Food safety for pregnant women

What is food poisoning?

Food poisoning (also known as foodborne illness or food-related illness) is caused by eating food that has been contaminated by bacteria, viruses or parasites. Food can become contaminated by these microorganisms at any time before you eat it, including at home during:

• handling
• storing
• cooking

There are many signs of food poisoning, but most types cause one or more of the following:

• nausea
• vomiting
• diarrhea
• stomach pain and cramps
• fever and chills

Symptoms can start within hours after eating the contaminated food, or sometimes not until days or even weeks later. Usually, people recover quickly and completely.

However, food poisoning sometimes causes serious complications, including death. This is the case for people who are more at risk for both food poisoning and related health complications, like pregnant women.

Food poisoning and pregnant women

Because of all the changes happening in your body, you and your unborn baby are at an increased risk of food poisoning. Your immune system is weakened, so it could be harder for you to fight off infections.

Some bacteria, such as Listeria can go through the placenta. So if you become sick, there is an increased risk that your baby could get infected. Your unborn baby’s immune system is not developed enough to fight off harmful bacteria.

Food poisoning can be even more dangerous to your baby’s health than to yours. If you develop food poisoning during the first 3 months of pregnancy, it can cause a miscarriage. It if happens later in the pregnancy, it can cause your baby to be born prematurely. Food poisoning can also cause a stillbirth or a baby who is born very ill. Because your baby depends on you for everything it needs, it is very important that you be careful about what you eat and how you store, prepare and cook your food.

This guide offers helpful advice on how to reduce your risk of food poisoning.

Safe food alternatives for pregnant women

Some types of food can be a higher risk for pregnant women because of how they are produced and stored. To lower your chances of getting food poisoning, you should avoid those foods. The following chart can help you make safer food choices.

Safe food alternatives for pregnant women

Type of food	Food to avoid	Safer alternatives
Hot dogs	Hot dogs straight from the package, without further heating.	Hot dogs that are well cooked to a safe internal temperature. The middle of the hot dog should be steaming hot or 74 °C (165 °F). Tip: Avoid spreading juice from hot dog packages onto other food, or to cutting boards, utensils, dishes and counters. Wash your hands after touching hot dogs.
Deli meats	Non-dried deli meats, such as bologna, roast beef and turkey breast.	Dried and salted deli meats, such as salami and pepperoni. Non-dried deli meats that are well heated and steaming hot.
Eggs and egg products	Raw or lightly cooked eggs, or egg products that contain raw eggs, including some salad dressings, cookie dough, cake batter, sauces, and drinks (like homemade eggnog).	Egg dishes that are well cooked to a safe internal temperature of 74 oC (165 oF). Cook eggs until the yolk is firm. Homemade eggnog heated to 71°C (160 °F). Tip: Use pasteurized egg products when making uncooked food that calls for raw eggs.
Meat and poultry	Raw or undercooked meat or poultry, such as steak tartar.	Meat and poultry that are cooked to their safe internal temperature. (Refer to the Internal Cooking Temperatures Chart.)
Seafood	Raw seafood, such as sushi. Raw oysters, clams and mussels. Refrigerated smoked seafood.	Seafood cooked to a safe internal temperature of 74 °C (165 °F). Oysters, clams and mussels that are cooked until the shell has opened. Smoked seafood in cans, or seafood that does not need to be refrigerated until it is opened.
Dairy products	Raw or unpasteurized dairy products. Unpasteurized and pasteurized soft cheeses, such as Brie and Camembert. Unpasteurized and pasteurized semi-soft cheeses, such as Havarti and Monterey Jack. All unpasteurized and pasteurized blue-veined cheeses.	Pasteurized dairy products. Pasteurized cheeses such as cheese curds, cheddar, and cottage cheese. Pasteurized processed/spreadable cheeses such as cream cheese. Pasteurized and unpasteurized hard cheeses such as Romano and Parmesan.
Sprouts	Raw sprouts, such as alfalfa, clover, radish, and mung beans.	Thoroughly cooked sprouts.
Pâtés and meat spreads	Refrigerated pâtés and meat spreads.	Pâtés and meat spreads sold in cans, or that do not have to be refrigerated until they are opened.
Fruit juice and cider	Unpasteurized fruit juice and cider.	Unpasteurized fruit juice and cider that are brought to a rolling boil and cooled. Pasteurized fruit juice and cider.

What do I need to know when shopping for food?

