Vegan and Pregnant – Q&A with Doctors and Nutritionists as we get ready for baby #2!

Here we go again! Baby number two is coming end of July. His or her due date is three days away from my birthday (and yes, keeping the sex a surprise). I kind of hope the grand entrance is a birthday present. I can’t wait to lay eyes on this baby for the first time. In some ways, I feel like I’ll be able to appreciate it more than I did with the first birth. First time round, it’s all so surreal. Because I’d never experienced it before, it was hard to wrap my brain around the fact that a living human being would be emerging from my body. Second time round, will be different. I know what’s coming! I’m most excited to see Roen meet baby.

With just under halfway to go, the pregnancy has been almost identical to the one I experienced with Roen (which was also vegan). No nausea, no vomiting, no sickness of any kind. Just fatigue in the first trimester. One difference is that I’ve experienced zero food aversions this time. First round, the thought of coffee, yams, chocolate, greens and many vegetables made my stomach turn. This time, I haven’t been averse to anything, although I haven’t been craving (decaf) coffee like I sometimes do. Cravings have been similar too: salt and vinegar. I sprinkle vinegar on everything savoury! Also, loving cold, fresh fruit like oranges and juicy mango. 

Activity-wise, I didn’t work-out much in the first trimester because of the fatigue (getting through the day is enough!). Fortunately, that intense ‘full-body first trimester fatigue’ disappeared at the beginning of trimester two like it did last pregnancy. I’ve been able to work-out again and I’d say I’m squeezing in about three work-outs a week. I’m mainly doing circuit classes with Sessions Athletics (strength, agility, core), The Class at TurF (cardio and strength classes) and one run a week. I’m so grateful to be able to run this pregnancy! Last time, I had to stop before I’d even reached three months because of severe pelvic pain. What I didn’t realize was that slowing my pace and reducing my distance would’ve helped a lot. Those are the only changes I’ve made this round and I’ve been able to run! Effie in particular is so happy about this.

Health care-wise, we’re going with a midwife again. Loved our experience last round! Also I’ve requested the same doula. I cannot imagine giving birth without a doula!! 

I’m looking forward to documenting this plant-based pregnancy here on the site and on Instagram because I’m passionate to share just how amazing the vegan diet and lifestyle are when pregnant. Not a single health professional has flinched when I’ve mentioned I’m vegan. There are no red flags and I hope to disprove any vegan pregnancy myths by answering your questions below with the help of a few very helpful health professionals.

Meet my first expert panel who is weighing in on this round of questions:

Dr. Anne Bingham is a vegan obstetrician-gynecologist based in Connecticut who is more convinced than ever that plant-based nutrition is the key to better health including better pregnancies and healthier babies. Find her on Instagram here

Dr. Natalie Crawford is a vegan mom of two, a reproductive endocrinologist and an infertility physician practicing at Aspire Fertility in Austin, Texas. Find her on Instagram, @nataliecrawfordmd, and visit her website here. You can also listen to her podcast here.

Laura Bonney is a passionate vegan and Certified Holistic Nutrition Coach, soon-to-be Registered Holistic Nutritionist. She is also the founder of empoweredsoulwellness.com and leads online group programs (PURE) that assist clients transition to a whole-food, plant-based lifestyle with a community of like-minded people.

Vegan Pregnancy Q&A

Q: Would you discuss the safety of being vegan and pregnant?

Dr. Anne says: 

First of all, as an Obstetrician, it is always exciting to have a patient and her partner interested in a healthy diet during pregnancy. Nothing is more important than what you put in your mouth! And I can say without hesitation, that it is not only safe to eat a whole food plant-based diet (WFPBD), it is advisable. The key to this way of eating is to stress the WHOLE FOOD part of this – it is not enough to just say vegan. What’s the difference? Yes, a WFPBD is vegan – it is the avoidance of all animal proteins including fish, eggs and all dairy – but a WFPBD is a wide variety of foods, a rainbow of color in your diet which are going to bring you the health you are looking for in pregnancy and beyond. A broad variety of greens, whole grains, legumes, fruits and other vegetables will bring you the macronutrients of proteins, carbs and fats you need to grow a baby. I am NOT talking about processed foods which happen to be vegan. I urge people to look at labels if they are eating anything packaged to watch for signs of added sugars and fats which will bring them calories but not nutrition.

