You can keep a vegan diet and have a healthy pregnancy. However, a vegan diet does put you at risk for some nutrient deficiencies, which may harm your baby if left unchecked, and could impact your fertility when trying to conceive.
Overview
About 5% of people in the United States identify themselves as vegetarians. A smaller (but still significant) 2% of people consider themselves vegans. That’s an estimated 6 million vegans. Vegetarians abstain from meat, but may still eat eggs or dairy products. Vegans, on the other hand, avoid all animal products. Being aware of the nutritional challenges of a vegan diet, remaining open to supplementation and possible diet tweaks, and carefully monitoring what you eat are the keys to successfully combining veganism with fertility and pregnancy.
Potential Risks
The good news is that neither a vegetarian diet nor a vegan diet has been shown to increase any serious pregnancy complications or increase the risk of severe birth defects, as long as any B-12 and iron-deficiency anemia are monitored and corrected.
B-12 Deficiency
That said, those who don’t address these potential nutrient deficits may be at an increased risk of pregnancy complications and birth defects. B-12 deficiency during pregnancy may increase the risk of neural tube birth defects and may possibly lead to cognitive impairments. (More on this below.)
Anemia
Anemia during pregnancy is common, even among those who do consume animal products. Vegans are at a much-increased risk of developing anemia. Anemia can increase your risk of pre-term birth, having a low-birth-weight baby, or having a child with cognitive or developmental delays.
Nutritional Deficits
Another possible (but not direct) concern to be aware of with a vegan diet is that sometimes, veganism goes hand-in-hand with other restrictive dietary habits. Whether it’s veganism combined with raw-foodism, a macrobiotic diet, or some other further-narrowing of your food options, these all increase the risk of nutritional or calorie deficits. If you are vegan and have other dietary restrictions, it’s extremely important you meet with a dietitian.
Why B-12 Is Important
B-12 is difficult (to impossible) to get on a vegan diet. B-12 is only available from animal sources. For vegans, this means supplementation and eating fortified foods. Vegetarians may be able to get enough B-12 from dairy and eggs, but supplements are still usually suggested. You probably know that folate (folic acid), another B-vitamin, plays a vital role in the development of the fetal brain and spinal cord. Much of these developments occur very early in the pregnancy, possibly before a woman even realizes she has conceived. According to the World Health Organization, low B-12 levels may increase the risk of neural tube birth defects.
Consequences
Also, babies and young children who have B-12 deficiencies may suffer long-term consequences. This may include developmental delays, decreased cognitive function, and poorer school performance. Some research has found these children may never fully recover from the damage done. This is why it’s important all women of childbearing age get enough folate and B-12 in their diet. Folate comes from eating dark leafy greens, asparagus, broccoli, and beans, and lentils. A healthy vegan diet should be rich in these foods. To get enough B-12, a supplement will be needed. You may get enough from a prenatal, or your doctor may recommend a separate or additional B-complex or B-12 supplement. Talk to your gynecologist about your best options.
Avoiding Iron-Deficiency Anemia
As mentioned above, another nutritional risk with a vegan or vegetarian diet is developing iron-deficiency anemia. When trying to conceive, anemia may increase your risk of experiencing ovulation problems and infertility. Anemia during pregnancy can cause problems for the mother and child. “It is very common for women to experience anemia during pregnancy,” explained Yaffi Lvova, a registered dietician. “This is more of a concern in the vegetarian and vegan populations since the [non-heme] iron consumed in the plant-based diet is not absorbed as efficiently as heme iron (iron from an animal source).” There are plant-based sources of iron. But as Lvova explains, the form of the iron matters. Plant sources of iron are non-heme iron. The body doesn’t use this form of iron as efficiently as animal-sourced heme iron.
What to Eat
To decrease your risk of developing anemia as a vegan, you’ll want to include foods high in the non-heme iron in your daily diet and eat foods high in vitamin C at the same meal. Combining vitamin C with iron-rich foods helps with iron absorption. Plant-based foods that are high in iron include:
Fortified cerealsBeansLentilsNuts and seedsDried fruitDark leafy greensQuinoaMolassesPeanut butterBrown riceTofu
For your vitamin C foods, consider enjoying your iron-plant foods along with:
A glass of orange juiceStrawberriesPineappleBrussels sproutsKiwiYellow bell pepper
Your doctor should closely monitor your iron and anemia risk with regular blood testing during pregnancy. But you should also be on the lookout for signs of a deficiency. “Signs and symptoms of iron-deficiency anemia include fatigue and weakness, shortness of breath, pale or yellow skin, lightheadedness, cold hand and feet, and headache,” explains Lvova.
Other Needed Nutrients
Studying diet is complicated. We know that nutrient deficiencies like low B-12, folate, and iron can cause serious adverse effects. But we don’t really know the full impact of other nutrient deficiencies, especially when it comes to veganism and vegetarianism. There just isn’t enough specific research. We do know that a poor diet during pregnancy (regardless of whether the mother eats animal products or not) can impact a child’s long-term health. But exactly how and why is difficult to pinpoint. Below are the nutrients or elements that vegans may struggle to get without additional effort or supplementation.
