Article Review: Eat More Fish!

This is the article critique I submitted for my pregnancy nutrition class. This covers a very important subject of eating fish while pregnant. Did you eat fish while pregnant? If so, did you follow your doctors recommendation of only two servings a week? What kind of fish did you enjoy?

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A common discussion among pregnant women, their providers and the birthing world in general is whether or not fish is healthy to eat while pregnant and breastfeeding. Consuming fish regularly provides docosahexaenoic, or DHA, plus omega-3 fatty acids which are needed in any healthy diet, especially that of an expecting mother. An article printed by The Telegraph, a British newspaper, titled “Pregnant Women Should Be Allowed to Eat More Fish”, reports that women should be consuming more than the recommended amount of fish during their pregnancy to encourage vital brain development in their unborn baby while also receiving the benefit of this necessary fatty acid.

“Docosahexaenoic acid, an essential fatty acid, [is] thought to be important to the development of infants, particularly [in] regards their eyes and brain” (MedicineNet, 2012). This is a brief definition of DHA and why it is important during pregnancy. Since 2004, the Food Standards Agency along with medical professionals have recommended that women consume no more than two servings of fish per week, or 12 total ounces, which the article acknowledges that recommendation is “ultraconservative” (Gray, 2010). This suggestion is also seen in our text on page 114 which was printed a year after this article was released.

The article goes on to say that women should actually be consuming three portions of fish a week to ensure proper DHA and omega-3 fatty acids intake (Gray, 2010). Our text, unlike the article, describes the types of fish which are higher in mercury content and should be consumed less, if not at all. Those fish include swordfish, king mackerel, tilefish and shark, as well as no more than six ounces of “white tuna” a week. There is a danger to the fetus if too much mercury is consumed, however there is a number of other fish with less mercury content and high in DHA.

DHA has been nicknamed a “brain food” of sorts. “Women who consume adequate amounts of EPA and DHA during pregnancy and lactation tend to deliver infants with somewhat higher levels of intelligence, better vision and otherwise more mature central nervous system function than do women who consume low amounts of these fatty acids” (Brown, 2011). The article touches on this topic briefly while also stating that some research has found no correlation with better academic abilities in children later in life (Gray, 2010). Regardless, it is important to emphasize the importance of DHA consumption and how eating fish while pregnant is not nearly as bad as others have made it seem. When I was pregnant with my son, I avoided fish. I was only basing my decision off of what had been recommended to me by my doctor. Also, my husband is highly allergic so avoiding it was not difficult. However, later in my pregnancy I did enjoy a number of salmon meals. I know that I was not receiving an adequate amount of DHA despite taking a daily prenatal vitamin. I have gained a much better perspective on fish and how important it is while pregnant. I will ensure I consume enough DHA next time by taking fish oil and eating more than one serving of fish per week. Our text states that taking fish oil daily is safe and beneficial (Brown, 2011).

The only reference the article makes to data proving that not taking in enough DHA, or the recommended 340 grams per week, showed children were born with a greater risk of having low verbal intelligence (Gray, 2010). How high was that risk? Were these children exposed to any other teratogens while in the womb? Was the mother taking a regular prenatal vitamin? These are all the questions, and more, I asked myself as I read that statement. Studies like this can be a great stepping stone in determining whether or not fish can or should be consumed while pregnant. However, it is not clear on any of the other circumstances surrounding those women and their babies with lower verbal intelligence. There are many other factors which could cause a child to be delayed verbally. This is the first I have read that a lack of DHA could be one of those factors.

This article brings up a great point, encouraging women to eat more fish and that it is less dangerous than previously thought. The information provided is true in that consuming an adequate amount of DHA is very important while pregnant. However, our text still only recommends two servings versus three servings listed in the article. I consider myself to be less conservative and agree with the article. I do not think the information in our text is as accurate, despite it having been published a year after this article. I am not sure if that is because doctors must still only be recommending two servings or if the author of our text is biased. Our text even states, “Fish and seafood are by far the richest food sources of EPA and DHA (Brown, 2011)”. If DHA is so important for the developing baby then why is our text still only recommending two servings per week? In this case, our text does not support the recommendation presented in this article.

I would recommend other pregnant women read this article so that they receive information on this subject from different perspectives. Only she can decide what is right for her and her baby. I already find myself wanting to share this information with the labor and delivery nurses I work with as a means to create healthy discussion about something that is really important. I would tell them that they should read the article and consider the fact that most fish do not have a high content of mercury and that adding that natural form of DHA to their diet would be very beneficial. I would also share the research given about how good DHA is for brain development, which I think supersedes any other discussion about it. For me, that is a done deal. I will be taking in more DHA either through fish or fish oil. I would add more information about the brain development and how DHA specifically affects a positive result, especially in pregnancy. This is the first I have heard, even after having a baby of my own, that DHA specifically targets brain and vision development which would have been nice to know ahead of time.

