Life as a pregnant woman is full of rules and guidelines. You can’t eat or drink this, they say. Make sure you’re eating and drinking that. Always sleep on your left side. Loni Jane Anthony knows the pressure firsthand. As a popular blogger who adheres to a strict, plant-based diet, the Australian has experienced her fair share of pushback from fans during her pregnancies. Mainly, she gets criticized for following her strict vegan lifestyle during her pregnancies and while breastfeeding.
In an interview with The Daily Mail, nutritionist Fiona Hunter actually called Anthony “deluded” for believing her diet was the best choice for her unborn child. But when Anthony gave birth to a healthy, 8.7-pound baby who thrived while breastfeeding—even as she continued her plant-based diet—she finally silenced those who criticize her lifestyle. She continues to believe that a plant-based, vegan lifestyle is the perfect option for pregnant or breastfeeding moms, as well as her growing toddlers. Now, I’m no vegan, but I find it interesting to see how much time is spent policing women’s health choices while pregnant and breastfeeding. During my own pregnancy, for instance, I was criticized on more than one occasion for eating fish, despite the fact that the FDA actually encourages women to eat certain fish during pregnancy. However, it seems that since some high-mercury fish are off-limits while you’re pregnant, many people have uniformed opinions about women eating all fish. If you’ve ever been pregnant, you know that opinions about how to care for your body and your unborn child can be a source of controversy. It turns out, though, that beliefs about nutrition during pregnancy vary greatly from culture to culture. This may leave pregnant women scratching their heads—who’s really got it right?—wondering what foods and practices are okay for their unborn child.
So, before we move on, we should understand the basic tenets of a healthy pregnancy.
Although there is plenty of disagreement across cultures when it comes to nutrition recommendations for pregnant women (and even within cultures), there are some basic things that the global health community agrees on. This is largely thanks to the World Health Organization (WHO), which shares basic guidelines for a healthy pregnancy, no matter your culture or dietary habits. Pregnant women should eat a varied diet of protein, fats and fatty acids, carbohydrates, vitamins, and minerals, the WHO says. They should consume plenty of green and orange vegetables along with protein sources like meat, beans, and nuts. The organization also recommends that all dairy consumed during pregnancy is pasteurized and that women remain active during their pregnancy to avoid excessive weight gain.
But like I said, what women eat during pregnancy appears to vary greatly from culture to culture.
And many cultures, it seems, aren’t quite as uptight as the United States’.
There really weren’t many no-nos…
While I’ve always been provided with a whole list of foods I needed to avoid while pregnant, moms in other cultures don’t necessarily have the same experience. Valerie Turner Quirey, mom of one, was pregnant and gave birth in Brazil, but was only given one piece of advice from her obstetrician during pregnancy: “Don’t get fat.” “One month, he felt like I had gained too much [weight], and he told my husband to not let me eat so much… but that was literally the only guidance he gave me,” she says, adding that she ate a Nutella crepe soon after. Another mother, who has three children and was pregnant in both Ireland and Belgium, said that she wasn’t given much guidance in Ireland—she was allowed to continue eating as she did when she wasn’t expecting. In Belgium, however, their recommendations were similar to the advice she had been given in the United States. “In Ireland they don’t really talk about it,” she says. “In Belgium, they suggest eating salmon once every other week, eating a lot of protein, greens, and fruit … staying away from raw food.” Brittany Sprague, a mom of three who was pregnant and gave birth to her youngest in Finland, says that the mentality about nutrition during pregnancy there was one of personal choice. “Living in a place where fresh fish was the norm, sushi wasn’t as much as a no-no,” she shares. “A multi-vitamin wasn’t mentioned ever. There really weren’t many no-nos, but the food there is a lot fresher and it is quite obvious when it goes bad.” Although women were discouraged from smoking in Finland, Sprague says, many still did and got very little criticism for it. Her experience makes sense, considering literature created for pregnant moms in Finland, like this pregnancy handbook by The Ministry of Labour, takes a pretty relaxed approach on the topic. In fact, the exact words used are that the mother and her partner should “consider giving up smoking.” “There seems to be more of a ‘operate at your own risk’ mentality,” Sprague shares. “It was really freeing, a lack of judgement overall.” Note: On the subject of smoking, it seems the U.S.’ cautiousness is for good reason. According to the Centers for Disease Control and Prevention (CDC), smoking while pregnant increases the chances of early birth, birth defects, and SIDS, to scratch the surface.
