Image by Moondance from Pixabay
The world reacted strongly last month when US President Donald Trump took an adventurous step into the world of pregnancy advice, recommending women limit their use of acetaminophen (paracetamol) during pregnancy due to concerns about links with childhood autism.
For many women their reaction was one of distaste at what they saw as yet further policing of women’s bodies and minimisation of their pain. For others, their reaction was of excitement at prominent voices calling into question a pharmaceutical establishment they saw as in complete need of an overhaul.
Meanwhile, health professional bodies shuddered at the foreseeable negative impact of untreated fevers in pregnancy, further wavering levels of childhood immunisation, and a growing distrust of the health system. And for many pregnant women and new parents they were now anxious about their baby’s wellbeing, having utilised the only painkillers widely available to them during pregnancy.
There has been no shortage of subsequent analyses of the evidence related to these recommendations and urgent safety broadcasts from a swathe of health organisations. These assessments are a necessary read, but further scrutiny of the scientific data is not my aim in this piece.
Regardless of any assurances, what remains for many pregnant women and new parents is an ever-escalating experience of fear and worry as they seek to avoid each substance of potential risk to their baby. Amid the constantly evolving guidelines and anecdata, the risks faced during pregnancy and infancy are constantly multiplying. Their foreboding presence can be felt everywhere you turn.
Back when I was first pregnant a decade or so ago, I remember trying to enjoy a getaway in a little cabin in the Hunter Valley. Yet far too many moments of this ‘relaxing’ holiday felt entangled with danger. How could I enjoy the spa bath while worrying about accidentally raising my body temperature so high I might risk miscarriage? How could I enjoy my fancy meal while wondering whether the ricotta cheese had been cooked well enough to be sure it wasn’t coming with a side of food poisoning dangerous to the baby I carried within?
It is of course wise to weigh up the evidence, as we are able, and make careful decisions intended to limit the risks to our children. The use of any medication or intervention is always a balancing of potential benefits versus potential harms. Minimising unnecessary use of medications in pregnancy is definitely a wise course of action, whether it turns out that paracetamol usage in pregnancy significantly impacts fetal neurodevelopment or not.
But while we don’t want to be popping paracetamol for no reason, that is not the practice of most pregnant women. Untreated fever or pain also has negative impacts on women and babies and, considering the lack of other safe painkillers, this remains a resource for women to turn to as needed.
As more and more substances or factors during pregnancy have become associated with various possible risks, avoiding them all completely is simply impossible (as well as quite possibly unnecessary). Pregnancy has the potential to become an unbearable minefield if we attempt complete control of every possible exposure.
The reality is that risk and uncertainty are, and have always been, an integral part of the childbearing experience. The very nature of pregnancy is that of taking on a child we didn’t know or choose and then submitting them to our own limited skills, knowledge and capacity regarding how to best care for them in this big scary world. Bringing a child into the world is a genuinely bold and brave act, which never goes perfectly, but is nonetheless a noble pursuit of self-giving and love.
As a result, it’s understandable that feelings of fear or worry emerge throughout pregnancy. These feelings have the intended purpose of ensuring that we treat our babies with care, as each generation is tasked to nurture and nourish the next. Yet there can come a point where our anxiety is so overwhelming that it inhibits our functioning and capacity to nurture. Where this may be the case, many free resources are available to seek understanding and support.
Another layer to the reality of these kinds of feelings is found in their spiritual aspect. The experience of fear and worry in pregnancy is a tangible and confronting reminder that we are not in control. Our responsibility as parents is to do the best that we can to weigh up risks and minimise the harms our children face. It is not to provide them with a life free of risks. That is well and truly beyond our purview. Accepting risks is part of the process of embracing life.
There are some practical things we can do during pregnancy to minimise risks to our baby including watching what we consume or are exposed to, but there are so many more factors further beyond our control. What we can always do to nurture our child is to pray for them. Our awareness of risks can turn us to humbly rely on God in new ways and perhaps at a level which we haven’t felt the need before.
‘Humble yourselves, therefore, under God’s mighty hand, that he may lift you up in due time. Cast all your anxiety on him because he cares for you’ (1 Pet 5:6–7, NIV).
Pregnancy leads us to take the first steps into the experience of learning how to entrust our children to their heavenly father. Our worry and uncertainty can turn us towards humble dependence upon our life-giving God, a God who has embraced the ‘risks’ involved in giving life to humanity. This practice of entrusting our child to God in the uncertainty of pregnancy sets us up to rely upon God in the unfolding parenting journey ahead. We will go on to worry about the endless risks our toddler invents, whether our teenager will arrive home safely from a party, and then worry with them as they navigate all the twists and turns of adult life
We must courageously embrace the risk and uncertainty inherent in the process of embracing life, casting our anxiety on the God who cares for both us and our children. This is an important part of how we love and care for them. We aren’t in control, but we do know someone who is.
For safety information regarding medications and other environmental exposures during pregnancy here is a resource I recommend.
Jodie McIver is a registered midwife and author of ‘Bringing Forth Life: God’s Purposes in Pregnancy and Birth’ (available here and here). Jodie and her husband Tim are in Anglican ministry together and parents to three children.
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