Calories in pregnancy are only slightly increased from when you are not pregnant – an extra 340 calories after 12 weeks and an extra 450 calories after 22 weeks. This can easily be accomplished with added grains, fruits and vegetables and very easily with nuts or nut butters.

Avoiding eggs, dairy and meat means avoiding significant doses of fat, cholesterol, and calories all of which do not bring better health.  Also eating these foods may bring risks of infection, exposure to proteins which may increase risks of Type I DM to the fetus, and inflammation which may increase the risk of heart disease to the fetus. Also the fat contents in these foods increase a mom’s risk to diabetes.

Avoiding fish means avoiding exposure to pesticides, heavy metals and plastics – a good idea to stay away from pregnant or not!

It is important to think about how the nutritional value of the food is packaged – calcium, iron and protein (often seen as the reason people are eating dairy, meat and fish) – are  much better packaged in whole foods which do not bring us the same risk for harm.

Micronutrients in pregnancy need to include folic acid (found in leafy greens and legumes) which is the most critical to have in the diet very early in pregnancy – even when trying to conceive. This is why we often encourage a vitamin which includes folic acid  – this has been shown to reduce the risk of a neural tube defect (spine bifida) which happens very early in fetal development. Best to talk to your provider to see if any special conditions exist that might mean you need more than the standard dose. Vit B12 and Vit D are also best supplemented through a vitamin – especially in winter months or in more northern latitudes for the Vit D. Iron I will discuss later. DHA for brain development has been suggested by some studies and I’m not aware the jury is out but  this is easily obtained in a vegan supplement (200mg).

Erin says: 

First of all, I’m not a health professional but I’m happy to share my experience and opinion: based on everything I’ve read, a whole food vegan diet while pregnant is not only safe, it’s safer than being pregnant on an animal-based diet. The only foods doctors told me to avoid (before they know I’m vegan) are processed meats, soft cheeses and shellfish. I can’t imagine cooking with raw meat while pregnant. I’d be paranoid about ecoli and salmonella. Plants are so extremely nutrient dense — they are a goldmine for the pregnant body. I’ve spoken to dozens of pregnant plant-based mamas who’ve shared with me that they, too, have experienced wonderful, low or no-symptom pregnancies (and they, too, give some credit to the plant-based diet). Lastly, none of the healthcare professionals I’ve dealt with in my two pregnancies expressed an ounce of concern about my plant-based diet. It’s really a non-issue. Last pregnancy, I wrote a blog post about ‘What I Learned From Doctors and Nutritionists About Being Vegan and Pregnant’ and compiled the opinions of several experts.

Laura says: 

I agree with Erin! But you don’t have to take our word for it. Even the Academy of Nutrition and Dietetics agrees, stating that ‘appropriately planned vegetarian, including vegan, diets are healthful, nutritionally adequate, and may provide health benefits for the prevention and treatment of certain diseases. These diets are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes’.  If you’re not vegan (yet!), I know how veganism can sometimes be hard to wrap your mind around. It may be a bit scary or intimidating (especially when you’re growing a little one inside of you). If you think about it, a plant-based diet makes so much more sense when it comes to being ‘safer’ than consuming animal parts and their secretions (meat, dairy and eggs).  Not only is the fear and pain that those sentient animals experienced bundled up in the end product that’s sold to you in grocery stores (who wants to contribute to and consume that?), but the end products are filled with things like heavy metals (seafood and fish), saturated fat, bacterial risks, nitrates and chemicals in processed meats, pus in milk products, and growth hormones in cheese. Since there is a scientifically proven healthier way to eat for all life stages (whole food plant-based for the win!), it’s really a no-brainer.

