Category: Things to Know When You’re Pregnant

The Power of Eating Dates in Pregnancy

For centuries midwives have relied on the power of food to promote health, healing, and to assist with maintaining a healthy pregnancy and delivery. As an example, dates are a fruit that have transcended time and tradition and have been used as a culinary staple in many cultures for centuries. Dates are a common food throughout Europe, the Middle East and Africa. In the US, dates are a delicious snack and healthy alternative for extra fiber or nutrition. They are truly a versatile option for adding to food or eating on their own with unique health options. However, I recently read a post by my friend and colleague, Nina Spears, a Registered Dietitian, who explained the benefits of eating dates during pregnancy and how to incorporate dates into a typical American diet. She based her findings in the latest evidence and recent international studies have supported what Nina puts forth.

In short, dates are a great source of fiber, magnesium, potassium, folate, Vitamin K and healthy fructose. The existing literature supports that a diet containing dates is an ideal way to help women have shorter and easier labors and births naturally. The studies also support that eating dates could help reduce the risk of induction.

NIna offered several suggestions to incorporate dates into a typical diet. Her suggestions include blending dates into a shake, adding them to hot or cold cereal, adding them to salads, adding them to chicken or tuna salad in a whole wheat tortilla or pita wrap, adding them to your own homemade trail mix, drizzling them over waffles, pancakes, oatmeal, yogurt, French toast, or making them into a parfait. Nina also suggests adding chopped dates to cookies, muffins and substituting dates for raisins, currants or sultanas or incorporating them with nuts for extra protein.

The international research surrounding the use of dates in pregnancy, especially at or before 36 weeks gestation, is compelling. Check out Nina’s full post at The Benefits of Eating Dates During Pregnancy – Baby Chick (baby-chick.com) Share your comments and experiences!

The Benefits of Eating Dates During Pregnancy – Baby Chick (baby-chick.com)

Paul Quinn, PhD, CNM -Prenatal PossibilitiesLeave a comment

Liver and Onions

I admit I was surprised when one of my followers reached out to me directly and asked me for this specific recipe. Turns out she has always been a fan of liver and that her grandmother and mother would make it for her family. When she was diagnosed with anemia during pregnancy, her mother told her to eat more liver. Liver is high in essential vitamins, minerals, and protein so it has been a time-honored food recommended for pregnant women. One problem: most people do not know how to make it. Need a simple way to make it?  I have the ideal recipe.

Most people dislike the earthy, ferrous taste of liver or its texture. It can be bitter and can become rubbery or chewy if it’s cooked too long. This recipe cuts through the bitter taste by soaking the pieces of sliced liver in milk prior to cooking. The slices cook faster and more completely than cooking a whole piece of liver and the sweet onions caramelize to provide another layer of texture and flavor. Liver isn’t for everyone, but if you’re craving its unique taste, this is the recipe to try!

Liver and Onions

Serves 4

  • 2 pounds beef liver, sliced
  • 1 ½ cups milk (low fat, 2% or whole cow’s milk)
  • ¼ cup butter or margarine, divided
  • 2 large yellow or Vidalia onions, peeled and sliced into rings
  • 1 ½ cups all-purpose flour
  • ½ teaspoon salt
  • ¼ teaspoon fresh ground black pepper
  1. Rinse the liver slices under cold water then place in a medium bowl.  Cover the liver slices with milk and allow to sit for at least one hour.
  2. In a large skillet, melt 2 tablespoons of butter over medium high heat. Saute the onion rings until soft. Remove the onions and turn off the heat.
  3. Put the flour in a shallow dish and season with the salt and pepper. Sift with a fork to combine.
  4. Drain the milk from the liver slices and discard it. Shake off the excess milk from the liver slices. Dredge the liver slices in the flour.
  5. Heat the skillet over medium high heat. Melt the remaining butter in the skillet. Place the flour-coated liver slices in the skillet and cook until browned, about 4 to 5 minutes per side. 
  6. Add the onions back to the skillet and reduce heat to medium. Cook an additional 2 minutes. The liver slices should be lightly pink on the inside.
  7. Remove from heat and serve with boiled potatoes or a green vegetable.

Featured photo by greissdesign

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Perfect Pickles

One of the longest running jokes, or myths, about pregnancy is that pregnant women crave pickles and ice cream–both alone and in combination. In my practice women report to me that they do, indeed, have some unique cravings that they did not have prior to pregnancy. Cravings are real and there is some science behind why women have more cravings during pregnancy than at any other time.

First, culture plays a huge role in why women crave certain foods. If a woman is familiar with, or exposed to, certain foods in her lifetime she is likely to crave them again during pregnancy. Its hard to crave something you have never eaten!

