Improving pregnancy outcomes for expecting mothers
Pregnancy is a major life event for nearly all women. What a woman puts into her body before, or during this time can greatly impact both hers and the health of her fetus. Whether meticulously planned or otherwise, there is a ton of information out there for maternal health during pregnancy and sifting through all that information can easily become overwhelming and stressful.
Why is it important to prepare for pregnancy anyway?
Pregnancy, birth outcomes, and the future health of the child are all impacted by the mother’s mental/emotional and physical health both before and during gestation. If the expectant mother has underlying health conditions such as diabetes, thyroid disorders, or blood pressure issues, or even being older than 40 at the time of pregnancy, she may be monitored and treated as a high-risk pregnancy. High-risk pregnancies require more diligent care from health providers, physicians, and naturopathic doctors.
This post breaks down the prenatal vitamin and the purpose each nutrient serves for both baby and mama.
When to start taking a prenatal:
As soon as you find out your pregnant, but even starting a couple of months before you are planning to conceive all the way up to the postpartum period is encouraged. Ontario standards of practice for perinatal care advise women to take a folic acid supplement (or in their multi) prior to conception.
Required for the healthy development of vertebrae, spinal cord, limbs, heart, eyes, ears, and regulating the health of genes. Be careful though; vitamin A in doses of 10,000IU or more it can be toxic to the developing fetus (especially in the first trimester), causing malformations and defects in the heart and genitourinary systems. Better to stick with B-carotene.
Also known as pyridoxine, helps with nausea and vomiting experienced by the mother during the first trimester of pregnancy.
This vitamin comes in a few forms, methylcobalamin, hydroxycobalamin, and cyanocobalamin. Methylcobalamin is used by individuals who have impaired methylation while cyanocobalamin breaks down to cyanide and cobalamin in the body. Naturopaths and health-care providers prefer the first two forms of vitamin B12 when supplementing their patients, which helps with nausea/vomiting and low energy.
Ascorbic acid supplementation may help prevent the rupturing of membranes by stimulating collagen synthesis. Vitamin C is also associated with a lessened risk of pre-eclampsia (a disorder of pregnancy, associated with marked high blood pressure and increased protein in the urine).
Deficiency is associated with low birth weight and pre-term birth, as well as a higher risk of developing MS or diabetes later on in life. Vitamin D is important for the development of a healthy immune system and lungs in utero. When expectant mothers increased their intake of D3, a decreased risk of asthma in 40% of children between the ages of 3 and 5 was observed. Vitamin D3 is important for bones and teeth development. Recommended dose: 400-1000 IU daily.
Vitamin E does thin the blood, so your naturopathic doctor or MD will note to monitor the dose. This vitamin helps with the formation of cells and is used as an antioxidant.
Important for making the components that develop into blood clots.
Decreases risk of low birth weight (especially in malnourished women). Zinc important for protein synthesis and nucleic acid metabolism, and RNA. This nutrient may prevent congenital malformations. Recommended dose: 10-25mg/day.
Expecting mothers require more to meet the demands of fetal needs. Maternal thyroid hormone decreases slightly during the first trimester to meet the needs of the fetal thyroid hormone and to make up for the increased excretion. Too much or too little iodine may contribute to the development of congenital hypothyroidism.
Important for the development of the skeleton, tissues, and hormones. Usually given up to 1000 mg daily.
Magnesium is required for building body tissues and preventing the uterus from contracting prematurely. 500 mg daily.
Iron is imperative for hemoglobin production and is sourced from our diets (red meats and plant sources such as dark green leafy vegetables. Hemoglobin carries oxygen in the blood for all of the tissues in the body throughout life. The growing fetus accumulates iron from their mother, who then experiences a decrease in her own iron stores. Iron-deficiency anemia is pretty common in pregnancy for this reason and these women may have a desire to chew on ice. Ferrous fumarate is a form of iron that is commonly used in over-the-counter prenatal vitamins however, it is not very well tolerated by the GI system. Some iron supplements like ferrous fumarate and succinate tend to also cause or worsen constipation. The most bio-available form of iron is iron glycinate.
Speak to your naturopath about how much iron is right for you.
Omegas and Essential Fatty Acids
DHA (an essential fatty acid) is important for the development of the brain and nervous tissue which is most significant from the 3rd trimester to the first 3 months of breastfeeding and early childhood.
Working with the naturopath:
Pregnancy is an exciting and overwhelming time for most women so choosing the right prenatal vitamin shouldn’t be. While there are a lot of options out there, I focus on selecting vitamins that specifically provide therapeutic doses to best support the health of mama and baby throughout all stages of pregnancy. (Not all vitamins are created equal and it’s important to keep in mind that some may cause more harm than good).
As a naturopathic doctor, I always ensure that my patients are up to date and aware of which vitamins and supplements they should (or should not) be on, what lifestyle factors and other wellness habits can improve their health outcomes, and any other naturopathic modalities might best support them.
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