Dr. Natalie says: 

There is no evidence that being vegan in pregnancy has any maternal or fetal harm. Observational studies have shown no higher incidence of birth defects or poor outcomes in patients that are vegan and those who are not. I see patients trying to conceive and I support and encourage plant-based eating. [Piccoli BJOG 2015]

Q: Did you use formula with Roen?

Erin says: 

We never had to use any formula with Roen because there was (very fortunately) an oversupply of breast milk which she drank for 19 months. We didn’t have to wean her off, either. She very gradually became disinterested and didn’t even notice when, one night, we didn’t offer it to her. Since she wasn’t reliant on my milk for comfort, we didn’t need to replace it with another ‘white liquid’. Also, by that time, she’d been on solids for 13 months and was getting all of her nutrients from food. If she was thirsty, she drank water.

If Roen had needed formula, we would have chosen something non-dairy as cow milk contains hormones insulin-like growth factor 1 (IGF-1) and bovine somatropin (BST), as well as pregnancy hormones estrogen and progesterone. Cow’s milk is also the #1 food allergen in children and can have a high content of antibiotics and pesticides. Lastly, it turns out, soy milk is closest nutritionally to breast milk, so we would’ve chosen something like Baby’s Only Organic Soy (from iherb.ca), Earth’s Best Organic Organic Soy Based Powder (from Amazon) or Enfimal Soy (from Superstore and Walmart).

Q: What do you eat in a day during pregnancy?

Erin says: 

My diet doesn’t change while pregnant, although I am hungrier so do end up eating a bit more than usual. I mix up my diet constantly and eat different foods every day. My focus is to not count calories, but colours. I try to incorporate as many different whole food, plant-based, colourful ingredients into my diet as possible. Here’s an example of a pretty average day of eating for me:

Breakfast:

  • Two pieces of Silver Hills sprouted grain toast with avocado, mustard and maybe some sauerkraut
  • Large green smoothie (spinach, frozen banana, soy milk, ground flax, hemp hearts, cinnamon, vanilla, two dates)
  • A piece of fruit (usually an apple, grapefruit or orange)

Snacks:

  • Fruit (fresh or frozen)
  • Hummus and crackers or bread or cucumber
  • Dinner leftovers
  • Smoothie

Lunch:

  • Chickpea ‘egg’ sandwich (see how to make this in my recent saved IG story)
  • Dinner leftovers (veggie stews, curries, stir-fries)
  • Tofu scramble with bread
  • A thrown together bowl with whatever’s in the fridge (eg. quinoa, lentils, chopped veggies, olives, seeds, nuts, vinaigrette dressing)

Dinner

  • Baked tofu, roasted veggies, greek potatoes, big salad
  • Pasta with veggies mixed into the sauce or veggies on the side
  • Broccoli! We steam some almost every night for ourselves and Roen
  • Veggie burgers with a sprouted bun
  • Bowl / big salad with greens, a grain, any other veg I can find in the fridge to chop up, maybe some nuts, vegan cheese.

Q: Supplements you take pregnant vs. not pregnant?

Erin says: 

While not pregnant, I take a multivitamin and B12…when I remember! I’m not diligent about this daily routine, nor do I focus on how much I take. I’ve never been low or deficient in any vitamin. I just got some routine blood work done and asked my midwife to include iron and B12 on the requisition form so I could share those numbers with you. At 22 weeks pregnant my B12 was at 332 (healthy range is 153 to 655), hemoglobin was 131 (healthy range is 115 to 155) and feratin was 30 (healthy range is 15 to 247, and while mine might appear to be low it’s actually quite high for a pregnant person, said my midwife). While pregnant I take a prenatal vitamin instead of the multi. I’m not loyal to one brand, but right now I’m using Garden of Life Prenatal Once DailyRainbow Lights are also a good vegan prenatal vitamin option.