Next, there are key hormones that play a large role in stimulating hunger or the feelings of fullness. Fat cells in the body secrete leptin, which is a hormone that is responsible for trigger the brain when a sense of satiety (or “feeling full”) is reached during a meal. In pregnancy, a woman’s body becomes resistant to leptin and the interaction in the hypothalamus in a woman’s brain is interrupted. With this disruption in leptin, a powerful appetite stimulant called neuropeptide Y (NPY) is now capable of binding to cannabinoid receptors leading pregnant to feel hungry more often and cravings to begin.

Another hormone, ghrelin, signals hunger to the brain and its levels are typically highest before a meal. In pregnancy, the levels of ghrelin are also distorted so ghrelin levels peak at various times, further increasing the frequency of feeling hungry or needing a snack.

Pregnant women often crave salty or vinegary types of foods that have texture or a crunch. Pickles are an ideal snack to satisfy those types of cravings. However, jars of pickles, while delicious, contain varying amount of salt or preservatives that may not make them the smartest choice for a snack, and they can also promote some unwelcome side effects like gas or heartburn. My solution? Make your own pickles!

I have the easiest recipes to make homemade pickles that are low in sodium, have no additional preservatives, and can be kept on hand for a snack emergency. My recipe can be either sweet or more acidic depending on your tastes. However, these recipes let the pickles store in simple jars or containers so no canning, or the whole canning process, is needed. Plus, any crunchy vegetable can be added like slices of carrots or radishes to add extra crunch and taste. Cut the pickles thin or thick, or use a crinkle cut knife to make beautiful slices with ridges.

Try adding in different fresh herbs like dill or parsley to heighten the flavor. Eat these alone or with a sandwich, on top of meat, or as an appetizer. They make a great homemade gift to bring to a party or brunch. The possibilities with these pickles are endless!

Perfect Pickles

Makes 3 medium jars 

  • 4 cups water
  • 2 cups white vinegar
  • 1 ½ tablespoon kosher salt
  • 1 teaspoon white sugar
  • 4 cups sliced pickling cucumbers (either ¼ inch circles or in spears)
  • 1 small sweet onion, thinly sliced
  • 4 garlic cloves, peeled and sliced
  • 1 tablespoon mustard seeds (optional)
  • 1 tablespoon whole black peppercorns (optional)
  1. Prepare the brine: Combine water, vinegar, salt, and sugar in a medium saucepan. Bring to a boil over medium-high heat and stir until all the salt and sugar is dissolved. Remove from heat and allow to cool to room temperature.
  2. Add the cucumber slices to jars or containers with tight sealing lids. Do not overpack them and leave room for them to float easily in the brine. Add in the onion, garlic and seeds if using.
  3. Add enough cooled brine to cover the cucumber slices. Seal the container and store in the refrigerator for 1 week. Pickles should last about 4 to 6 weeks in the refrigerator.

Sweet Pickles

Makes 2 medium jars 

  • 2 cups sliced cucumbers (either ¼ inch discs of in spears)
  • 1 small sweet onion, thinly sliced
  • ½ cup water
  • 1 cup apple cider vinegar
  • 1 teaspoon salt
  • ½ cup white sugar
  • 1/8 cup packed brown sugar
  • 1 teaspoon mustard seeds (optional)
  • 1 teaspoon celery seeds (optional)
  • 1 teaspoon white peppercorns (optional)
  1. Place sliced cucumbers and onion in heat safe jars or containers. Do not overpack; leave enough room for the cucumbers to float easily in the brine.
  2. Prepare the brine: Prepare the brine: Combine water, vinegar, salt, and sugars in a medium saucepan. Bring to a boil over medium-high heat. Reduce heat and simmer for 5 minutes.
  3. Pour the hot brine over the cucumbers and onions. Allow to cool.
  4. Add in the seeds and peppercorns if using. Seal the container and refrigerator for at least 2 hours before serving.
  5. Store up to 2 months in the refrigerator.

Featured photo by Reka Biro-Horvath 

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The Pressure’s On…

To all of the women who have reached out to me through emails or direct messages to ask me questions: Thank you! I love hearing your thoughts and questions. One of the most common questions I get is about high blood pressure and what the differences are between high blood pressure, hypertension, and preeclampsia. So, here is a post on the differences between each of the maternal conditions related to blood pressure that happen during pregnancy.

What is blood pressure?

Blood pressure, essentially, is a measurement of how forcefully the blood is circulating through the arteries. It is impacted by several factors, but most importantly by the heart rate and the elasticity of the arterial walls. When the blood meets resistance, the heart has to work harder to force the blood to circulate. That increased workload of the heart translates into high blood pressure. Blood is supposed to flow freely throughout the body, not be under force or pressure to get to all parts of the body.