You should:

• buy cold or frozen food at the end of your shopping trip
• check the “best before” date on your food
• check fruits and vegetables to avoid buying items that are bruised or damaged
• avoid spreading bacteria from raw food to ready-to-eat food by:
  • putting raw food in individual plastic bags (which can be found in the produce section and at some meat counters)
  • keeping your raw meat, poultry, fish and seafood away from other food in your grocery cart
  • labelling and using the same bag or bin for raw meat, poultry, fish and seafood
• refrigerate or freeze raw meat, poultry, fish and seafood as soon as you get home from the grocery store; perishable food should not be left out for more than:
  • 1 hour during summer outdoor activities
  • 2 hours at room temperature
• wash your reusable grocery bags often, especially if you are carrying raw meat, poultry, fish and seafood

What do I need to know when storing food?

It is important to keep cold food cold and hot food hot. Perishable food should never reach temperatures between 4 °C to 60 °C (40 °F to 140 °F). This is because this temperature range is where bacteria can quickly grow and cause food poisoning.

You can reduce your chances of getting food poisoning if you:

• set your fridge at 4 °C (40 °F) or lower
• set your freezer at -18 °C (0 °F) or lower
• put raw meat, poultry, fish and seafood in sealed containers or plastic bags on the bottom shelf of your fridge - this prevents raw juices from dripping onto other food
• store cut fruits and vegetables in the fridge
• refrigerate or freeze raw meat, poultry, fish, seafood and leftovers immediately; dangerous bacteria can grow if left out for more than:
  • 1 hour during summer outdoor activities
  • 2 hours at room temperature
• cook raw meat, poultry, fish and seafood by the “best before” date, or no more than 2 to 4 days after buying it
• freeze raw meat, poultry, fish and seafood if you do not plan on cooking by the “best before” date

Fridge and freezer storage

If you freeze food that is well-wrapped, it can last longer.

What do I need to know when defrosting food?

You should:

• defrost your raw meat, poultry, fish and seafood in:
  • the fridge
  • the microwave
  • a sealed bag or container submerged in cold water
• if you use the microwave, cook it immediately after thawing it
• defrost larger pieces of meat (such as a whole turkey) in its original wrapping and submerge it in cold water
  • change the water often to make sure that it stays cold (approximately every 30 minutes)
• do not refreeze thawed food

You cannot always tell if food is safe by its look, smell or taste. When in doubt, throw it out!

What do I need to know about food and cleanliness?

Reduce the risk of bacteria growth and food poisoning by properly cleaning your:

• hands
• kitchen surfaces
• utensils
• fruits and vegetables
• reusable grocery bags and bins

Hands

You should always wash your hands:

• before and after touching raw meat, poultry, fish and seafood
• after using the washroom
• after touching pets
• after changing diapers

Wash your hands with warm, soapy water for at least 20 seconds. A hand-rub sanitizer can be used if soap and water are not available.

Fresh fruits and vegetables

Before you eat or cook fresh fruits and vegetables:

• gently wash them under cool, running, drinkable water
  • you do not need to use anything other than water to wash fruits and vegetables
• use a scrub brush on fruits and vegetables that have a firm skin, such as:
  • carrots
  • potatoes
  • melons
  • squash
• avoid soaking fresh fruits and vegetables in a sink full of water. Sinks can contain bacteria that can be transferred to your food

Kitchen surfaces and utensils

You can prevent the spread of bacteria in the kitchen if you:

• clean sinks, kitchen surfaces or containers immediately after they have been  in contact with raw meat, poultry, fish and seafood
• do not reuse plates or utensils that have touched raw food
  • wash them in the dishwasher or in warm, soapy water
  • use only clean plates and utensils for your ready-to eat foods
• use one cutting board for ready-to-eat foods, and a different one for raw meat, poultry, fish and seafood
• use paper towels to wipe kitchen surfaces, and change dishcloths daily
• avoid using sponges because they are hard to keep bacteria-free
• clean your counter tops, cutting boards and utensils before and after preparing food using a kitchen sanitizer (follow the directions on the container) or prepare a bleach solution in a labelled spray bottle (you can use a ratio of 5 ml of household bleach to 750 ml of water) and rinse with water

What do I need to know when cooking food?

