Blog - David Ghozland MD - Board Certified OB/GYN

What’s the real skinny on sushi and pregnancy

I am always asked whether eating sushi is safe in pregnancy. I always have to mention that consuming any fish or meat that is raw is not safe during pregnancy.

However, this is where I want to be clear about that statement. Raw meat or fish does not cause birth defects. Toxoplasmosis a bacteria that sometimes is found in raw meat and not in fish can cause birth defects. However, there are many parasites in fish that may cause you to feel ill and it is the medications used to treat those parasites that may actually cause harm to your baby.

Cooked fish and vegetables as ingredients in your sushi are a great source of nutrition and make for a healthy meal. The seaweed wrapper itself is a good source of calcium.
Most sushi restaurants flash freeze their fish and thereby destroy and kill any parasites and or microorganisms that might be harmful. It is for this reason, that in a reputable sushi restaurant it is most likely safe to consume raw fish while you are pregnant.

Ask the sushi chef first and then enjoy it with a smile.

Another thing I would like to point out in regards to Mercury is almost all fish contain traces of mercury. However it is the large predator fish who live long and prey on other fish that seem to have the highest levels of mercury.

The CDC currently recommends that the following fish be avoided: Swordfish, shark, king mackerel, fresh large tuna ( usually bluefin ) and tile fish. I also recommend that you avoid all fresh water fish ( those that live in rivers and lakes ) such as trout since they tend to contain high level of mercury as well.

As I mentioned before all fish contain some mercury so it is therefore recommended to limit fish intake to 12 ounces per week. I would encourage you not to eliminate fish from your diet. It is an amazing source of protein and Omega 3 fatty acids.

Posted in Pregnancy |

Should I apply for a new life insurance policy while pregnant?

I often see patients trying to do all the right things during pregnancy.

Many of them start applying for new life insurance policies to protect their future families.   It is important to realize that pregnancy is not the time to be checking cholesterol in order to determine your future for heart disease.   And you should certainly not have to pay elevated insurance premiums if it is found to be higher then the average. This elevated cholesterol is a normal part of pregnancy and the action of elevated levels of circulating estrogen and progesterone acting on your liver to increase the production of these lipids.  These elevations are independent of diet.

I would recommend waiting till after delivery, the cholesterol lipids quickly return to pre-pregnancy levels shortly after delivery.

Hope this helps ;)

Dr. Ghozland

Posted in Pregnancy |

Is oral sex during pregnancy dangerous?

NO!!!  Enjoy yourself a little, oral sex is safe in pregnancy.

How did this rumor start?

Medical journals from a long time ago reported a few extremely rare cases of fatal air embolism in pregnancy resulting from forcefully blowing a lot of air into a woman’s vagina during oral sex. The reason this happened is because of the change in the enlarged blood vessels during pregnancy in the pelvic area thereby allowing air to enter the blood vessel and cause complications.

However, the incidence so rare and remote of this happening that you are more likely to be hit by lightening during pregnancy then getting an air embolism during oral sex.

The bottom line is that oral sex is safe and may be enjoyed during pregnancy.


Dr. Ghozland

Posted in Pregnancy |

Can a full moon cause a woman to go into labor?

As a full moon approaches, I am convinced that more of my patients will go into labor. Of course as a scientist this can be hard to explain and yes I have been proven wrong on many full moons. However, for the most part the number of people breaking their water bags early or simply going into spontaneous labor seems to be higher depending on the lunar calendar according to the nurses and doctors who work the labor and delivery shift at night.

My personal belief of lunar effects on labor is something that is commonly shared among nurses working the night shift in hospitals. Most of us have the habit of looking up to the sky to see where the moon is prior to starting a night shift rotation at the hospital. Besides, the lunar role in obstetrics, there are many facets of our society that seem to be under lunar control. For instance, conception and fertility have also been linked to moon phases; and then there are the entirely non-pregnancy related behaviors, like homicide rates, suicide rates, emergency room admissions and outbreaks of insanity. Supposedly, all of these things increase on a full moon.

It’s called the lunar effect, and, as far as births are concerned, the primary explanation for the effect focuses on the moon’s gravitational pull. It basically states that much the way the moon’s gravity controls the tides, it can control a woman’s body. The human body is 80 percent water, after all. And, given that both menstruation and ovulation roughly follow a lunar cycle — occurring on a monthly basis — it doesn’t seem too far off to think that the moon could have a say in childbirth as well.

