Before you know you're pregnant....

[NakedFinger]

The inspiration to finally post this thread came after watching "I Didn't Know I was Pregnant" on TLC and thinking "God knows what harm they did those 9 months of not knowing they were pregnant", although I have been thinking about this for quite some time now....

My friend had gotten pregnant unexpectedly, and the first thing she thought about was everything she had done the month prior that could have been bad for the baby....including a wild bachelorette party. If you don't find out until after a month (missed period) that you are pregnant, its possible to unknowingly take part in "don't do while pregnant activity" such as drinking....smoking...MRI's/Xray's, the list goes on and on.

I remember being told once that alcohol doesnt pass to the baby in the first month. Kind of "natures way" of allowing that cushion until you find out you are pregnant. I hardly know if that's accurate or not, so I tried researching on line what happens if you drink before you find out you are pregnant. All of the forums, articles, etc said that you should just stop drinking (or smoking, etc) while TTC because it will not only help chances of conception, but also help you get use to not doing those things by the time you get pregnant.

Its nice in theory, but what if you get pregnant by accident and don't know or aren't TTC? What happens that first month, and does it really not effect the baby yet?

My husband and I aren't planning on physically TTC yet (timed sex, tracking cycles, etc). However, we will most likely start out by "were not trying not to get pregnant", or basically not doing anything to prevent it, and if it happens awesome, but not going crazy with trying yet. But we could do that for months and months before anything might happen, or before we realize we need to time it. So do I just not drink AT ALL in case i just get pregnant? (I dont mean to sound like an alcoholic or anything, lol. I don't need to drink, but I like my wine, and I do have two bachelorette parties and two weddings (among other events) coming up. I also take medication for chornic pain that I know for a fact I couldnt take while pregnant. Do I stop taking that now just in case??? And the questions continue.

Sorry to ramble...just trying to put my cluttered thoughts on "paper". Since all the answers online seemed to be geared toward women actually TTC, I thought I would ask the knowledgeable women on PS whom may have experienced this scenario or talked about this with their doctor when the got pregnant. Thank you for any insight!

 

[charbie]

My suggestion? Get off the meds. Sooner trather than later, especially if you know you'll have to wean off soon enough anyways. And then I wouldn't drink for the last two weeks of your cycle, particularly if you have a predictible cycle.

 

[Miss Sparkly]

Nature and evolution does not have expectations and does not evolve in that way for the modern human. Thinking that you're safe the first month of pregnancy is just wishful thinking.

http://ehealthmd.com/library/smokingpreg/sap_alcohol.html

"FAS is characterized by particular physical and mental/neurological defects-abnormal facial features, reduced or slowed physical growth, a small head, and slowed intellectual/behavioral development. The latter defects are thought to be related to reduced or slowed development of the brain itself. Damage to the nervous system-the brain, spinal cord, etc.-can occur in the first few weeks of pregnancy, before a woman even knows she is pregnant"

I have not experienced this and never will. My coworker did. Her baby was an oops and she drank (she has wine with dinner each night) and took birth control for the first couple weeks of her pregnancy. She quickly got to the point where she was too ill with morning sickness to want to drink, saw her doc for the flu, and found out she was pregnant. She went on to have a very healthy baby girl.

I personally wouldn't give up the things I love for something so uncertain (being pregnant or not)

 

[lliang_chi]

NakedFinger, I think your best bet is to talk to your doctor. Especially in regards to your pain medication. The other stuff, drinking, etc, I still do, even though I'm TTC. I don't smoke, but I think if I did I would quit because it's a bad habit to have anyway.

As for stuff like XRays etc, I'd just take this time to know your cycle, e.g. when you ovulated, then if something happens, just let the doctors know there is a chance you MIGHT be pregnant.

 

[Octavia]

I recently had an x-ray and the doctor insisted on shielding me with the lead lap blanket because I'm not on HBC, was more than a week past my period, and had been "active" with DH recently. He said they shield if there's any chance whatsoever, regardless how slim. I don't know if this is standard procedure or if that doctor is just very cautious, but I don't see why you can't just ask for the shield anyway if you're not 100% sure. I'm not sure what they would do for an MRI, though. As far as drinking, I think if I was "not not trying" or actively trying I'd probably avoid or drink very little between ovulation and my period, but I do temp and chart so I have a pretty good idea of when that all happens...it would definitely be harder if you don't know. Talking to your doctor is a good idea, she can probably give you a lot more info!

