When I was pregnant with my first child, I distinctly remember the list of food restrictions that I was given by my midwife. The idea that I needed to limit my caffeine intake, say goodbye to alcohol for nine months, and avoid unpasteurized milk and cheeses was a no-brainer.
What surprised me were some of the other food items I was now being instructed to limit or outright avoid.
These included:
- Freshly squeezed fruit juices.
- Medium-rare or rare steaks.
- Deli meats.
- Pate.
- Sushi.
- Fish, including swordfish, salmon, and tuna.
- Shellfish, including crab.
Now you may be looking at this list, shrug your shoulders and think “No big deal”.
When you are married to a Frenchman like I am, however, reducing or steering clear of any of the above food items is easier said than done!
When I showed “mon amour” the list, he scoffed and said, “You would starve in France if you followed that list! I am sure my mom ate all of that stuff when she was pregnant with me and my brother”.
He then proceeded to Facetime his mother who of course, wholeheartedly agreed that my list was “du grand n’importe quoi!” Loosely translated for you non-Francophiles –
“a lot of rubbish/nonsense!”
After the call, I politely reminded my husband that his mother, or “Mamie” as she would soon be called, had given birth over thirty years ago. I pointed out that advice had shifted considerably since the late-1970s when we were both conceived. Smoking and drinking, while pregnant was not actively discouraged back then, and wearing a seatbelt, was not even the norm!
Our discussion abruptly ended at that point because, of course, he had no suitable comeback. I continued to quietly peruse my lists and make modifications to my dietary intake as my pregnancy progressed. I did fairly well at monitoring myself up until the seventh-month mark which is when I found myself attending a destination wedding in France.
I was actually pretty excited to attend. I had a gorgeous empire-waist dress and my feet were still able to fit into my pre-pregnancy heels at that point – although I did have some ballet flats to change into just in case.
The day itself started out well. We entered the church and were able to find seats towards the back, near the exit for “les toilettes”. It was a sweltering hot early September afternoon but it was suitably cool inside the old stone church. I remember being quite content to sit and rest my feet for the duration of the 2½ hour ceremony.
The ceremony was followed by a brief cocktail reception in the courtyard of the church where I sipped on sparkling water from a champagne glass. After an hour we disembarked for the reception at a beautiful 17th-century chateau. That is when things took an unexpected turn.
After an hour at the venue we were seated for the first of several courses. I was famished at this point as I had nothing to eat since lunch. As I scanned the menu that had been left at my place setting, I groaned inwardly. The meal I had been so looking forward to was potentially looking like a pregnant woman’s nightmare!
First course: “foie gras” (goose or duck liver) – normally something I relished eating prior to pregnancy but definitely a hard “no” while pregnant.
Second course: seafood bisque – again something I would enjoy regularly but now looking to be a potential “no” unless I could discern exactly what type of seafood was in the soup.
Third course: steak – not normally an issue but given the French propensity to serve it still mooing, I was hesitant to say the least. I would need to make sure to ask that it was “bien cuit” or well-cooked.
Fourth course: a “charcuterie board” (Meat and cheese platter) – another hard “no” apart from any bread that might arrive with it!
What was a pregnant girl to do?
Given my husband’s lack of concern regarding my current dietary restrictions, I decided not to get him involved. He was deep in conversation with an old friend anyways. I decided to take matters into my own hands and instead caught the attention of one of the members of the wait staff.
Thankfully in my sober state, seven years of middle and high school French came rushing back.
“S’il vous plaît monsieur puis-je avoir votre aide?” – Please Mister, may I have your help?
“Monsieur” made his way over to the table, quietly appraised my burgeoning belly and replied, “Oui, Madame?” – “Yes Ma’am?”
In my heavily accented French, I managed to ask him “Quels fruits de mer sont dans cette bisque?” – “What seafood is in this bisque?”
I was hoping for a low mercury choice like crab, lobster or cod.
Why a low mercury choice?
The US FDA has published extensive guidance on the nutritional value of fish, including crab, for pregnant and breastfeeding women. Fish is both high in protein and Omega-3 fatty acids. Omega-3 fatty acids such as EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are integral in supporting the development of the central nervous system, vision and cognitive development of a fetus. Evidence also suggests that the regular consumption of Omega-3’s by pregnant and breastfeeding women also reduces the likelihood of allergies in infants.
Studies have also indicated that instances of early labor and delivery and preeclampsia are also reduced if women ingest enough Omega-3 fatty acids throughout pregnancy. A developing fetus that absorbs these essential nutrients is also less likely to suffer from low birth weight.
Despite all of these inherent health benefits, all types of fish, crab included, contain varying levels of mercury.
According to the “March of Dimes”, consumption of high levels of mercury is toxic towards a developing fetus. Elevated mercury levels can cause congenital abnormalities, vision and hearing problems, and neurological issues.
