might not be so clear cut.

In fact, the vast majority of things in life seem to fall in to “grey areas”. If there is a small chance that something may cause harm, I think it is best avoided whenever possible, if only so you are not left wondering or feeling guilty if you should be unfortunate to have a problem. Many things are avoided without much difficulty. To use dentistry as an example here – routine x-rays are easily avoided as they can wait for 9 months. Cosmetic treatment is also easily avoided as it is not essential. Equally, most foods are easily avoided, even if we do miss them.

However, sometimes something that falls in to a grey area has a very clear benefit. Taking many medications falls in to this catergory. One medication that I take daily is not totally proven safe in pregnancy. But if I stop taking it, the potential effects for me, and hence on the baby, are overall greater. No one would take my medication if they didn’t need it, or could get by without. But I can’t. The benefits outweigh the risks.

Most medical and dental treatment is the same. The risks of failing to have toothache treated, to use another dental example, are ongoing pain which may be disruptive to your life, cause stress which can affect the baby and require you to continually take painkillers. Although paracetamol is safe on an occasional basis, taking it daily for 7 months is a bad idea in itself. You might also risk developing a nasty infection. In the very worst case, severe dental infections can spread and become very serious – again a potential threat to your pregnancy.

And here’s something about the one everyone thinks is a no-no: x-rays. Yes, they can be used in pregnancy. Once again, it’s a case of risks vs benefit. Having an x-ray does not mean you will definitely have a problem with your pregnancy or baby. In fact, the overwhelming balance of evidence is that you won’t have a problem at all. Having routine x-rays is unwise because even the tiniest risk isn’t worthwhile if there is no gain. In certain cases though, there is potentially a big gain. Sticking with the dental examples, that may be the preventon of pain and infection and not losing a tooth. The dose from a small dental x-ray with modern digital equipment is not any greater than if you take a couple of medium-haul flights durng your pregnancy. Pregnant women living on Dartmoor receive more than a dental x-rays worth of extra radiation compared to a woman living in London, but there is no coresponding increase in birth defects in Devon. The x-ray tube is pointed towards your teeth and well away from the baby.

I think that there are a lot of misconceptions about what is and isn’t safe in pregnancy. But I also think unnecessary avoidance of too many things, especially foodstuffs, has the potential to cause stress that surely is not good for pregnancy itself. And sometimes the avoidance of things like medication amy cause more harm that taking it. Women need to be supported to weigh up the risks and benefits for themselves, and understand what they are sacrificing and why, rather than just given a dictatorial list of things they must not have or do.

There are no guarantees. We just have to do the best we can.


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