Protein
There are plenty of vegan sources of protein, including beans, lentils, and whole grains. The problem isn’t that you can’t get enough protein with a vegan diet, but that if you’re not careful and paying attention, you could easily fail to meet your nutritional requirements. For a singleton pregnancy, you need 71 grams of protein daily. The best way to be sure you’re getting enough is to take a couple of weeks to measure and write down your food intake. Many dieting apps can help you with this. Then, you’ll know if your protein needs are being met or not. “Protein needs certainly can be met with a vegetarian or vegan diet,” explains Lvova. “But when those needs reach up near 100 grams per day for a twin pregnancy, nutrition may need to be tracked to ensure a healthy mother and child.” It’s also a good idea to be on the lookout for signs of not getting enough protein. “If a woman is low in protein, she may experience fatigue, poor concentration, mood swings, poor wound healing, among other symptoms,” says Lvova.
Vitamin D
The best nutritional sources for vitamin D are fatty fish (cod, salmon, sardines) and egg yolks. Vitamin D is also commonly found in fortified milk, including alternative milk like almond and soy. But not all alternative milks have significant levels of vitamin D. Low vitamin D levels have been associated with infertility in some studies. Some research has found that women with higher levels of vitamin D were more likely to have IVF pregnancy success. During pregnancy, vitamin D is essential for your baby’s healthy bone development. Vitamin D deficiency is associated with an increased risk of preeclampsia. Vegans may struggle to get enough food-based vitamin D, and therefore should be sure to get regular sun exposure and may require a supplement. Talk to your doctor about what’s best for you.
Calcium
The majority of the non-vegan population gets their calcium needs primarily from dairy products. It is, however, possible to get calcium from plant sources. It just requires careful meal planning (and including a good amount of these foods). Research has found that women who include many dairy products in their diet were less likely to have endometriosis and less likely to have problems with ovulation. During pregnancy, calcium is extremely important for the development of your child’s bones and teeth. Plant-based foods rich in calcium include fortified alternative milk, pinto, red, and white beans, bok choy, broccoli, kale, spinach, and sweet potatoes.
Zinc
Meat and seafood have the highest sources of zinc, but you can get zinc from plant-based sources. Zinc is vital for male fertility. Low zinc can cause low sperm count and hormonal imbalances. Zinc has also been found to boost IVF success when couples in treatment took supplements. Not getting enough zinc during pregnancy can lead to poor fetal development, increase the risks of infection (which may increase the risk of premature labor), and cause low birth weight. Possible plant-based foods rich in zinc include beans, nuts, seeds, oatmeal, and fortified cereals. One additional problem for vegans is that zinc absorption can be inhibited by foods high in phytates. This includes grains, nuts, and potatoes, all popular vegan foods and (some) sources of zinc. Because of this, vegans may need to aim for a higher intake of total zinc than non-vegans.
Omega-3’s
The number one source for omega-3s is fish, which is not a good option for vegans or vegetarians. Omega-3s, DHA, and EPA are essential for brain health. Research on mice has found that omega-3 fatty acids may play a role in both male and female fertility, but these effects haven’t yet been found in human research. During pregnancy, increased intake of omega-3s, EPA, and DHA decrease the risk of premature labor, improve birth weight, and lower the risk of preeclampsia. It’s also possible that omegas play a role in the development of the fetal brain. After pregnancy, low levels of omega-3s can increase the risk of postpartum depression. Omega-3s in the mother’s diet are essential during breastfeeding, too. Babies whose mothers got good levels of omega-3s had improved visual and cognitive development, and possibly may be at a lower risk of developing allergies. Nut and seed oils are often recommended options for vegans, but studies have found that they don’t always convert properly in the body. The ideal vegan omega supplement appears to be microalgae oil. This can be expensive, but well worth the health benefits.
Iodine
Iodine is primarily found in seafood and dairy products. Studies have found that most vegetarians get enough iodine, but vegans are at risk for deficiency. During pregnancy, not getting enough iodine can negatively impact fetal brain development. Vegans should be sure to use iodized salt, and they may need a supplement. However, because too much iodine can be a problem, it’s best to talk to your doctor before supplementing.
Steer Clear of the Unhealthy Vegan Route
Many people assume that a vegan or vegetarian diet is going to automatically be a healthy one. After all, the root of both words is vegetable. This isn’t always the case. In order to get enough calories, vegans and vegetarians may find themselves eating refined bread and pasta. In regard to packaged carbs and overly refined grain products, Dr. Anita Sadaty says, “In addition to being nutrient-poor, [these kinds of foods] may raise the risk of gestational diabetes.” The solution? Careful attention to diet. Making an extra effort to include whole grains, plenty of vegetables, and healthy vegan-proteins like beans, nuts, and lentils. Just being aware that “vegan” doesn’t automatically mean “healthy” can help you remember to make more nutritional choices.
A Word From Verywell
A vegetarian diet has many positive benefits, including decreasing your risk of high blood pressure, heart disease, metabolic syndrome, and some cancers. Vegetarians also tend to be at a healthier weight. Eating plenty of vegetables, healthy whole grains, and fruits are likely to benefit any pregnancy and trying to conceive efforts. “The healthcare team should always be aware of anything that may affect conception and pregnancy, including choice of diet, any nutritional or medical supplements—even all-natural supplements such as herbs and homeopathic remedies,” says Lvova. People choose a vegan diet for a variety of reasons. In some situations, vegans or vegetarians may choose to loosen their dietary restrictions just while trying to conceive or during pregnancy. This may mean including a little fish (pescetarianism) or some animal products, or even adding some meat occasionally, to their diet. “Even including a small amount of animal protein in the diet will increase the absorption and use of iron and other micronutrients—even improving the absorption of iron from non-animal sources, which will help to improve health while trying to conceive and during pregnancy,” says Lvova. If you choose to remain vegan while trying to conceive and during pregnancy, it’s highly recommended you also consult with a dietitian, who can help you get what you and your baby need.