 

References:

MedicineNet, 2012. Definition of DHA. Retrieved on September 6, 2012 from:

http://www.medterms.com/script/main/art.asp?articlekey=23903

Brown, J. E. (2011). Nutrition Through the Life Cycle (4th Ed). Belmont, CA:Wadsworth.

Gray, R. (May 30, 2010). Pregnant Women Should Be Allowed to Eat More Fish. The Telegraph. Retrieved on September 6, 2012 from:

http://www.telegraph.co.uk/health/healthnews/7782834/Pregnant-women-should-be-allowed-to-eat-more-fish.html

Defining Midwifery

I have seen this article floating around the childbirth interwebs and cannot help it any longer. I must post this and share the anthropological aspect of midwifery. It’s kind of funny because, not a few weeks ago, a friend had mentioned to me that the study of childbirth by an anthropologist mainly focuses on midwifery around the globe. I had not really thought about anthropology, however I have had thoughts about creating and influencing the childbirth atmosphere to be more like other countries’ views of this life-changing event. In my own opinion, pregnancy and childbirth are thought of in the medical world as a disease or illness, which is far from it! Granted, there are situations in which medicine is necessary. I’m not talking about those situations. I’m talking about a normal, healthy pregnancy with little to no risks…those are the births that belong in a home surrounded by a midwife, family and friends (or not, in some cases…see Unassisted Birth).

The link below goes to my “Behind the Midwife” page where I think this article belongs. This is why I want to become a midwife, this is what and who a midwife is and if anyone has questions, it’s a great way to give answers. Sometimes, I wish I could whip out something witty and awesome when someone asks me WHY or WHAT IS THAT when I tell them why I’m going back to school. It’s easy to say that I don’t care what anyone else thinks, but the truth is that I do care and that some people just don’t get it. Fine, but at least this article does a wonderful, beautiful job of defining midwifery from an anthropologists point of view. Enjoy.

Midwifery by Robbie Davis-Floyd, PhD

Encouragment

I have been reading Giving Birth by Catherine Taylor. Her writing is wonderful. She is a journalist and does a wonderful job of hooking you into her story right away. She is following midwives around, interviewing them and witnessing clinical appointments and births. This is not the review, but I wanted to share some really encouraging words that have moved me. These are the kinds of these that just keep that spark inside of me glowing. I have so much peace about my decision to become a midwife and it’s writing like this, first hand accounts and real experiences that really get me excited.

“The most rewarding job in the world is being a MOTHER-the second most rewarding job is being a MIDWIFE.” (found on a wall in a midwife’s office)

“What I like about midwifery is that I am able to promote what’s okay, to look at what’s right about the women in terms of her ability to have a baby. Women are, for the most part, built to have babies. We’re designed to give life. So how can we facilitate that process? And, I have to say, doctors don’t get trained that way as much, and it affects how they deliver care. However, for a doctor who’s been in practice long enough,I think his or her success still depends on being able to access what’s going well for a particular family and to ask, ‘What can I do to help them recognize what’s good and to recognize where they need help?’ So I think both of our trainings have merits.” quoted by Nancy, a midwife.

“Midwives explain that they belive it is important not to solicit thanks for their work or to take credit for the birth because it both undercuts the recognition that the mother and her family deserve and wrongly grants the power of birth to an authority outside the mother and her family.”

Where do you find encouragement? What are you reading right now that is motivating you?

Randoms

  • I’ve noticed many of you lurkers out there are searching for info regarding Brio Birth. First of all, welcome! Secondly, this blog is NOT about Brio. I will no longer be posting about it or the experiences I’ve gone through. If you have not read my previous posts, you can do so HERE and HERE. If you read the first link, you have to read the 2nd as they are two polar opposite posts. Okay, no more Brio talk.
  • I would still really like to post birth stories, though there seems to be little interest in that. If not birth stories, what else would you like to read more of here?? Please leave me a comment. 🙂
  • As you can see, I have given the blog a little face-lift. I love changing things up and now that I will be starting school in the fall, I wanted to have a more noticable side bar with the curriculum I will be following. The classes listed for now are in the order I believe I will be taking them in. They are all pre-recs for nursing school and thanks to the two other degrees and five years I’ve already spent in college, it isn’t much. HOWEVER, I really need to up my GPA so the 5-6 classes prior to applying will help me do that.
  • Work has been slooooooow lately. I don’t have any fun stories or learning experiences to share, but tomorrow is Friday and for some reason that is the day most of our unusual patients come through.
  • I’m reading two books right now, The Birth Partner’s Handbook by Carl Jones and Giving Birth by Catherine Taylor. Reviews will be up as soon as I am finished. BTW, if you are an aspiring midwife or doula, I highly recommend going to your local book store and checking out the used section. I have found several of the books on my reading list for cheap and its a great way to grow my library.

