The Safety of Vegetarian Diets During Pregnancy

Benefits and drawbacks of vegetarianism

Vegetarian diets have become increasingly popular over the years due to its health benefits. For example, vegan diets have shown beneficial aspects like reducing the chance of developing cardiovascular disease and diabetes [1]. Although there are benefits, a vegetarian diet during pregnancy is a debated topics for quite a few reasons. A recent systemic review of vegetarian diets during pregnancy, showed that data around this topic can be scarce and inconsistent[2]. Some studies show benefits, while others discourage this type of diet in fear of nutrient deficiencies and impact on fetal development [3]. Nutrients such as vitamins, minerals, proteins and water are necessary all throughout pregnancy[4]. Certain individuals who follow a vegetarian diet can be lacking in some of these nutrients. Specifically, vegetarians can be lacking in vitamin B, vitamin D, iron and omega 3 fatty acids, which would normally be gained through meat products[4].  Therefore, these nutrients need to be supplemented with alternative options. For example, soymilks and meat substitutes can assist with a vegetarians intake of substances like B12 and calcium[4].  If an individual on a vegetarian diet is not educated on what types of nutrients a growing fetus needs, this could be detrimental to the growing baby. Although there is varying research, a vegetarian diet is has not been seen to be exclusively beneficial to a mother and child.     
One of the important substances needed during pregnancy is iron[5]. As the fetus develops the mothers blood volume expands, and the demand for iron increases[6].  Lower maternal gestational iron is associated with several issues ranging from low birth weight to abnormal brain structure[6]. A vegetarian diet leaves the mother and child particularly vulnerable to having iron deficiency [1]. In terms of economics, in lower resourced countries plant based diets tend to be more affordable and obtainable [5]. Generally speaking if all the nutritional requirements are still being met through supplements and a well varied plant diet, the pregnancy should not see many clinical issues [5]. Access to lab testing and medical care must be readily available, which is often not the case in underdeveloped countries.  Therefore, many individuals may have certain deficiencies like iron and are unaware, or do not have access to the resources to supplement these deficiencies.
One tactic that can be extremely beneficial for those who have access to it, is a nutrient analysis. This analysis would have the individual record of their exact food intake for a certain period of time[4]. Since every vegetarian diet is unique this would give the provider better insight into what kind of supplements the person needs. Additionally, the age of the mother and overall health status must be taken into consideration because that will affect how much of each nutrient the individual needs[4]. As the bible says “for it was You who created my inward parts; you knit me together in my mother’s womb. I will praise You because I have been fearfully and wonderfully made” Psalm 139:14. We are all made fearfully, wonderfully and uniquely. This shines a light on the importance of individualized care, especially in diet/lifestyle during pregnancy.

Nutrient deficiencies in vegetarian pregnancies

One of the most important considerations to analyze when assessing the health and nutrition of a women during pregnancy is that not all women have the same needs during pregnancy. Some women are capable of maintaining a vegetarian diet during pregnancy, while also sustaining a healthy pregnancy.  Judith Brown and her colleagues consider a healthy diet as one that “provides adequate amounts of energy, essential nutrients, and fiber and also provides anti-inflammatory properties and lowers the risk of chronic disease.”1  It is possible to meet these requirements while following a vegetarian diet during pregnancy.1  
Pregnancy requires an increased amount of energy intake and an increased intake of some important vitamins and minerals.1 These vitamins and minerals include folate, choline, vitamin A, vitamin D, calcium, fluoride, and iron.1 A carefully managed vegetarian diet can support all of these increased needs.1 However, there are some nutrients that vegetarians need to be cautious of consuming in adequate amounts. These nutrients include vitamin B12, vitamin D and the omega-3 fatty acids.1 These nutrients typically come from animal products that vegetarians do not consume.1 Women who are able to increase the intake of these nutrients and continue to meet their needs for all other nutrients, while also increasing energy intake through a carefully planned vegetarian diet should be able to maintain a healthy pregnancy.1 Some ways to ensure that a vegetarian diet remains sufficient during pregnancy is to incorporate plant based protein options that are complementary.1 Most plant protein products do not contain all of the proteins that animal protein products include, so consuming multiple plant sources that complement each other are necassary.1 For example, legumes can be consumed with grains in order to achieve the same nutrient balance of other animal options.1 Vegetarian diets that also avoid fish products can be safe as long as analysis is given to the amount of omega-3 fatty acids consumed.1 In addition, vegan diets can be safe with careful consideration to what is lost by refraining from dairy and other animal products.2 
There is some debate about whether a vegetarian diet is safe during pregnancy because the diet is impacting both the health of the mother and the health of the baby. There has been conflicting research about the safety of vegetarian and even vegan diets during pregnancy.3 Some evidence supports that it is not only acceptable, but may also be better for pregnant women.3 Previous research suggest that vegetarian or vegan diets may contribute to pre-eclampsia or major birth defects due to vitamin B12 and iron deficiencies.3 However, a systematic empirical review led to a different conclusion that suggests that none of the studies reported any adverse maternal or fetal outcomes due to vegetarian or vegan diets.3 One of the studies reviewed suggested that there may even be a protective effect of pre-eclampsia when women avoid animal products.3 Overall, this research concluded that vegetarian, vegan, and omnivorous pregnancy outcomes were very closely related, as long as the diet options were a result of choice and not a result of environmental factors such as poverty.1 This may suggest that consideration should also be given to the economic status of vegetarian women during pregnancy. Although there are plenty of options available in grocery stores that help serve the needs of a vegetarians, low socioeconomic status women may not have access to these options.2 Age may also contribute to the options available.2 
In conclusion, vegetarian diets can provide all of the energy and nutrients that other diets provide with careful analysis and consideration. Women that choose to refrain from eating meat can have healthy and safe pregnancies. However, vegetarian diets may need to be abandoned when needs are not being met. We can also look towards 1 Corinthians 10:31, So, whether you eat or drink, or whatever you do, do all to the glory of God.