Laura says: 

Supplements are all the rage these days, but if you’re eating a varied whole food plant based diet, and also making sure you’re eating enough food every day (especially while pregnant), supplements may not be necessary. A prenatal vitamin is usually recommended for before and during pregnancy, and can include sufficient daily amounts of many other vitamins and minerals as well, like vitamin B12.  If you’ve had bloodwork done and find out that you are deficient in a particular vitamin or mineral, do your best to boost it through food first, as you get so many other health benefits by eating nutrient dense food versus taking a supplement (ex. fiber, antioxidants, etc.). Supplements cannot compensate for a poor diet. Something to keep in mind if you find out that you do have deficiencies is that you may not be absorbing nutrients properly due to an existing health issue. As supplements don’t require a prescription and you can easily grab them off of the shelf at the grocery store, it can be tempting to just start ‘treating’ yourself, even without getting bloodwork done. Work with a health professional who can work with you to find the root cause of any health issues, and support you on your way to healing and optimal health through your pregnancy and beyond.

Q: Any tips for vegans who are craving meat while pregnant?

Dr. Anne says: 

Pregnant women often have cravings! The food industry continues to bring us ways of managing cravings with foods that might have the same chewiness or give the same flavor as meat. Be careful and read labels so that you are not getting a giant dose of calories with salt or sugar or even lots of ingredients you can’t even pronounce!  Seitan can be chewy and so can soy curls – portobello mushrooms with barbecue sauce can give the same meat like density.

Laura says: 

Interesting question…that must be tough! I’ve personally heard more stories of pregnant women developing an aversion to meat while pregnant. If you are craving meat, go and search out a vegan alternative and see if that helps…there are so many out there (like veggie burgers and meat alternatives like those made by the brand Gardein).

Erin says: 

The mind is so powerful. For non-vegans who are experiencing strong meat cravings, this could be your body’s way of telling you that you need more protein of iron. Because you associate animal products with protein and iron, your body doesn’t know what else to crave — it’s only natural that you’re craving meat. But if you’re interested in reducing your animal foods intake, try a bean salad or a tofu dish to curb your craving. Maybe this is just what your body needs! For vegans with meat cravings, I wonder if watching one of the documentaries that originally turned you off meat could help flick that switch in the brain? Earthlings and Dominion are the two most powerful, I’d say.

Q: Books or blogs you’d recommend that helped you know what to eat and what supplements to take?

Erin says: 

My diet doesn’t change much when I’m pregnant (besides the extra vinegar I’m consuming thanks to the cravings!!!) and I’ve never read specific books or blogs about pregnancy diets. I’ve read many books about the whole food plant-based diet, however, and thanks to them, know how powerful, healing and nutritious this diet is at every stage of life. My favourite nutrition books are How Not To Die by Dr. Michael Greger and The China Study by T. Colin Campbell. I also believe in listening to my body. It’s amazing how we actually crave the nutrients and minerals we might be low in! For example, early on in the pregnancy, I was craving oranges daily. I later learned that they’re high in folic acid — so perhaps I was low? My body guided me in their direction.

I asked for vegan pregnancy nutrition book or blog recos in the vegan Facebook group I co-moderate and got some greats leads:

Laura says: 

Tuning in to your body is an amazing thing! We all need to do that more often, pregnant or not. A few general suggestions I have for everyone (pregnant or not) are nutritionfacts.org (as well as Dr. Greger’s books ‘How Not to Die’ and its companion ‘How Not to Die Cookbook’). There’s also the free ‘Daily Dozen’ app to help you easily keep track of your daily whole food intake. A great book that addresses the focus on protein is ‘Protein-aholic’ by Garth Davis, M.D. Another very comprehensive online resource, with evidence-based nutrition recommendations for pregnancy and otherwise, is veganhealth.org.

Q: Is there any supplement you took before or during pregnancy to assist?

Erin says: 

No — just my usual multivitamin and B12 spray.

Q: Do you try to make sure to eat specific things in your diet now that you’re pregnant? (Any tips on foods to eat that will increase fertility?)

Erin says: 

No. My diet has remained pretty much the same despite the higher quantity of vinegary and tangy things my taste buds have been craving! Give me salt and vinegar anything! I feel confident that on top of my predominantly whole food plant-based vegan diet, the prenatal vitamin is covering all my bases.

