The Truth About Omega-3s During Pregnancy

by Robin Jordan, CNM, PhD

What pregnant woman wouldn’t want to grow a smart baby, one that has every last genetically programmed fully functioning brain cell, is ahead of the preschool pack, becomes the straight-A class president, and attends an Ivy League university?

That might be a stretch. But research indicates that women who eat adequate amounts of omega-3 fatty acids—specifically DHA and EPA found in many fish and fish oils—have babies who have higher cognitive, verbal, and visual functioning than babies born to women with lower intakes of these fatty acids.

Additional benefits of consuming adequate DHA and EPA in pregnancy are higher infant birth weight and a reduction in risk of preterm birth. Research also supports a reduction in pregnancy hypertension and postpartum depression, and we’re not even getting into the gamut of health benefits for the general population! (Okay, a short list: decreased cardiovascular disease, hypertension and dementia, to name a few).

It all sounds easy, right? But it may not be that simple.

Separating Fact from Fiction

There are plenty of areas of confusion on omega-3s during pregnancy. A recent study making the news rounds does not support the findings of improved mental and visual function in offspring whose mothers consumed DHA and EPA supplements. There may be reasons for these results—or lack of. The researchers tested babies only up to 18 months old, and women’s prior patterns of DHA and EPA consumption were not taken into account. Now here’s where it gets confusing: the ratio of omega-6 to omega-3 in the diet could have played a role in study findings. Omega-3s compete for binding spots in the body with omega-6s, primarily linoleic acid (LA). LA is found in foods containing corn, soybean and safflower oils (think crackers, cakes, soda), and beef--foods that are consumed in overabundance in today’s typical diet. DHA and EPA compete with LA for receptor sites in the body. So if a woman has a diet high in LA rich foods, then the DHA and EPA she takes in might not be used by the body. When people eat less omega-6s, they can make huge increases in their body’s omega-3s!

The Mercury Conundrum

What about fish? Isn’t it full of mercury? Only certain kinds of fish like shark, mackerel, swordfish, and tilefish are high in mercury. Many others are perfectly safe to eat. Just know what they are! Dr. Joseph Hibblen, a researcher with the US Department of Public Health has stated that the benefits of eating fish during pregnancy far outweigh any risks of eating safe fish during pregnancy. Based on his analysis of other studies, he concluded that the effect of not eating enough fish in pregnancy appears to be a 5-6 IQ point difference! The general guideline of “up to” two fish meals per week is being challenged by experts as too low, that pregnant women (and the rest of us!) should be eating more.

We don’t know everything about omega-3s in pregnancy; however, we do know enough to conclude that DHA and EPA are important to pregnancy and fetal health. Who knows the difference a few IQ points can make!

Midwives and other health care professionals, read Robin’s article on the omega-3 fatty acids DHA and EPA in the November/December issue of the Journal of Midwifery & Women’s Health.

Women, get more guidance on omega-3 fatty acids during pregnancy from this free Share With Women handout.

Remembering Women Who Were Widowed in Pregnancy on 9/11

As we approach the anniversary of 9/11, now is an appropriate time to revisit a study published in the March/April 2008 issue of the Journal of Midwifery & Women’s Health called “The Lived Experience of Widowhood in Pregnancy.” This groundbreaking study examined the experiences of women who were pregnant when their husbands were killed in the 9/11 attacks or while serving in the US military during the Iraq and Afghanistan wars.

This was the first study to examine the experiences of pregnant widows. (Most previous studies of widowhood have focused on women in their 60s or older.) Authors examined the experiences of 10 women who lost their husbands during pregnancy. Using 8 themes that emerged from the data analysis, the authors described the emotions and challenges experienced by these women, including their struggles with loss, emotional trauma, depression, and creating a support system for their birth. The study offers strategies that midwives and other women’s health care providers can use in helping these women cope with their loss and impending motherhood.

Approximately 7 million women in the United States become widows every year. It is not known how many women are pregnant at the time of their husband’s death. However, the authors emphasize that we need only look at recent historical events to see that the number of widows of childbearing age is rising.