Why it matters for pregnancy

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Photo by Kewei Hu

In pregnancy we keep a close eye on women’s blood pressures. Most people have no symptoms when their blood pressure is elevated. Dangerously high or sudden spikes in blood pressure may be associated with dizziness or headaches, but elevations in blood pressure are typically unnoticed.  

The reason why we get so concerned about blood pressure during pregnancy is because we are always worried about the placenta. Since the placenta is how the baby gets nourished and sustained, we in obstetrics want to keep the placenta working properly. The placenta is vascular and susceptible to blood pressure changes. High blood pressure in the mother means the placenta is under pressure too and that could lead it to not function properly as a filter and source of nutrition and oxygenation for the baby.

Types of blood pressure issues

There are different kinds of high blood pressure issues for pregnant women. Among these include:

Gestational hypertension.  

Women with gestational hypertension have high blood pressure that develops after 20 weeks of pregnancy. Treatment for gestational hypertension differs and can range from close monitoring to medication. Typically there is no organ damage and the condition usually goes away once the baby is delivered. However, some women with gestational hypertension may progress to have persistent high blood pressure or hypertension after delivery or worsen to develop preeclampsia.

Chronic hypertension.

Chronic hypertension is high blood pressure that was present before pregnancy or that occurs before 20 weeks of pregnancy.  Some women are aware they have hypertension because it was diagnosed by their health care practitioner, but sometimes it is not diagnosed until pregnancy. Since there are generally no symptoms with high blood pressure, it is often hard to determine when it actually began (i.e. with pregnancy or before).

Chronic hypertension with superimposed preeclampsia.

This condition occurs in women with chronic hypertension before pregnancy who develop worsening high blood pressure during pregnancy. What makes this significant is that women begin to have protein in the urine or other blood pressure related complications during pregnancy. Protein in the urine is an indicator that the high blood pressure is causing the kidneys to not work properly.

Preeclampsia.

Preeclampsia occurs when hypertension develops after 20 weeks of pregnancy, and is associated with signs of damage to other organ systems, including the kidneys, liver, blood or brain. Untreated preeclampsia can lead to serious — even fatal — complications for mother and baby, including development of seizures. Fortunately there are various medications available to treat preeclampsia. However, since this condition is serious, most women are monitored closely and are often admitted to the hospital for the duration of the treatment.

Just a summary

This is just a snapshot of the various blood pressure-related conditions during pregnancy. It is not exhaustive or all-inclusive. The message I want to emphasize is that blood pressure is an important parameter to monitor during pregnancy.  Most women never realize they have elevations in blood pressure, so we act swiftly to create a monitoring plan and schedule additional testing as needed.

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Quick and Easy Shrimp

At the end of the day, sometimes two of the hardest things you can have to do are decide what to have for dinner and then prepare it.  Plus, you’re hungry! So you want to get dinner made fast. Solution: A recipe with minimal prep time and even shorter cook time that tastes delicious.

Fish Safety

I wrote before that certain types of seafood are safe to eat during pregnancy. Shrimp is one of them! When harvested and stored properly, shrimp is safe to consume and actually contains protein and a few other nutrients. Opt for shrimp that is sustainably farmed and of the freshwater variety.  Fresh, or frozen shrimp, is best when bought with the peel on and the heads removed. It’s convenient if the vein along the back of the shrimp is already removed as long as the peel hasn’t been cracked or opened for an extended period of time.

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Many experts recommend purchasing frozen shrimp and thawing the shrimp on your own immediately prior to use. Shrimp are deep frozen when they’re caught at sea and delivered to the retailer in that state. The retailer then thaws the shrimp and puts it on display, typically on ice.  Since there is no way to tell how long the shrimp have been defrosted, it’s safer to buy the shrimp frozen in a bag and thaw out on your own.

Things to Avoid

There are things to avoid. Shrimp are highly perishable and can spoil quickly, so do not eat shrimp if they have a foul odor or an ammonia-like smell. Your shrimp should be firm and not limp, slimy, or breaking apart which would also indicate decay or spoilage.

With fresh shrimp, this dish gives a wonderful caramelized sauce that pairs wonderfully with any type of crispy green vegetable like green beans, broccoli, or even Brussels sprouts. Try this when you’re looking for a quick shrimp fix!

