• Arienne Bloomingdale, Lauren B Guthrie, Sarah Price, Robert O Wright, Deborah Platek, Jess Haines, and Emily Oken.
• Department of Population Medicine, Harvard Medical School and the Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA.
• Am. J. Clin. Nutr. 2010 Nov 1; 92 (5): 1234-40.

BackgroundMany pregnant women in the United States do not consume enough docosahexaenoic acid (DHA)--an essential nutrient found in fish. Apparently conflicting findings that fish consumption is beneficial for the developing fetus, yet potentially toxic because of mercury contamination, have created uncertainty about the appropriate fish-consumption advice to provide to pregnant women.ObjectiveOur objective was to determine knowledge, behaviors, and received advice regarding fish consumption among pregnant women who are infrequent consumers of fish.DesignIn 2009-2010 we conducted 5 focus groups with 22 pregnant women from the Boston area who ate <2 fish servings/wk. We analyzed transcripts by using immersion-crystallization.ResultsMany women knew that fish might contain mercury, a neurotoxin, and had received advice to limit fish intake. Fewer women knew that fish contains DHA or what the function of DHA is. None of the women had received advice to eat fish, and most had not received information about which fish types contain more DHA or less mercury. Because of advice to limit fish intake, as well as a lack of information about which fish types they should be eating, many of the women said that they would rather avoid fish than possibly harm themselves or their infants. The participants thought that a physician's advice to eat fish and a readily available reference regarding which fish are safe to consume during pregnancy would likely have encouraged them to eat more fish.ConclusionPregnant women might be willing to eat more fish if this were advised by their obstetricians or if they had an accessible reference regarding which types are safe.

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