Here I have gathered the things mothers-to-be ask me about most often during pregnancy. Read straight through, or jump to whichever heading matches what is on your mind right now.

What is in this section

Pregnancy and the workplace — working right through the pregnancy, and how to handle the tug-of-war between the sharp boss lady and the bone-tired mother-to-be
How the home pregnancy test came to be — what humanity used to test for pregnancy before a strip could answer in minutes
Cervical incompetence — a condition that usually causes no symptoms at all, yet can end in miscarriage or very preterm birth: who needs watching, and how
What you eat and the risk of miscarriage — what a 2023 meta-analysis found: which foods help, and which turn out to be irrelevant
Cosmetics and pregnancy — how to read the label, which ingredients to avoid and which are fine

What you eat and the risk of miscarriage

The August 2023 issue of Fertility and Sterility, the journal of the American Society for Reproductive Medicine, carried a paper by Yealin Chung and colleagues: The association between dietary patterns and risk of miscarriage: a systematic review and meta-analysis. It pools the studies that looked at food type against miscarriage risk. Let us go through what they concluded.

Food type and the risk of miscarriage, from the systematic review and meta-analysis by Chung et al. (2023)
Food	Studies	Effect on miscarriage risk
Fruit	3	61% lower
Vegetables	3	41% lower
Fruit and vegetables together	3	37% lower — no better than fruit or vegetables on their own
Meat, all kinds	2	No association with miscarriage
Red meat	—	Does not raise the risk
White meat	2	Trend towards lower risk, but not yet clinically significant
Seafood	4	19% lower
Dairy products	5	37% lower
Eggs	3	19% lower
Cereals	2	33% lower
Fats and oils	—	Does not lower the risk
Sugar substitutes	2	Does not raise the risk

What counts as red meat and white meat

Red meat is meat that looks red while raw — beef, buffalo, pork, venison, goat, lamb, wild boar. Eating a lot of it is a risk factor for plenty of health problems, metabolic disease and heart disease among them. Sorry to disappoint everyone, but a high red meat intake does not raise the risk of miscarriage the way many of you assume.
White meat is meat that looks pale while raw — chicken, turkey, fish, shellfish, prawns. We already regard it as the healthier choice, and that fits with the two studies suggesting white meat may lower the risk of miscarriage. The data are still too thin to call it clinically significant.

Seafood — good, with a caveat

Good news for the seafood lovers: across four studies, a high seafood intake — meaning at least two meals a week — cut the risk of miscarriage by 19%. That said, the effect depends on the population studied and on which seafood is eaten, because in some areas seafood carries a heavy load of contaminants such as heavy metals, which are bad for you and for the baby.

Dairy, eggs and cereals

Dairy products means milk, butter, cheese, cream, yoghurt and ice cream — and whey and casein protein too. Besides being a source of the calcium and vitamin D a growing baby needs, all five relevant studies found that a high dairy intake lowered the risk of miscarriage by 37%.

Eggs — hen, duck, quail or ostrich — are good-quality protein at a low price, and the yolk is rich in the nutrients a growing baby needs, vitamins and cholesterol among them. Three studies found that a high egg intake lowered the risk of miscarriage by 19%. For cereals, two studies found that a high intake lowered the risk by 33%.

Fat is Good, Fat is Good, Fat is Good

Some of you have sat in my clinic and been made to recite Fat is Good three times in a row. Modern medicine has spent years casting fats and oils as the villain destroying our health, well past what the evidence supports. Do not forget that fat is a crucial nutrient for a developing baby — for nerve cells and for the membranes of every cell. Cholesterol is also the precursor from which all the sex hormones are built, female (estrogen and progesterone) and male (testosterone) alike.

That said, a high fat intake does not lower the risk of miscarriage.

Sugar substitutes

We Thais do have a sweet tooth. Even a savoury dish gets a pinch of sugar to round the flavour out — though I am never sure whether it is the flavour or the waistline that rounds out first. Cakes and desserts go without saying: they have to be sweet enough to make your teeth ache. Even green curry, kaeng khiao wan, where the wan — sweet — in the name refers to the shade of green, not the taste.

Sugar in quantity can lead to central obesity and then to anovulation, my dear. Which brings us to sugar substitutes — the natural ones such as stevia and monk fruit, and the assorted extracts they put into the Zero, Light and Sugar Free fizzy drinks. Two studies found, thankfully, that these do not increase the risk of miscarriage.

Other foods that do not raise the risk

Beyond the twelve entries above, there are ten more foods you have probably seen blamed for one disease or another. Pooling the studies, none of them was found to raise the risk of miscarriage at all.

Refined sugar
Desserts
Chocolate
Sweet drinks and fizzy drinks
Nuts and beans
Soy and soy products
Plant protein
Fast food
Processed meats (sausage, ham, Thai pork roll, pork crisps, pork floss)
Fried foods

In short: food and miscarriage

Out of everything on that list, six foods came out as protective against miscarriage.

Fruit
Vegetables
Seafood
Dairy products
Eggs
Cereals

And the other thing worth practising, and reminding yourself of daily: eat varied, complete and in sensible amounts. That is what works best.

How the home pregnancy test came to be

I am fairly sure every reader here has used a urine pregnancy test (urinary pregnancy test, UPT) at some point. But do you know what humanity used to test for pregnancy, before we had a strip that gives an answer in a matter of minutes?

I have told that timeline in full in an article of its own — come and read it at How the home pregnancy test came to be.

With my best wishes

May you all have a beautiful baby, a safe hour and an easy delivery. — Dr. Patsama

References

Chung Y, et al. The association between dietary patterns and risk of miscarriage: a systematic review and meta-analysis. Fertility and Sterility. 2023 Aug.

During pregnancy