Dr. Natalie says: 

Studying diet and fertility has always been difficult sue to heterogeneous outcomes and surrogate markers of fertility, but current evidence supports that diet is a modifiable factor contributing to fertility outcomes. A recent study published in 2019 evaluated a variety of diet types, and it looks like the best diet for fertility includes one that includes: supplemental folic acid, vitamin B12, vitamin D, organic (low pesticide) fruits and vegetables, whole grains, soy, and omega 3 fatty acids. Specifically, red meat has been associated with an increase in infertility and should be avoided. [Chavarro Fertil Steril 2019; Jinno Hum Reprod  2011; Chavarro AJOG 2008]

Q: Can you touch on getting enough protein/iron on vegan diet during pregnancy?

Laura says: 

The protein question! This is definitely one of the top questions vegans are asked (and especially myself as a vegan holistic health coach, soon-to-be holistic nutritionist). Yes, of course everyone needs to consume protein, but it is in so many plant-based foods! Just a few great sources are soy products, beans, whole grains, vegetables, nuts and nut butters. These protein sources come with an abundance of other amazing nutrients, while protein from animal products come with many negative effects, including hormone disruption (cortisol spikes – the ‘stress hormone’), and can affect the health of your baby while they are growing inside of you as well as into their own adulthood. Some great science-based information on some of the effects of animal protein can be found here.

Iron is an important mineral that we all need to consume, especially women who are still menstruating or are pregnant.  As Erin mentions, so many plant-based foods include, or are fortified with iron. As with protein, where we source our iron is important. Iron sourced from plants is non-heme iron, while iron sourced from animal products is heme iron. Heme iron is more readily absorbed, but this isn’t necessarily a good thing. This means that we tend to store iron even when our bodies don’t need it. These higher iron stores can correlate with diseases such as heart disease (our #1 killer), type 2 diabetes, cancer, etc. Our bodies are better able to regulate absorption of non-heme iron. You can also boost your iron intake by using a cast iron pan to cook with as well as pairing iron-rich foods with vitamin c-rich foods to assist with iron absorption. Try to avoid drinking coffee and tea with meals as these beverages impair iron absorption (as do calcium supplements). If you do choose to take an iron supplement, it should be taken between meals to reduce interference with zinc absorption. If you’d like to read more extensively about iron (as well as other vegan nutrition information), a great site to check out is theveganrd.com.

Erin says: 

First, let’s talk protein. We are such a protein-obsessed society, most of us actually consume too much protein. I don’t focus on getting protein in a day because almost every food (besides fruit, junk food and the odd low-protein item like the cassava) contains protein. Remove the meat from the traditional dinner plate consisting of a slab of meat, veggies and potatoes, and you’d still be left with enough protein. Veggies and potatoes contain protein. If you’re getting enough calories in a day, it is basically impossible to not get enough protein in a day. Have you ever met anyone with a protein deficiency (kwashiorkor)? I haven’t. Sadly, most people get too much (animal) protein and wind up in the hospital with clogged arteries / heart disease (the number one killer in the Western world).

As for iron, so many plant-based foods are fortified with iron (dairy-free milks, vegan cheeses, cereals etc). There are also lots of whole plant foods that are rich in iron: lentils, soybeans, tofu, tempeh, lima beans, quinoa, brown rice, oatmeal, pumpkin, sunflower, cashews, sesame, certain tomato sauces, swiss chard, collard greens, blackstrap molasses, prune juice. Also, you can increase your body’s absorption of iron by adding citrus to iron-rich foods you’re enjoying. If you’re still worried about not getting enough iron, head to any vitamin shop where you’ll find a variety of plant-based iron supplements (I don’t take one but I hear this one from Vitality is good).

Dr. Natalie says: 

I find that most vegans, especially if whole food plant based, are not protein deficient and are not iron deficient. Encouraging a diet with leafy greens, spinach, kale, legumes, seeds, beans and nuts will result in naturally normal iron levels and prevent anemia.

Dr. Anne says: 

It is well known that there is a wealth of protein in a plant-based diet. In fact, most vegans get more than the recommended daily amount (46 gms per day for women according to USDA). In pregnancy this amount needs to be increased to 1.1 gm/kg/day. I do not recommend using a calculator for this but rather to have confidence in this diet if you are eating a wide variety of foods!