In this blog entry, I am going to explore the evidence on both sides of the argument and allow you to determine if the lunar calendar affects pregnancy labor.

If you ask around most hospitals, you will hear especially from the night shift labor and delivery nurses that labor and lunar cycles go hand in hand. Although we all love to trust and believe our nurses, these are verbal anecdotal stories based on their own experiences and not evidence based.

However, there is some substantial studies that have been performed looking at just this “myth” . A 1959 study broke the month into consecutive three-day periods and found that the three days of a “full moon window” — the day before, day of and day after a full moon — had more births than any other single three-day period [source: Shulman]. Another study, this one published in 1966, studied birth rates by moon phase — full, half, one-quarter and three-quarter. The authors found that within the study period, more births centered around the full-moon phase than any other.

Although these studies seem promising and convincing, they are more of an anomaly then the norm. Most studies that have been repeated in order to justify a link between lunar cycle and labor have failed to do so. For instance, the following study is one of many in the data base. In 2005: Looked at 564,039 births in North Carolina between 1997 and 2001 and found “no predictable influence of the lunar cycle on deliveries or complications” This study is comprised of a large data pool and certainly renders enough statistical power to disprove those prior single center studies.

So, where does that leave us?

I personally believe that although studies have not been able to correlate the two, there is something mystic and perhaps logical about a myth that deals with lunar effects and gravitational pulls and the higher incidence of births. Perhaps, I practice cognitive bias and only take of notice of higher birth rates when the moon is full.

It is also important to explain some important misconceptions in regards to certain aspects of the moon. I made reference to them in the early part of the blog as an example of some of the commonly pointed out facts. For instance, a full moon really only lasts an instant and not the three days described in the earlier study I pointed out are not a reality. Also, people like to reference the moons gravitational pool on the body but most studies have shown this phenomena to be extremely weak and as far as the full moons gravitational forces on the tides, well, again science has shown us that it is actually a function of how far the moon is from earth at any given time and not related to the phases of the moon cycle.

So I hope that this myth buster was both relevant and educational.

Posted in Pregnancy |

What is and why do I have to consider Omega Fatty Acids during my pregnancy

There are 3 types of Omegas 3s:

Eicosapentanenoic acid (EPA) and Docosahexaenoic acid (DHA) naturally occur in fish and the algae they eat.  They can also be synthesized in the body from Alpha Linoleic Acid (ALA) which is a primary essential fatty acid, which means that our bodies can make this acid on its own.

ALA can be obtained from plant sources, nuts, seeds and green leafy vegetables, your body can take ALA and convert it to the other omega 3s but the exact amount of conversion remains unclear and is different from person to person.  The amount of DHA needed during pregnancy and lactation is 13 grams.

DHA is the most important omega 3 for your babies brain and eye development while pregnant and during infancy.  The largest growth spurt for the brain is in the 3rd trimester and therefore it is essential to continue taking your prenatal vitamins and DHA throughout your pregnancy. In a study of 98 pregnant women, researchers at the School of Pediatrics and Child Health at the University of Western Australia found that two years after birth, the children whose mothers had received a high dose of fish oil (including 2.2 g of DHA) in the second half of their pregnancy had higher scores in tests of their eye-hand coordination. Another study, from the University of Oslo in Norway, found that four-year-olds scored better on IQ tests if their mothers took DHA supplements during pregnancy and breastfeeding.  Given that research, it’s a ” no brainer ” that every pregnant mom should be taking DHA with prenatal vitamins.

In regards to eye development, DHA is a fundamental component of the retina ( almost 50% of the retina is made of DHA ).  A deficiency of DHA in the retina is manifested by poor night vision and other visual defects.  A study of 167 pregnant women conducted at the University of British Columbia’s Department of Pediatrics suggested a correlation between visual acuity in two-month-old babies and their mother’s DHA intake during their pregnancy.

There are many other benefits to DHA intake during pregnancy as well.  Research has show that DHA may play a role in preventing some preterm deliveries, increase head circumference and birth weight and prevent postpartum depression
How much DHA should we be consuming during pregnancy?  An actual number has yet to be defines, however, most Ob/Gyn physicians recommend 200mg per day of DHA. Besides DHA supplements found at the pharmacy and in your prenatal vitamins, an excellent source of DHA is found in fish.

Vegans, fear not — algae is an all-natural plant source of DHA, so you can incorporate foods like seaweed into your diet.

I hope that this blog entry has shed some light on DHA and it’s effects on your pregnancy.

Posted in Pregnancy |