Pregnancy and fish. What is safe to eat?

Is it true that pregnant women should not eat fish even if it is very nutritious? Mustapha

Fish is a nutritious food for everyone, including children and pregnant women. Unfortunately, due to human activity and natural reasons, mercury compounds may find their way into water bodies that fish may be inhabiting, leading to fish taking in mercury from the foods they eat or even direct entry into the fish through the gills used to breathe.

Fish, especially those that live longer such as Tuna or sharks, or those found in mercury-polluted waters, especially oceans, may have high levels of mercury that may be toxic to the unborn child.
Therefore, it may be prudent to avoid eating these types of fish during pregnancy.

That said, mercury is a highly toxic element with no known safe level of exposure.

Fortunately, the most consumed fish in Uganda, the Tilapia, do not seem to have toxic levels of mercury in them and, therefore, can be consumed during pregnancy unless one’s antenatal clinic advises otherwise.

However, tilapia should not be undercooked or eaten raw because of the likelihood of it causing infections such as listeria or E. coli since pregnant women are usually susceptible to infections.

In the same vein, pregnant women should avoid eating undercooked, raw meat or eggs, hotel or town-made vegetable salads or fruit juice, and raw (unpasteurised) milk, to avoid getting several infections including Toxoplasma, E. coli, listeria, and salmonella since they can affect both the mother and featal health.

Also, they should avoid eating liver because of its high content of Vitamin A, which can lead to featal abnormalities.
Of course, pregnant women should avoid alcohol and should limit the amount of coffee (caffeine) they take.
 

Is pain during sexual intercourse normal?

My 32-year-old girlfriend feels a lot of pain during sexual intercourse. What could be the cause? Kora

Dear Kora, Dyspareunia is when a man or woman has recurring pain in the genital area or within the pelvis during or after sexual intercourse. This kind of pain is more common in women than men, may affect any woman and may happen during penetration or during sexual intercourse.

When it happens during penetration, it may be blamed on insufficient lubrication, birth injuries or a scar from the cut made during childbirth to enlarge the birth canal (episiotomy).

It may also be due to infections (Herpes Simplex), inflamed outer genital part, involuntary spasms of the muscles of the vaginal wall (vaginismus) or inborn abnormalities such as the absence of a fully-formed vagina (imperforate or persistent hymen).

Deep pain usually occurs with deep penetration (may be more pronounced with certain positions) with the causes, including disease conditions such as endometriosis (presence of the inside membrane of the womb elsewhere), pelvic infections with inflammation, uterine problems such as a prolapse or fibroids, ovarian cysts or bladder infection.

Surgery to the pelvis, including removal of the uterus or radiation treatment for cervical cancer can also lead to changes that make sexual intercourse painful.

Emotional factors or stress and sexual abuse may not only interfere with lubrication but may also be the cause of involuntary vaginal muscle spasms (vaginismus), which could be what you referred to as inability to achieve penetration.

If an infection or medical condition contributes to the pain, treating the underlying cause may resolve the problem. You could also try switching positions and allow enough time before sexual intercourse to achieve enough lubrication.