Of course, whether or not you eat meat during a pregnancy is not all that controversial in the grand scheme of things. Comparatively, there are many more fascinating variations that exist from culture to culture for pregnant/breastfeeding women. For starters, the international thoughts on drinking during pregnancy and breastfeeding aren’t as black and white as you might think. In the United States, the CDC takes a hard stance on drinking: Don’t do it. “There is no safe time to drink alcohol during pregnancy,” they write, warning that children may suffer from things such as poor coordination, speech and language delays, intellectual disabilities, and heart, kidney, or bone problems. The German government has more recently taken a very strong stance on drinking while pregnant, launching an entire campaign encouraging women to avoid so much as a sip while pregnant. In comparison, some French women take a more relaxed approach to drinking. Although the official stance in France is abstaining from alcohol throughout pregnancy, many women still drink in moderation, trusting other mothers as their source of advice over their doctors, according to Stéphanie Toutain, PhD, in a 2010 study.
Beyond the more commonly known taboos surrounding drinking during pregnancy, different cultures have more specific, interesting rules about what a woman should or shouldn’t consume.
In traditional Chinese medicine, for example, pregnancy is viewed as a hot and damp condition, according to Elizabeth Trattner, a holistic practitioner who integrates ancient medicine into her practice. “Mothers are encouraged to eat cooling foods like watermelon and cucumbers,” she says. “If a mother has hyperemesis (morning sickness), both herbs and food are prescribed to help with the nausea.” In the past, food taboos in Nigeria were a factor in widespread malnutrition during pregnancy, according to research in the International Journal of Obstetrics and Gynecology. In 1982, researcher EA Ugwa reported that two-thirds of pregnant women were avoiding milk, cowpea seeds, and the nutritional supplement Bournvita for fear of their baby becoming too large. In 2016, a study published in The Annals of Medical Health & Science Research suggested that food restriction during pregnancy was no longer as prevalent of a problem in Nigeria. Specifically, their findings showed a wider understanding throughout the culture that eating more calories and consuming protein and fats during pregnancy are important to the health of mother and baby. In my own pregnancies, I heard my fair share of warnings about two of my favorite foods: sushi and coffee. The truth is, most of the apprehension about consuming either is widely anecdotal. Most respected sources in the United States, such as The American Congress of Obstetrics and Gynecology, suggest moderation of caffeine instead of completely abstaining, stating that there isn’t enough research to make a definitive decision about the impact of caffeine on miscarriage risk and preterm birth. There are other countries that don’t appear to be even that strict. In the UK, one writer for The Guardian reported being told to limit herself to five cups of tea or a couple cups of coffee a day, which doesn’t see like that much of a limitation. When it comes to eating sushi, multiple American mothers tell me they felt uncomfortable eating it at all (or felt they might be judged by others), but sushi isn’t inherently dangerous for pregnant women—it’s the risk of foodborne illness that is the big concern, which is a risk anytime you consume raw or undercooked food, according to Canadian Family Physician. As long as women are avoiding fish that is high in mercury and careful about raw fish, they can feel comfortable eating their favorite sushi roll throughout their pregnancy, according to the British National Health Service.
Being pregnant can be an experience filled with anxiety, and endless nutritional guidelines may only heighten anxiety for expecting moms.
Outside of a few obvious no-nos, like drinking and smoking, it seems best to focus on what moms should be eating—plenty of fruits, vegetables, and healthy sources of fat and protein. And honestly, even that decision should be between the mother and her doctor.