 

[dreamer_dachsie]

The embryo does not share your blood supply until about 21 days past ovulation, which is approximately "5 weeks pregnant" if you hav ea typical 28 day cycle. Make of that what you will. This is before some women know they are pregnant, before morning sickness and the like, but every woman I know who was actively TTC knew they were pregnant when they missed their period, around 14-18 days past ovulation. So most women I know knew they were pregnant before any damage could be done by a glass of wine here or there.

 

[Blenheim]

Dreamer beat me to it. I continue to drink while TTC, but don't drink to excess. I also know when I ovulate and am a notoriously early tester.

As far as x-rays, George had to have an x-ray when I was a little less than a week past ovulation when TTCing this baby, and the x-ray tech wouldn't allow me to be in the room (protective apron or not) because of the chance I might be pregnant. However, I didn't exactly have a medical need to be in the room.

 

[Pandora II]

Meds for chronic pain and pregnancy - I took tramadol, codeine and lamotrigine throughout my pregnancy due to chronic pain. I did reduce the lamotrigine for the first 14 weeks just in case of cleft palate (but only because my niece has one and so the risk was elevated beyond that of just the med).

My GP, OB, pain specialist and the neonatologist at the hospital I was at were all very supportive and agreed that there was no reason why I shouldn't have a baby and remain on the meds (coming off was not an option). I was with one of the leading hospitals in the UK and in the largest maternity unit in Britain, so I knew I would have superb treatment.

Daisy was born after a 54 hour labour ending in an emergency forceps delivery and still had Apgar scores of 10 and 10 which are the highest you can get. The neonatal team were on hand to check her straight after birth, we stayed in hospital for a week - I got a single room which is very rare here - and she was checked every two hours for signs of withdrawal.

She did have a very high-pitched 'heroin baby' cry, but at no time was she in any discomfort. She was given tiny and gradually reduced doses of Oramorph to help her withdraw without any pain and was off it completely withing 36 hours of birth.

She has always hit all her milestones well ahead of schedule and is a very bright and naughty little girl!

Obviously if you can come off the meds then that is great, but otherwise stay on them as the chemicals your body will make in response to pain can have a far more negative affect. Or, if you can, move to opiates as these are extremely safe in pregnancy.

Oh, and I am still breastfeeding my daughter now - the transfer of opiates through breast-milk is negligable (unless you are one of the rare super-convertors of morphine which you would probably know if you are by now).

On the other issues, my youngest sister found out she was 7 months pregnant in October - long story and no she really didn't know, neither did she look pregnant (and she's not fat by any stretch) and even my father who's a doctor and saw her regularly didn't suspect.

She takes Lithium, Venlaflaxine and a host of other meds all of which are category D, she'd been drinking, smoking and gawd knows what else for the whole pregnancy. She was sent up to London for detailed scans and to try and get a due date and the scans all came back perfect. Her little boy was born in January weighing 9lbs 8oz and is perfectly healthy and seems a bright little chap.

 

[Tacori E-ring]

Alcohol negatively affects the fetus during all three trimesters. I would avoid it if I were actively trying and try to abstain while pregnant. I would consult your doctor about the other medication you are on.

 

[Haven]

This is a great thread! I've often wondered about the same things, NF. I don't take any medications, and I'm not on BC, and like you we aren't actively TTC, but it could happen. I do drink a glass of red wine most nights after dinner, and I always wonder if I should maybe stop doing that just.in.case.

Thank you for sharing all of this wonderful information, ladies.

 

[lliang_chi]

Neat, and Haven, I totally love myself a glass of wine. I'm actively TTCing now but haven't abstained completely from drinking. At the same time I'm WELL past the age of "falling down drunk" boozing so I think (in my non-medical opinion) that i can still enjoy some wine and just swear off it when I do get pregnant. Also to be completely honest I'm never a 1 glass of wine gal. I drink company, be it Sister, husband, or friends, and we'll always do maybe 2-3 glasses each. But like I said, we're not falling down drunk but have a happy buzz going.

Ok, gonna shut up now because I totally look like a booze hound....