Honey Garlic Shrimp

  • 2 tablespoons of minced garlic
  • 1 teaspoon ground ginger
  • ½ cup honey (as always, I highly recommend using a good quality honey like the kind I use from the Tanis Apiary in Pompton Plains, New Jersey)
  • ¼ cup low sodium soy sauce
  • 1 pound medium shrimp, uncooked, shelled and deveined
  • 1 ½ cup green beans, broccoli, or Brussels sprouts
  • Brown rice or soba noodles to serve
  1. Prepare the sauce:  In a small bowl, combine garlic, ginger, honey and soy sauce. Set aside.
  2. In a second medium bowl, place the shrimp. Pour 1/3 of the sauce of the shrimp and toss to coat. Cover with plastic wrap and refrigerate for up to 1 hour.
  3. After the shrimp has been marinated, heat a non-stick medium (about 10 inches) skillet over medium high heat. Add 2 tablespoons of the sauce into the skillet and heat until steaming or slightly sizzling.
  4. Toss in the green vegetable of choice and cook until tender, about 6-8 minutes depending on the vegetable used. Remove and set aside.
  5. Take shrimp out of the marinade sauce and in 2 batches (5 to 10 shrimp per batch). Cook 1 to 2 mins per side until the shrimp are browned and begin to curl. Do not overcook! Take the shrimp out onto a plate and set aside.
  6. When the shrimp are all cooked, return the vegetables to the skillet and heat through. Add the shrimp back into the skillet. Add any remaining sauce. Heat for 2 to 3 minutes, tossing to coat the shrimp and the vegetables in the caramelized sauce.
  7. Serve over brown rice or soba noodles. Drizzle any remaining sauce from the skillet over the shrimp and vegetables.

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The Facts about Fish

There has been so much confusing press about seafood and whether it can be consumed during pregnancy. Let me start out by saying that Yes, certain seafood can be consumed safely during pregnancy (and some is recommended for pregnant women). The issue surrounds two things: mercury content in some seafood, and if the seafood is consumed raw or undercooked.

Mercury is an element that can collect in many of the world’s oceans, lakes and streams. When the levels of mercury rise, the fish that swim within those waters become contaminated with mercury and convert it into methylmercury, a potent neurotoxin that gets stored in the meat and flesh of the fish. High levels of mercury cause birth defects in unborn babies. The good news: not all the waters of the world are contaminated. Further, not all types of fish are affected by, or store, mercury.  

Fish, or seafood, has been praised for its health benefits. Indeed, seafood contains essential protein, vitamins and minerals that are healthy for women throughout the lifespan, and especially while pregnant. Fish is one of the richest sources of DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid). The Omega 3 fatty acids in some seafood, for example, are thought to potentially decrease the risk of premature delivery and supports and promotes growth and development of the baby’s brain and vision.

So, what’s safe?

Let me break it down:

How Much?  

Aim for 2 to 3 servings of fish per week that can replace the protein in other meals (that equates to about 8 to 12 ounces of allowed seafood per week)

The fish that are safe

Photo by Marie-France Latour

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Photo by Marie-France Latour

Its OK to eat the following fish:

  1. salmon
  2. tilapia
  3. shrimp
  4. tuna (canned, light)
  5. cod
  6. catfish
  7. crab
  8. sardines
  9. pollock
  10. canned or shelf-safe smoked seafood is OK

Fish to Avoid

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Photo by Christine Siracusa

  1. Raw or undercooked fish of any kind, including sushi and sashimi
  2. No nova lox, kippered or jerky style salmon that you would buy in a deli or put on a bagel
  3. No raw mussels, oysters or clams
  4. shark
  5. swordfish
  6. king mackerel
  7. tilefish

Use caution with bluefish, striped bass, pike, trout, or walleye that may come from contaminated waters. Be sure to check if they are from contaminated lakes or rivers (see my note about this below). When in doubt, either avoid eating seafood from those waters or limit your intake to less than 6 ounces per week.

How can you tell if the fish if from safe waters? 

Seafood stores, the local grocery or restaurants are held to high sanitation and food preparation standards. Among those standards include where they procure their meat and seafood from and what process they go through for storage, cleaning, and the avoidance of cross contamination with other fish or proteins. The concern arises when people fish or harvest seafood or fish on their own from local lakes, streams, rivers, or nearby large bodies of water. Farm raised fish, or commercial fisheries that harvest large quantities of fish, adhere to the same strict standards for handling and testing fish they catch or raise.

To find out if local waters are safe, contact the local health department or the website of the Environmental Protection Agency (EPA). Or, corporations such as Safe Catch have high standards for mercury levels and overall seafood safety.  Safe Catch is also a sponsor endorsed by the American Pregnancy Association.

Featured photo by rawpixel

Paul Quinn, PhD, CNM -Prenatal Possibilities3 Comments
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