It is not always possible to tell if food is safe by its colour or how long it has been cooked. Cooking food according to the proper internal cooking temperature can help you make sure your food is safe to eat. Always cook raw meat, poultry, fish and seafood to a safe internal temperature. Follow these tips to avoid eating under cooked meat:

• Use an instant read digital food thermometer for a more accurate reading. Meat can turn brown before all the bacteria in your food are killed.
• Remove your food from the heat and insert the digital food thermometer into the thickest part of the meat. Make sure it is inserted all the way to the middle and does not touch any bones.
• For hamburgers, insert the digital food thermometer into the side of the patty, all the way to the middle.
• When cooking several pieces of meat, make sure to check the internal temperature of the thickest pieces. Food can cook unevenly.
• Keep hot foods at or above 60 °C (140 °F). Bacteria can grow quickly in the temperatures between 4 °C to 60 °C (40 °F to 140 °F).
• Clean your digital food thermometer in warm, soapy water between each temperature reading.

Leftovers

Even leftovers can cause food poisoning if not properly stored or reheated. Follow these tips to help prevent you from getting sick.

• You can quickly cool leftovers by putting them in shallow containers. To lower the chances of bacteria growing in your food, you should refrigerate or freeze leftovers as soon as possible.
• Perishable food should not be left out for more than:
• 1 hour during summer outdoor activities
• 2 hours at room temperature.
• Store leftovers safely by cutting and deboning the meat from large cooked birds, such as turkey.
• Avoid overstocking your fridge, so that cool air can circulate better.
• Eat refrigerated leftovers as soon as possible (within 2 to 4 days).
• When reheating food, make sure it is cooked to an internal temperature of at least 74 °C (165 °F). Bring gravies, soups and sauces to a full, rolling boil and stir during the process.
• You should avoid reheating the same leftovers more than once.

Women Health Tips from Gynecologist’s Perspectives

• Are you taking new patients? This seems like an obvious question, but many prospective patients forget to ask this up front, get very interested in a particular gynecologist and then find there are no openings available.
• Do you take my form of insurance coverage? Do you submit directly or will I have to pay you and file for reimbursement?
• If you don’t have insurance coverage, ask about fees and how they are to be paid. For example, will you be expected to pay at the time of the visit or will you be billed?
• Which hospitals are you affiliated with? If this Ob-Gyn does not have admitting privileges to any hospitals ask why. Also ask how hospitalizations are handled.
• Do you have any sub-specialty training?
• Ask whether the Ob-gyn has any special training or experience managing any complicated medical, obstetric or gynecologic conditions you may have (such as diabetes, endometriosis, infertility, etc.).
• Do you agree to an informational interview/introductory visit by prospective patients? What is the charge for such a visit? (insurance companies generally do not cover such a visit).
• Do you have a general information pamphlet you can send me and/or a biographical overview for the gynecologist? Once you’ve made an appointment with a new gynecologist, it is usually a good idea to ask the office to send you any new patient forms before your first appointment so you can make the most of your time there.
• How does the practice handle emergency (or after hours) visits or phone calls?
• Does the practice have a doctor on call 24 hours a day or do they share call with other groups? If an answering service picks up calls after hours, how long is it usually before someone returns your call? If you phone the office, can you talk to a gynecologist or other health care provider immediately? Some physicians return all calls at a certain time each day, while others reserve a special line for messages or have nurses or physician assistants answer questions. The most important factor is not who answers the calls, but how quickly they are answered and whether you have access to emergency medical advice.
• Who covers for the doctor when s/he is unavailable?
• Ask whether other physicians or non-physicians (such as a nurse practitioner or physician assistant) will participate in your care. If so, ask whether this is considered optional.
• If you are nearing menopause: ask about the doctor’s approach to menopause and hormone replacement therapy.
• Does the gynecologist (or another affiliated health care provider) answer e-mail questions?
• Does the gynecologist or the practice have a web-site to which you can get practice related or medical information?
• What are your views about recommending alternative, complementary or integrative medical approaches?

Important Questions to Ask Your Gynecologist During Your First Visit:

• Ask any of the questions listed above that you didn’t get answered before your first visit.
• Write down any questions you have about your condition before your visit and ask them during the visit.
• Are there any other questions I should have asked you?
• When should I schedule my next visit?

Important Questions to Ask Yourself After Your First Visit:

• What did I think of Dr. So-and-So?
• How was the overall experience of the visit?
• Was I treated with courtesy and respect by the physician and the office personnel?
• Do I feel like I’m in good hands?
• Did I feel comfortable asking all of my questions?
• Did I feel rushed?
• Did I feel heard and understood?
• Do I want to see this doctor again?

Your relationship with your gynecologist is one of the most intimate professional relationships you may have. While this relationship will take time to nurture, you should have a feeling even on the first visit that this is a person you will be able to trust with your most private or serious concerns.