~LC

 

[Tacori E-ring]

So, I realize I am a buzz kill. Feel free to ignore my post but for those who are concerned or interested I looked in my textbook. The brain is one of the first organs to develop to the book says weeks 3-8 are crucial. In the first trimester alcohol interferes with the brain cells. Second trimester (especially the 10th-12th weeks) facial features are affected. The risk in the third trimester is problems with visual and auditory info. U.S. Surgeon General advises pregnant women not to drink at all. FAS (fetal alcohol syndrome) can cause retarded growth, facial deformities, problems with heart and limbs, issues with central nervous system, behavioral problems, vision & hearing loss, neurological abnormalities, delayed intellectual dev., balance problems, memory problems, aggression, oversensitivity to stimuli, the list goes on.

 

[MichelleCarmen]

Hi,

Please don't take this the wrong way, but I think it'd be wise to use BC until you've tapered off the pain meds! Not only will you be certain the baby won't have issues, you also don't have to worry about going through w/drawals while pregnant!!! (and you're also drinking while taking medication(s))....

Also, start taking prenatals right now so folic acid is built up in your system!

You're planning a pregnancy (ETA - I do think the concept of going off BC and just letting things happen as they do IS trying ...make the most to ensure a healthy baby. Good luck.

 

[amc80]

I rarely drink at all. I might average to one drink per week. I get about 3 sips into a glass of wine and I can feel it. Yeah, light weight. We are going to be trying on our wedding cruise. I'm still going to drink. My personal feeling is if it's too early to get a positive test then it's probably too early to matter. SO many women get pregnant without knowing and continue to live their normal lives.

 

[Blenheim]

Tacori - Does the book specify if "3-8 weeks" is fetal age or gestational age? The neural tube starts to develop around 5 weeks gestational age/3 weeks fetal age, and the book is referring to 10-12 weeks as second tri, which makes me think that the book is using fetal age and that it's talking about a point at which you could get a positive pregnancy test.

 

[Tacori E-ring]

Blen, good question. I believe they are referring to gestational weeks. One sentence says, " For example the corpus callosum, a crucial structure that connects the cerebral hemispheres, is extremely vulnerable to alcohol use during the sixth and eighth gestational weeks." The other weeks are not specified but I would assume they wrote it using gestational. Another important thing to note is that many symptoms of FASD (fetal alcohol spectrum disorder) are not obvious until several years after birth.

Regarding the opioids, most cross the placental barrier which sends large doses to the developing fetus. Tissue dependence and w/drawal is more serious for a small infant. Babies can actually die from the w/drawal of opiods. I would urge anyone to consult their doctor before they actively TTC if you are on pain meds. There is a higher risk of m/c, placental separation, premature labor, breech birth, still birth, and eclampsia.

I made the personal choice not to have a single drop of alcohol while pregnant. For me, it is just not worth the risk.

 

[Blenheim]

Tacori, thanks for looking that up. I have one pregnancy book that refers to everything in regards to fetal age, and it confuses the heck out of me if I read it just after reading something that refers to gestational age, and so I just wanted to be sure.

 

[Tacori E-ring]

No problem Blen. This is helping me study! Personally I think having some drinks before your know you are pregnant (first month or so) is very different than drinking after you have confirmed your pregnancy. However there is always a risk so I think I think it is good to be informed on the facts.

 

[amc80]

Personally I think having some drinks before your know you are pregnant (first month or so) is very different than drinking after you have confirmed your pregnancy.

Agreed. Also a big difference between the casual drinker (a glass of wine in the evening) versus the binge drinking partier. If I were the latter, I would probably abstain completely if I were trying to get pregnant. In the case of casual drinking, I would stop once I got a positive test.

