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Pregnancy brings changes to women’s bodies and lifestyles.  That much, we can agree on.  However, the well-being of the pregnant woman is a complex matter, not fully understood within medical and health professions. 

Over the past two weeks, we’ve been quizzed about Canadian recommendations for health during pregnancy.  These recommendations represent the official positions of medical and health organizations such as the Public Health Agency of Canada.  However, the experts in other countries don’t necessarily make the same recommendations nor do they use the same tactics for spreading their messages.

In Canada, one exemplary recommendation is that there is “no safe amount or safe time to drink alcohol during pregnancy.”  Contrast this with the Department of health in the UK recommendation for not drinking alcohol while pregnant, which comes with a caveat, “If you do drink, limit yourself to no more than one or two ‘units’ of alcohol once or twice a week and avoid getting drunk.”*

The United States takes an in-your-face approach to informing women about the dangers of alcohol consumption during pregnancy. Every bottle of wine must be labeled, “According to the Surgeon General, women should not drink alcoholic beverages during pregnancy because of the risk of birth defects.”

France, whose people have a reputation for imbibing during pregnancy (the French drink 58L of wine per person each year, the highest wine consumption in the world), is slated to follow the U.S.  As of October this year, bottles of wine sold in France must come labeled, “The consumption of alcoholic drinks during pregnancy, even in small amounts, can have severe consequences to the health of your child.” **

Alcohol consumption during pregnancy is one area of gynecology and obstetrics where many questions remain.  To some extent, this accounts for differences in recommendations.  Government and health agencies face additional quandaries over which messages will be more helpful for women in their constituencies: graphic warnings, educational explanations, or authoritative recommendations. 

In the end, it is women who must negotiate health and wellness before, during, and after pregnancy.  What you know, what you think, and what you can do about alcohol consumption are much bigger issues for the pregnant woman to grapple with than public health agencies can express.  What is your experience with alcohol and pregnancy?  How would you decide to drink alcohol or not?  Can your own living conditions and lifestyle preferences tolerate changes to consumption?  These are the kinds of questions that all kinds of pregnant women ask themselves.  What do you think?

*from the UK Department of Health publication The Pregnancy Book, 2006.
** from Decanter.com, 2006.

Last week, we had a quiz on the latest recommendations from health and medical experts in Canada.  This week, let’s look at the answers according to the Public Health Agency of Canada.  How do you think these recommendations would be received among people you know?  If you’re pregnant, are you following these Canadian recommended best practices?  Next week, we’ll compare the Canadian recommendations with similar ones in other countries.
 
1. While you are pregnant, it is safe to drink alcohol.
The Answer is “D”: There is no safe amount of alcohol during pregnancy. We know that a baby’s brain is very sensitive to alcohol while it is developing, but we don’t know how much alcohol it takes to do this damage. No alcohol is the best (and the safest!) choice for having a healthy baby. 
2. While you are pregnant, you should gain no more than…
The Answer is “D”: It depends on your weight before pregnancy. If your Body Mass Index (BMI) prior to pregnancy was between 20 and 27, the recommended weight gain is between 25 and 35 pounds. However, if your pre-pregnancy BMI was over 27, the recommended weight gain is between 15 and 25 pounds. Finally, if your BMI prior to pregnancy was below 20, your recommended weight gain is between 28 and 40 pounds.
3. Now that I’m pregnant, I can eat more.
The Answer is “TRUE”: You need to increase your calorie intake, while maintaining a balanced diet.
4. You can expect to lose a tooth during each pregnancy.
The answer is “FALSE”: It’s a myth that the calcium needed to make your baby’s teeth comes from your own teeth.
5. Folic acid is helpful for the proper development of the baby’s skull, brain and spine.
The answer is “True”: Folic acid is a B vitamin that is important for the healthy growth of your baby. All women who could become pregnant should take a multivitamin containing 0.4 mg of Folic Acid every day.
6. Second-hand smoke can hurt the foetus.
The answer is “TRUE”: Studies show that regular exposure to second-hand smoke may harm you and your baby. Second-hand smoke contains the same toxic chemicals and carcinogens that smokers inhale. It is especially harmful to babies because their lungs are still growing and developing.
7. While I’m pregnant, my baby is well protected from the chemicals in cigarettes that you smoke.
The answer is “FALSE”: When you or people around you smoke, your baby smokes too.
8. When you are pregnant, experts recommend that you accumulate 30 to 60 minutes of moderate activity:
The answer is “C”: Medical experts recommend regular physical activity as beneficial during pregnancy.
9. Pregnancy is an exciting time, so shouldn’t I be feeling happy?
The answer is “FALSE”: Pregnancy triggers an outpouring of various hormones, which can alter your mood in significant ways. One minute, you might be in tears, at other times you might feel fine; this is normal although it can be uncomfortable. You may feel anxious about becoming a mother, or about having enough money to care for your baby. Your concerns are something most new mothers-to-be experience.
10. If you’re well organized and determined, pregnancy shouldn’t change your regular schedule.
The answer is “FALSE”: You must realize that your changing body and your baby’s rapidly developing body are on timetables of their own.

