Vegetarian & Vegan Diets During Pregnancy in the United States: A Brief History

Beth’s daughters, picking potatoes

— by Faith Groesbeck

Some social scientists believe that human evolution is closely linked to the need for animal protein to meet the nutritional needs of gestating a primate with a very large brain. The nutritional requirements of humans during pregnancy has been studied over time as they relate to nearly every complication of maternal and infant health. Perhaps due to our origins as hunters and gatherers, vegetarian and vegan diets have received a lot of scrutiny as being unnatural and harmful.

The Western history of dietary recommendations during pregnancy has swung like a pendulum of extremes from starvation to overeating and for the moment has landed in the middle. In the 19th C., when maternal mortality was high and cesareans were life-threatening, pregnant people were cautioned not to overeat to prevent large babies. Starting in the 1920’s, maternal weight gain was recorded at every prenatal visit. As late as 1974, text books advised women to gain no more than 25 pounds during pregnancy.

Then, in 1977, Dr. Thomas and Gail Brewer published What Every Pregnant Woman Should Know. Their research showed that preeclampsia was the result of protein deficiency. Subsequently, they advocated for a diet containing at least 100 grams of protein per day. They provided lists of food combinations to obtain “complete” protein that were difficult to comply with for vegetarians and nearly impossible for vegans.

Although researchers who followed were unable to replicate their studies, their teachings became very popular among healthcare providers. The Bradley Method and Childbirth Education Association of Metropolitan New York, where I received my training, both advocated the Brewer Diet for many years. Despite the lack of evidence, many providers believe that a vegetarian diet is dangerous during pregnancy. In fact, I was eating a vegan diet when I became pregnant for my son in 1997 and was advised by my midwife to at least eat canned salmon with the bones!

I had been influenced by books like Diet for a New America, written in 1987. That book’s popularity was followed by the low-carb craze and the Atkin’s Diet. I was working for Dr. Ronald Hoffman at the Hoffman Center for Holistic Medicine in Manhattan in the mid-1990’s. Dr. Hoffman promoted his own diet, the Salad and Salmon Diet, which was a little less extreme, but still focused on increasing lean protein.

Today, the pendulum has swung back again toward a plant-based diet. Thanks in part to the many documentaries in recent years that explore the negative environmental and health consequences of meat consumption, more people in the United States identify as vegetarian or vegan than ever before. Not surprisingly, many of my clients abstain from meat during pregnancy. Unsure of the most current research, I decided to explore the issue to learn the health impact of vegetarian and vegan pregnancies.

I found a systematic review, published in the British Journal of Obstetrics and Gynecology in 2015, that got me up-to-date and answered my questions. What they found was that studies finding poor outcomes in pregnancy did not always distinguish between those that were vegetarian by choice and those whose circumstances forced it upon them. It also found that, over time, in developed countries, food options for vegans and vegetarians have improved, making it easier to eat a well-rounded meat-free diet during pregnancy. Other than cautioning vegetarians to pay some attention to preventing iron-deficiency anemia and B12 deficiency, they could find no other concerns.

Although I’m no longer a vegetarian or vegan, I am a conscious eater and appreciate those who also eat conscientiously in regards to their own health or that of the planet’s. I can provide herbal teas for my vegetarian and vegan clients to boost their intake of minerals, including iron. I can easily modify my lactation cookie recipe by substituting for eggs and butter. Since educating myself, I can also affirm the health of a vegetarian and vegan diet during pregnancy.

How about you – were you vegan or vegetarian during your pregnancies? Did you feel supported by your community and providers? Please share your stories!

Bibliography:

“3 Historical Trends in Clinical Practice, Maternal Nutritional Status, and the Course and Outcome of Pregnancy.” Nutrition During Pregnancy: Part I: Weight Gain, Part II: Nutrient Supplements. Washington, DC: The National Academies Press, 1990 .

Brewer, Gail Sforza. What every pregnant woman should know: the truth about diets and drugs in pregnancy. Random House, 1977.

Milton, Katharine. “The critical role played by animal source foods in human (Homo) evolution.” The Journal of nutrition 133.11 (2003): 3886S-3892S.

Piccoli, G. B., et al. “Vegan–vegetarian diets in pregnancy: danger or panacea? A systematic narrative review.” BJOG: An International Journal of Obstetrics & Gynaecology 122.5 (2015): 623-633.

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