 

[Kay]

I have no medical training and cannot give medical advice; I can only relate my own experiences. I started taking pre-natals when I went off HBC and we used condoms for 2 months while I got the HBC out of my system (I have since learned that is not necessary). After that, we didn't do anything to prevent pregnancy, but did not chart or do anything active to TTC. I have a family history of infertility, so I expected it to take a long time to get pregnant, if we could at all. As such, I was not inclined to change my life dramatically beyond taking vitamins and trying to eat better (I don't smoke and my binge drinking days were already long behind me). It turns out it only took us 2 cycles to get pregnant. I did not realize I was pregnant until almost 8 weeks, when I started getting MS and did the math. Then I started to panic bacause I had been at a party the month before and had 4 or 5 glasses of wine, plus I regularly had a glass or 2 with dinner a few nights a week. My DR said not to panic, as the studies suggest FAS is caused by regular high consumption rates. He was fine with me having 1 or 2 glasses of wine on occasion during my pregnancy. I am not going to advocate that anyone else drink, as we all have different comfort levels, but I chose to allow myself an average of 2-3 glasses per month when I was pregnant. My DD was full term, with a healthy weight, no chronic health problems, and, at 2.5 years old, appears to be ahead of her classmates in verbal and math abilities.

 

[Izzy03]

This topic isn't black and white, and each person has their own views on what behaviors are acceptable during pregnancy, but there is there is no way to tell exactly how much alcohol will affect the development of a fetus throughout a pregnancy. Obviously, well controlled studies cannot be performed on the topic for ethical reasons.

I have plenty of friends that consumed alcohol while they were TTC and before they knew they were pregnant.....all had healthy babies! In the hospital setting, the only babies I have seen with abnormalities were born to alcoholics and addicts with no prenatal care. Lots of women consume small amounts of alcohol in their third trimester, a very debatable topic among health care providers.

I am not AT ALL trying to conceive at the moment (my marriage is not in a good state for raising a baby) but had to go hormonal birth control for other reasons. I continue to drink IN MODERATION, and if I did find out I was pregnant I really wouldn't be too concerned about my intake affecting the development (and of course I would stop drinking at that point!). As for your pain medication, you should talk to your provider. In the meantime, listen to you body and have fun at your upcoming parties!!

 

[kama_s]

I worked in the lab that did a lot of the groundbreaking work on FAS, and I was going to post exactly what Dreamer said.

Also, re: the generic X-rays, the amount of radiation is very very very minimal (I used to calculate the fetal dose of radiation for some of my patients).

Re: your chronic pain medication, you have two things to consider: 1- washout period (i.e., how long it would take for the drug to be flushed out of the system entirely. If you give me the name, I can calculate this for you) and 2- if you do end up continuing to take it during your pregnancy what are a) the teratogenic risks and b) is there a possibility for withdrawal symptoms in the baby if you continue into 3rd trimester.

For the most part though, the risks perception is much greater than the actual risks. I would suggest you continue to do all that you currently are doing, but in moderate doses.

 

[dreamer_dachsie]

Most of the time, the "medical community", whoever that is exactly (I know it includes sources like Health Canada and the Surgeon General, but also seems to include "What to expect when you are expecting" somehow), uses blanket abstinence as the message of choice when it comes to pregnancy and taking any substance where there is even a minute possibility of issues arising. Don't eat sushi, soft cheese, drink one drop of alcohol, deli meats... etc. It is safer to recommend to all women to avoid all those substances completely than it is to actually educate the general population about the risks and where they come from (soft cheese, for example, really should mean *unpasteurzed cheese*, which you cannot buy in North America anyways so it is a moot issue... yet the recommendation remains and many women fearfuly avoid soft cheeses when pregnant). With alcohol, no amount has be proven safe, so zero exposure is the party line recommendation. And to be 100% safe, that is the recommendation women should follow of course. Yet at the same time, lots of other cultures do not follow that recommendation and pregnant women drink in moderation, and it seems those cultures are not overrun with FAS, or affected any more than N/Am culture is.

I guess my point is that I dislike the somewhat patronizing tone that a lot of medical literature takes towards pregnant women, when of course the issue of fetal exposure to anything is much more complex than can be conveyed in a single sentence message sent out to all women, as the posts in this thread certainly suggest.

As an anecdote, most women in my mom's generation and social circumstances in Britain in the late 70s did not know they were pregnant until they were 8-12 weeks along (you had to kill a rabbit as a pregnancy test!), and they drank and smoked and did recreational drugs in that time. Yet there does not seem to be a generation of highly affected kids out there, nor have I heard tell that recent rates of affected kids are lower than historical rates, prior to the abstinence message. I would be interested to see such population data, though it would be hard to gather as diagnosis has changed in the interim as well...

The one major benefit I have heard from mass recommendations to pregnant women is that taking folic acid when TTC and in early pregnancy has virtually eliminated spina bifida, which is wonderful news indeed.