If the coming spring finds your thoughts turning to your belly, or that of a fecund loved one, try this quiz*. 

The needs of a woman’s body change during preganancy, a fact that most of us know by now.  But, you may be surprised by some of the latest recommendations from Canadian health and medical experts when it comes to pregnancy.  We’ll look at the answers to this quiz next week. 
1. While you are pregnant, it is safe to drink alcohol:
a. Once a day
b. Once a week
c. Now and then
d. Never
2. While you are pregnant, you should gain no more than
a. 20 pounds
b. 25 pounds
c. 30 pounds
d. it depends on your weight before pregnancy.
3. Now that I’m pregnant, I can eat more.
True
False
4. You can expect to lose a tooth during each pregnancy.
True
False
5. Folic acid is helpful for the proper development of the baby’s skull, brain and spine.
True
False
6. Second-hand smoke can hurt the foetus.
True
False
7. While I’m pregnant, my baby is well protected from the chemicals in cigarettes that you smoke.
True
False
8. When you are pregnant, experts recommend that you accumulate 30 to 60 minutes of moderate activity:
a. Once a week
b. Twice a week
c. Most days, preferably daily.
d. Never
9. Pregnancy is an exciting time, so shouldn’t I be feeling happy?
True
False
10. If you’re well organized and determined, pregnancy shouldn’t change your regular schedule.
True
False
* This quiz is from the Public Health Agency of Canada.  You can find it on their website at http://healthypregnancy.gc.ca.  For more information, contact l’Équipe d’intervention médicale de Saint-Lazare at (450) 455-5824 or by email at info@saintlazare911.com.

While feeling lousy one day, you’re suddenly overcome by terrible stomach pain.  You can’t imagine what the problem could be and decide that it’s time to call in some professional help.  You dial ‘911’ and set the wheels in motion.

Have you ever wondered what happens if you call ‘911’ for a health problem?  We are fortunate to have here a coordinated emergency medical response system that is triggered when you make the ‘911’ phone call.  If you live in the Montérégie, here’s how the system works:

Your ‘911’ phone call is answered at the primary emergency call centre.  When you tell them you have a medical problem, your call is immediately transferred to Alerte Santé.  In the Montérégie, Alerte Santé handles all the medical emergency calls. 

When you reach Alerte Santé, you talk with an emergency medical dispatcher.  This person is a trained professional who will ask you a number of questions to determine the nature of your problem.  The emergency medical dispatcher can also guide you in what you should do next, including what kinds of first aid you can do if your situation requires it. 

You’ll also tell the dispatcher the address from which you are calling, and the cross-street closest to you.  This is important information that helps the emergency services to find you quickly.  (It’s even better when you’ve already made sure your civic address is visible from the street, day or night.)

The emergency medical dispatcher assigns your problem a prioritization code based on the information that you’ve given.  Not only does this determine how quickly medical help will respond, but also which services are required.  For the most urgent calls (for example, an immediate life-threatening situation), the dispatcher alerts the first responders (where available) at the same time that they advise the closest available ambulance to go to your assistance.  The dispatcher may also alert the police or the fire department, such as in the case of a highway incident. 

In the Vaudreuil-Soulanges region, first responders serve Les Cèdres, Hudson, Pincourt, and Saint-Lazare.  Alerte Santé sends first responders to only the most urgent medical emergencies within their municipal territory.  The ambulances, on the other hand, are sent whatever the nature of your medical emergency, although it may take some time if you have a non-urgent complaint.   In the Vaudreuil-Soulanges, and much of the Montérégie, the ambulances are from La coopérative des techniciens ambulanciers de la Montérégie (CETAM). 

Now that you’ve had a little peek at what happens during a medical emergency phone call to ‘911’, you can feel assured.  Alerte Sante’s medical dispatchers, CETAM’s ambulance technicians, and municipal first responders are all people positioned to quickly get you the help you need when you need it most.

If you’d like to know more about the ‘911’ system, you can visit Alerte Santé’s website at www.alerte.cc.  The first responders in Saint Lazare can be reached for information at (450) 455-5824, or in the case of a medical emergency, by calling ‘911’.