school daze

I have been accepted and will be registering for classes at a community college in town. This is the best route for me before I get into nursing school. It gives me an opportunity to raise my GPA and wait until my hubs is out of school himself. See, we just love school so much! 🙂

So far I am set to take Medical Terminology and Anatomy & Physiology I. The Med Terms is actually for work and will be beneficial to my future regardless if it’s a required pre-rec. Once I get more organized, I will post on the side bar all the classes I will be taking to get where I want to be. All through nursing school and beyond. It will take years, but I figure if I’m a CNM by the time I’m 35 I’m doing pretty good.

Remember if you want to share a birth story I would love to post it! Also, if you have any reading recs let me know. I will add them to the list. Have a great week!

MIA

Hi friends! Welcome! Seems I have a few new readers which just makes me so happy! I’m sorry I’ve been lacking in posts lately. Not much is going on other then reading my little heart out about breastfeeding. I checked out three books with the sole intention of skimming over all three briefly and then settling on one to finish reading to fulfill a requirement for the reading materials through CAPPA. I’m getting so excited!! Only a few more months before the workshop.

I’m trying to find a mentor in my area whom I can learn even more from and hopefully observe a few births with. I have 100% confidence in my becoming a doula, but seeing someone else perform is the best way for me to learn. Adapting my own methods and such will come with time.

A review on The Womenly Art of Breastfeeding will be up soon. I never read a book about breastfeeding when I was nursing Logan and I wish I had! I might have been able to overcome the challenges we had. Also, this is by the La Leche League which is VERY anti-formula feeding. Much like watching The Business of Being Born, the reader needs to take it with a grain of salt. There is a ton of excellent info, but the views are skewed. So many mamas TRY to breastfeed, or there’s a physical reason why baby can’t nurse, and so on, which is not covered very well. Overall, it was a good read.

I have some updates on Brio Birth, but will save that for another day. Have a great week!

The Reading List

I want to note the things I’ve read and hopefully stay on top of reviewing those materials once I’ve finished the reading. Hopefully this can also be helpful to those of you seeking great resources whether you’re pregnant or going to school. Bolded items indicate that I’ve read the book and there’s a link to a review.

In no particular order:

  1. Your Best Birth by Ricki Lake and Abby Epstein
  2. Ina May’s Guide to Childbirth by Ina May Gaskin
  3. Labor of Love by Cara Muhlhahn
  4. Spiritual Midwifery by Ina May Gaskin
  5. The Birth Partner Handbook by Carl Jones
  6. Husband Coached Childbirth by Robert Bradley
  7. Natural Birth, the Bradley Way by RObert Bradley
  8. Ask a Midwife by Catherine Parker-Littler (REVIEW TO COME)
  9. Pocket Guide to Fetal Monitoring and Assessment by Susan Martin Tucker
  10. The Labor Progress Handbook by Penny Simkin
  11. Core Curriculum for Maternal-Newborn Nursing by Susan Mattson and Judy E. Smith
  12. Diary of a Midwife: The Power of Positive Childbearing by Juliana van Olphen-Fehr
  13. Midwives: A Novel by Chris Bohjalian (just for fun)
  14. Unspeakable Losses: Healing from Miscarriage, Abortion and other Fetal Loss by Kim Klueger-Bell (great for nurses too).
  15. A Child is Born by Lennart Nilsson
  16. Any of the many Labor/delivery/Perinatal nursing books published, produced by AWHONN, such as Periantal Nursing
  17. Varney’s Midwifery by Helen Varney (no not a midwife, but the info here is invaluable to an OB nurse as well).
  18. The Breastfeeding Answerbook by LaLecheLeague International
  19. Labor and Delivery in my Pocket ( www.inmypocketbooks.com )
  20. Resource/website to get a HUGE selection of books and teaching materials relating to Childbirth, Midwifery, Lactation, Parenting, Newborn/Childcare:

    www.1cascade.com