Thursday, May 30, 2013

Dinner for Two

You are what you eat.


For pregnant women, the stakes are even higher: your baby is what you eat too.

As if women aren’t already constantly scrutinised about their physical appearance - and how it is related to the amount of their environment that they consume and burn as fuel for energy - what women eat while pregnant becomes a minefield that not only has the potential to affect them but also their babies. 

In addition to the usual body image anxiety, add to the list:
As if pregnancy wasn’t exhausting enough. Surely, you’d think if there’s any time in their lives when women get a ‘pass’ on the way they look and what they eat, it’s when they're pregnant, right?


Today, I was flicking through a women’s magazine at a cafe and spotted an article comparing the pregnancies of Kate Middleton and Kim Kardashian.  Ordinarily, I’m not particularly interested in  what either of them are up to. This particular article caught my eye, however, because it was about the amount of weight both women had gained during their pregnancy. Both are due around mid-2013, so are well into their third trimesters. 

Kate Middleton - whose natural build appears to be tall and slim - was being censured for being too skinny, not gaining enough weight, being too controlled in what she ate, and hiding her bump under tailored coats and dresses. By contrast, Kim Kardashian, who is shorter and more ‘curvaceous’ (bleurgh!) - was being censured for being too fat, gaining too much weight, eating whatever she wanted, and letting her fertile and full figure spill out of form-fitting clothes and flowy pants-suits. 

God forbid either woman could be just left alone to get on with it. 

Which begs the question that if these two women represented the too-little and too-much of the pregnant body, who is the woman who has the ideal shape? 

Could that be ... um ... nobody?

The article was couched in terms of concern for the food and body issues each woman must be experiencing. Clearly, Kate and Kim are well-off enough to look after themselves. The faux-concern expressed in this article was targeted less at them, and more at the readers of the magazine, who may well compare themselves to both Ks and find themselves wanting.

This is called the shaming and policing of gender.  

So what else would you expect from a women’s magazine, you might think. Fair enough.  But this policing of diet during pregnancy doesn’t begin and end with celebrity adulation.

I’ve blogged previously about  Annie Murphy Paul’s excellent book on fetal origins research. But she also had me fuming when it came to the topic of eating and pregnancy. In the ‘two months’ chapter, she focuses on the effects maternal nutrition has on the foetus. In the personal narrative part of the chapter, Paul acknowledged the anxiety she felt over her own food choices during pregnancy:

No activity of everyday life is so instantly changed by pregnancy as eating. New worries about food safety turn ordinary meals into minefields ... Is the cheese pasteurised? Is the fish cooked through? Is the egg still runny, the meat still pink? More daunting still is the notion that what you eat becomes the very stuff of which your child is made ... I did my best to eat healthily, but I continually second-guessed my choices, berated myself for my slip-ups, worried that I was missing some crucial nutrient ... Eating is no longer a simple bodily function, much less a pleasure to be savoured; it’s a series of fraught choices, an act with grave consequences, committed three times a day. (Origins, pp 12-3)

She then traces a brief history of (predominantly male) control of pregnant women’s appetites from Galen, to the Bible to modern medicine. Everyone, it seems, has had something to say about what women eat while pregnant. Again, it is couched in terms of concern: a 2009 study found that overweight women are more likely to have complications and require interventions during birth; further studies found that overweight women were significantly more likely to have overweight children than those of a ‘normal’ weight’. By comparison, such ‘natural experiments’ as tracing the birth outcomes of children born to mothers who were starved during the Dutch hunger winter, also showed that their children were at higher risk of future health problems.  It seems then, that are sound reasons for being concerned about extreme weight gain - or loss - in pregnancy.

So far, so fair enough.

After her gambol through the research, however, Paul then returned to the effect all of this new knowledge had on her own pregnancy diet.  That’s when it all got a little annoying. In narrating her attempts to find substitutes for un-fit food - like tuna salad (too much mercury) - Paul sounds somewhat like a woman’s magazine herself when she extolls the virtues of other fish:

Soon I’m finding all kinds of ways to eat fish: Sardines on buttered toast for breakfast (delicious with scrambled eggs). A snack of herring on crackers with a dab of Dijon mustard. For dinner, shrimp sauteed in butter with garlic and cayenne pepper. Catfish, breaded and broiled golden. Tilapia on the grill, with some mango salsa to perk up its admittedly anemic flavour. ... As I tuck into a snowy filet of flounder, squeezed with lemon and speckled with pepper, I think to myself: eating carefully can actually taste really good. (Origins, p 34)

I mean, really? And wtf is tilapia? (This, apparently)

Later we see her get advice from a nutritionist about eating a ‘colourful’ plate of food, who also dreams up a shopping list full of acceptable whole grains and suitable salad (that would be ‘arugula not romaine lettuce’).  Then we follow her to the whole food store while she fills her basket with all this stuff. Oh, and a ‘naughty’ bar of a dark chocolate at the end.

It wasn’t just the nausea I was experiencing at the time that made me feel sick while reading this chapter. 

Given that morning sickness was dominating my dietary choices, or lack of them, at the time, I was intrigued to note that not once in this chapter does she mention morning sickness.

For me, during this period, I found it easiest to keep down well-cooked fatty and salty food - like hot chips or a samosa - rather than salads or just about any kind of vegetable. Indeed, even the - not every strong - aroma of lettuce (iceberg, if you must know) made me gag. This being round two, my feeling was ‘just go with it, you can try and eat better once you’re feeling better’. The Pollyannish chirruping about ‘eating carefully can actually taste really good’ did not improve my mood much, however.

But that wasn’t all.

Even the teeny tiny iodine pills I was taking conspired against me. Not only did taking them during my first trimester continuously make me gag, the ‘helpful’ leaflet included in the packet said things like ‘eat a low fat healthy diet’, ‘eat slowly and chew throughly before swallowing’, and ‘eat lots of fresh fruit, vegetables, whole grain foods / bread’ but ‘eat less fried / processed food; pastry; takeaways, biscuits, cakes, fizzy drinks, sweets, sugar, white bread; chippies.’  In my pregnancy so far, I have to plead guilty to eating every single thing on the ‘eat less’ list - many more than once - and rather fewer on the ‘eat lots’ one.

Does this make me a bad mother-to-be?

Frankly, I doubt it.  The long-term nutritional advantages that I enjoy as a middle-class woman in good health living in a country with abundant fresh food, means that I have had enough to eat of a wide variety of foods - and the nutrients within them - just about every day of my life. This in turns means that my unborn child will be enjoying those benefits too. The odd plate of chips or some Whittaker’s creamy milk is not going to undo that.

There’s still the food safety angle of course.  But then who does set out to get food poisoning? Instead, I think it’s about seeing it in terms of risk: do you think it’s worth the risk to eat a particular ‘banned’ food during pregnancy or not? In my first pregnancy, I would’ve said emphatically not. I religiously avoided everything that was on the list of banned foods ... and even some that weren’t ‘just in case’.  My baby turned out fine.  This time round, I’m a bit more relaxed. I still steer clear of raw fish and runny yolks, but I have - gasp - eaten (pasteurized) soft cheese, hummus, vegetarian sushi and some deli food. And you know what? So far, so good (she says, touching every piece of wood available).   

For now, what I need to steer clear of as hazardous to my health is well-meaning concern and advice about what I should and shouldn’t be eating. As an adult woman, I’m perfectly able to navigate my own food choices ... and also to deal with whatever consequences might ensue. 

But I also dream of life post-birth when I can enjoy the simple pleasures of runny poached eggs and raw salmon sushi without a twinge of guilt or the need to second-guess myself.