 

[kama_s]

Dreamer, a lot of the folic acid research was also done in our lab

 

[TravelingGal]

Ditto Dreamer.

A small amount of alcohol, IMHO, is probably fine. The problem is define "small." 1/2 glass? One glass? Most people don't know a "standard" pour of wine (meaning by level of alcohol) should be 4 oz....that is a VERY small glass. The average person will pour themselves a 5 or 6 oz glass...and drink it pretty quickly. A typical restaurant pour is about 6 oz. Even when it comes to "standard" measurement for wine, there is confusion...I've heard it's anywhere between 3oz - 5oz.

Because of the confusion, it is easier for many doctors to say avoid completely. Saying it's OK to have a "glass" of wine is simply too vague.

 

[MonkeyPie]

To the OP - it has to be a personal choice. Lots of very smart women have expressed here their own beliefs and knowledge, now you have to decide for yourself.

One thing I do wish, is that people would stop saying things like, "I had a glass of wine every night and my baby was perfectly healthy!" (Not that anyone here said exactly that, but lots of examples were given of friends/family that did this.) Anecotes mean NOTHING for something like that, and I really don't get why anyone would even offer it like it helps.

 

[qtiekiki]

To the OP - it has to be a personal choice. Lots of very smart women have expressed here their own beliefs and knowledge, now you have to decide for yourself.

One thing I do wish, is that people would stop saying things like, "I had a glass of wine every night and my baby was perfectly healthy!" (Not that anyone here said exactly that, but lots of examples were given of friends/family that did this.) Anecotes mean NOTHING for something like that, and I really don't get why anyone would even offer it like it helps.

ITA. It's your personal choice. Your life, your body, your baby.

 

[dreamer_dachsie]

Dreamer, a lot of the folic acid research was also done in our lab

Cool! Do you actually follow pregnant women or is the research done on animals? I have always wondered. For both this and the alcohol research. One thing I wonder about in some of this research is the method of exposure in the lab versus the method of exposure in real life and whether they are correctly adjusted in the mass recommendations? In the lab, maybe it is intravenous injection into an animal, in real life oral consumption...

 

[kama_s]

Dreamer, a lot of the folic acid research was also done in our lab

Cool! Do you actually follow pregnant women or is the research done on animals? I have always wondered. For both this and the alcohol research. One thing I wonder about in some of this research is the method of exposure in the lab versus the method of exposure in real life and whether they are correctly adjusted in the mass recommendations? In the lab, maybe it is intravenous injection into an animal, in real life oral consumption...

We were not involved with any animal research. It was placenta or pregnant women. Bioavailability is definitely a major concern (as it would be with any phamacokinetic/pharmacodynamic study), so it is most definitely taken into consideration. My own research was the safety of a topical corticosteroid in pregnancy, and not only did I have to see if there were any risks with exposure but also compare any risk with oral or iv consumption. Incredibly difficult to do when it comes to a clinical trial.

 

[Mara]

I haven't read all the responses but I do remember reading that the placenta is not fully connected from the mother to the fetus until something like 8 or 9 weeks? I asked my doctor about this and she said that is pretty much why they tell you not to stress out about whatever you might have done before you knew you were pregnant. Until the placenta is in place, the baby lives off of a 'yolk sac' which has all the food and nutrients that it needs to continue growing and thriving until the placenta is in place.

At ~3w ... right before the week my period was due, I definitely had more than my share of sangria at a friend's BBQ. I don't typically drink that often so it doesn't take much and I was feeling ridiculously good. Of course a week later, when I found out I was preg, I was like OMG. That is when I did a little reading and asked my doctor when I had my first appt at 7w.

If you know you are going to TTC soon, I would def take folic acid or prenatals, we just decided to 'try' and I wasn't taking any vitamins or anything and I wish I had been. I also was taking a few different medications, most of which were not safe for baby. I stopped after finding out I was pg and talking to my doctor about them (so around 5-6w). I personally don't think you need to cut out doing every little thing but just be more aware of what you are doing/putting into your body if you are going to seriously do TTC. Good luck!

PS... TG my friend's doctor told her it was fine to have a beer 4-5x a week while preg. She didn't but she thought it was so interesting.