Most women become anemic during pregnancy and become more so if they were anemic before becoming pregnant. The body can regulate how much iron you absorb from your food if the iron is non-heme (as in non-blood source of iron, or not animal/meat). Heme sources of iron (meat) bring with them not only risk for inflammation, but increased risk for diabetes and heart disease. You can increase your iron absorption by adding Vitamin C in the diet through citrus or tomatoes. Tannic acids in coffee and tea inhibit absorption along with dairy.

In some cases women will need increase their dietary iron along with an over the counter supplement. Unfortunately iron is constipating which means more fibre!

Q: Do you have any info on taking a plant-based omega supplement during pregnancy?

Dr. Natalie says: 

I recommend all vegan women take supplements in pregnancy. I am a strong believer that the risks are too high for any potential benefit of avoiding supplementations.

Specifically, I want plant based women to take

  • Folic acid: 400 mag per day – even though folic acid is in foods such as leafy greens, broccoli, asparagus, avocado and beans, and fortified grains – the consequence is too severe if you are dietary deficient as folate deficiency has been well associated with neural tube defect. All women need a folic acid supplement
  • Vitamin D:  so many women are vitamin D deficient as it is fortified and food and converted from sun exposure, I recommend at least 1000 IU per day
  • Vitamin B12: Vitamin B12 is important in normal neurological development and prevention of anemia. There are some fortified foods (nut milk, cereals, nutritional yeast) – but unless fortified no plant naturally contains B12. 10 mcg per day recommended for vegans
  • Omega 3 supplementation: diets higher in omega 3 FA had shorter time to pregnancy and improved pregnancy outcomes, omega 3 FA (such as DHA and EPA) are also important in brain development. Plant based foods that are high in omega 3 include walnuts, flax, and chia seeds. I recommend vegan women take an algae based omega 3 supplement to ensure they are exposed to enough omega 3 fatty acid for optimal neuro-development outcomes.

Dr. Anne says:

Omega fatty acids are an essential part of our diet. The jury is not out on the need for supplemental omega 3 DHA in pregnancy, but there are vegan sources. I would not recommend fish oil as a source due to all the contamination. I regularly use NutritionFacts.org as my resource for any new info. Certainly there are some great  sources of omega fatty acids in walnuts, almonds, broccoli, flaxseeds, chia seeds and whole soy foods.

Erin says:

In my five years of being vegan I’ve never taken an omega supplement. I’ve always gotten my omega fatty acids through plant-based foods and I’ve never run into health issues. Recently however I saw a plant-based omega-3 supplement at Body Energy Club and thought I’d give it a shot to see if I felt any different. The brand is NutraVege: Omega-3 Plant Liquid Gels. I just started taking it so I’ll keep you posted!

Q: Gestational diabetes and vegan diet – have you looked into this if it help?

Dr. Anne says: 

I am not a researcher in my field. As an Obstetrician, I do however see and treat a large number of patients with diabetes which is diagnosed during their pregnancy (this is called gestational diabetes). We know that the building blocks for insulin resistance include high calorie diets which typically include high saturated fats in dairy and meat as well as the high intake of processed foods. I have seen a number of women improve their sugar level when confronted by this diagnosis – and they do it by changing their diet and increasing their activity level. Some women are able to make such profound changes that their sugar levels remain normal. Unfortunately, diabetes in pregnancy increases risks for premature delivery, difficult deliveries with risk of harm to babies and their mothers, and more risk for Cesarean section. Babies born to diabetic mothers have more risk for need for intervention by the Pediatric team which can mean they are not able to stay with their mothers to bond after delivery. Babies born to diabetic moms are at more risk of becoming diabetic themselves later in life. Moms who have Gestational Diabetes are also at increased risk for having Diabetes later in life. This is all avoidable with a healthier lifestyle!

Huge thanks to my incredible panel of experts for sharing their knowledge! Readers, feel free to share any questions you’d like answered in the comments of my latest Instagram post and I’ll include them in the next article. 

Comments are closed.