For fish to be considered a healthy choice, pregnant women should gravitate towards those types of fish that are lowest in mercury.
Thankfully, the FDA divides fish into three categories based on their mercury levels:
- Best Choices.
- Good Choices.
- Choices to Avoid.
The FDA advises that pregnant and breastfeeding women may safely eat 2 to 3 4oz servings or 8 to 12oz weekly total of fish from the “best choices” list. Crab is firmly ensconced in this category due to its low mercury level and nutritional value. Other acceptable choices include lobster, tilapia, and cod.
Thankfully for my growling belly and growing baby, “le crabe” was the first word that rolled off “Monsieur’s” tongue! Having not eaten any shellfish during the week, I knew I could safely eat the bisque and stay within the FDA’s weekly guidelines for fish consumption for pregnant women.
Another consideration involves food preparation protocols in the kitchen. Crab and other raw seafood are more likely to contain harmful parasites and bacteria such as salmonella. Ingestion of this bacteria leads to a type of food poisoning known as salmonellosis.
Having fallen victim to salmonellosis once before, several years pre-pregnancy, I had no desire to relive the experience. On that fateful afternoon, I began experiencing symptoms within hours of ingesting a salad that had obviously not been properly washed.
A fever and extreme chills led swiftly to overpowering stomach cramps and diarrhea that showed no signs of abating after seven days. It was only after I made a trip to the doctor and started taking heavy-duty antibiotics that I began to recover. To this day, just thinking of this memory makes me shudder!
Unfortunately, the normal hormonal changes that your body experiences during pregnancy automatically leaves you more susceptible to foodborne illnesses such as salmonellosis. Pregnancy also alters your immune system, making it more difficult for your body to fight off such illnesses once you contract them.
Salmonellosis can also be passed onto your unborn baby. Once born, your baby could experience symptoms including fever or diarrhea. They could also develop meningitis, an infection of the brain, and spinal cord membranes. Left untreated, meningitis can cause complications including seizures, brain damage, shock, and even death.
The best way to avoid contracting salmonellosis is to follow proper hygiene protocols while handling raw crab and other uncooked shellfish. This includes washing hands thoroughly before and after handling the raw ingredients and using separate kitchen utensils and equipment while preparing and cooking food. Finally, fully cooking shellfish will kill off any bacteria or parasites that cause foodborne illnesses such as salmonellosis.
Commercial kitchens, restaurants, and catering companies in France are legally bound to follow European food hygiene legislation managed by ANSES. ANSES, the French Agency for Food, Environmental and Occupational Health & Safety, has an entire department dedicated specifically to examining the safety of shellfish.
The wedding chateau may have been centuries old, but it was attached to a modern industrial-size kitchen. Given the five-star rating of the wedding venue, I was feeling confident that appropriate food hygiene methods were being followed. The fact that steam was wafting from the bowl also cemented my certainty that the main ingredient, crab, was fully cooked.
One final consideration is the origin of the crab. The FDA recommends pregnant women avoid fish, including crab, that has been caught recreationally by family and friends. This is due to the increased likelihood of the fish being contaminated by pollutants and/or having higher than average mercury levels.
Can pregnant women eat crab?
The American EPA suggests contacting your local fish advisory to determine whether or not it is safe to eat crab and other types of fish that are sourced in your local area. Given that I was seated in a high-end wedding venue nowhere near the sea, I was fairly certain that the crab I was about to ingest was not a gift from a wedding guest but sourced from a reputable fishmonger.
Not wasting another minute, I dove into the bisque with abandon, savoring each and every spoonful that I brought to my mouth. When I could see the bottom of the bowl, I swapped the spoon for slices of freshly baked baguette to wipe every trace of the rich creamy broth and pieces of crab from the bottom of the bowl.
I sat back in my chair and rested my hands on my belly which had finally stopped growling in displeasure. I could feel my daughter moving inside me, a sign that she was content as well.
Emboldened by my success with the bisque, I then managed to put in a special request for “un steak bien cuit” which “Monsieur” begrudgingly obliged. I obviously skipped the cheese and meat platter, being leery of the soft, runny cheeses and cold cuts.
Fortunately, I was able to sample the wedding cake, a magnificent three-foot-tall towering “piece montée”, which more than made up for the fact that I had to turn down the foie gras and cheese and meat platter.
At this point my hunger was fully satiated and my daughter was practically tap-dancing in my belly. I swapped my heels for the comfortable ballet flats in my purse and managed to dance the evening away with my husband.
I eventually left him with the groom and the rest of the wedding party. I made my way to bed where I slept soundly as my belly digested the seafood bisque. While much of the experience was out of my control, I was able to make informed dietary choices due to my prior research.
Pregnancy can be overwhelming but it does not need to be. If you are prepared, you can still enjoy some of your favorite foods and even have a little fun at the same time!