the pros of protein in pregnancy

While I love my job as a domestic engineer, I also feel blessed beyond measure to have a part-time job that I find both rewarding and fulfilling. Teaching childbirth classes for the past seven years has been a real gift and has caused me to learn so much while meeting great people and helping–even in some small way–their journey to parenthood.

One of the things I learned when I was first pregnant (more than 13 years ago now….but that’s for a different post altogether) was that pregnant women need to consume protein–usually 75 to 100g per day. I knew that protein is needed to construct a new person and the tissue that goes along with him or her and that protein deficiency can at times lead to the leading known cause of premature births: pre-eclampsia. But even with reading and studying, I could never seem to make the connection as to why the two went together. When pre-eclampsia came up in students, and even students who seemed to have an excellent overall diet, it baffled me. I came to understand that some women have pre-existing conditions or underlying medical issues that are either exacerbated or revealed during pregnancy, but even then, if their diet is better than just good, they can delay the onset of symptoms of pre-eclampsia.   And delaying the onset, resulting in allowing a baby to grow in utero for 36 or 37 weeks as opposed to 32, 33, or even 34 weeks makes a tremendous difference in those first days–and weeks–of life.

It wasn’t until earlier this class seires, however, that certain pieces of the puzzle seemed to fall into place. I get it. FINALLY.

When a woman is pregnant, her body’s main job is to protect the pregnancy and nourish the baby. In order to do that, her blood volume needs to increase by about 50%.  To achieve this extra blood volume, the liver makes a substance called albumin that has the job of pulling extra fluid out of the tissues of the body and into the bloodstream. Salt also helps to move the fluid from tissue to bloodstream through osmotic pressure. The key to this whole equation: albumin can only be manufactured through protein intake by mom. If a pregnant mom has either inadequate salt or protein intake, her blood volume begins to decrease in as little as two weeks. When blood volume drops, a condition called hypovolemia, the body goes into “protect mode” and changes begin to happen in ways similar (but not usually to the same degree) to when someone is hemorrhaging because basically, the body can’t discern the cause for the drop in blood volume, i.e., a true problem or just as a result of the mother eating less.  This process goes something like this:  the body must preserve the internal organs–at the expense of the limbs, if necessary, so the kidneys begin to produce renin, an enzyme which causes blood vessels to constrict.  Obviously, if the mother were actually hemorrhaging, this would be crucial in preserving the internal organs and the mother as a whole while waiting for assistance in halting the hemorrhage.   When hemorrhaging isn’t actually occurring in the pregnancy, however, these measures of constricting blood vessels result in an increase in mom’s blood pressure.  The usual treatment of salt restriction, weight restriction, or activity restriction only worsens the problem by causing the blood volume to drop even more….which continues the cycle of increased renin production and constriction.  Consequently, blood pressure numbers will continue to climb.

While this is happening, the kidneys are still working to increase blood volume by reabsorbing as much of the water and salt from the fluid that has already been filtered out of the blood, and returning it to circulating blood.  But since albumin is responsible for 75 – 80 % of osmotic pressure, and albumin and salt levels are dismally low, much of this reaborbsed can’t help but seep back into the tissues.  Thus begins the vicious cycle of the kidneys trying to keep (and reabsorb) what it has already filtered, and the fluid seeping out at the capillary level.  This is why the mother sees rapid swelling in her ankles, hands, and or face, and unusual weight gain.  When bedrest and the other measures are not successful, many times induction is attempted, often resulting in either a prematurely born baby, and hosts of other problems that come along with a baby being born before its time.

Certainly, since I’m not medically trained, I don’t know everything (or pretend to know everything) related to the subject.  The intricacies of the disease are still being studied, though I am slightly disappointed and disturbed at how the medical community seems to repeatedly ignore these facts and still recommend restricted salt and caloric intake when the problem arises.  When my  mom was pregnant with her first child (although that was over 40 years ago and things have changed tremendously since then), she was told to cut out salt completely from her diet!  It’s a wonder any of us made it (though it does explain a lot about my older brother now, ha ha).   So what is the lesson in all of this? In my humble opinion, since there are no known side effects to consciously trying to consume 75-100g of protein a day, why wouldn’t you?  In my classes, I gather different types of food to show how easy it is to ensure that the pregnant mama reaches her daily goal.  There are some instances that make this more difficult, such as allergies and preferences, but under most circumstances it is not difficult to achieve that number; many times moms are already eating that much and just haven’t paid attention. 

An added benefit of consuming protein is that during pregnancy, the body creates a strong amniotic sac, the two-layered membrane that surrounds the baby in the uterus.  Keeping this sac intact throughout the pregnancy (obviously) and even throughout the labor has numerous benefits to both mom and baby.  In labor, mom has more time to labor if the water hasn’t broken, more options available to her, and is usually more comfortable overall.   Contrary to movies and television, the water does not break at the onset of labor, but if left alone stays intact until around 8cm or beyond.  There are many benefits of allowing that sac to break on its own that I won’t go into here.  (Anecdotally, over the years, my students have independently reported back to me that if they had to have their water broken that the OB or midwife commented on how strong it was.   We refer to them as “Bradley bags of steel”!)  The longer I teach, the more I see that having little or no  time restrictions placed on a mother in labor allows them to navigate her unique birthing experience.  Once the sac is ruptured, some sort of time limit is automatically placed over the remainder of the labor. 

My best advice to pregnant moms is that they strive to eat between 75-100g of protein every day through a variety of whole food choices, including milk, eggs, meat, fish, beans, dairy, nuts and veggies.  In addition to other important elements of a healthy diet, it will help in growing a healthy baby and nourishing a pregnancy.  Studies suggest that adequate protein intake also helps in brain growth, so you could have a future scholarship recipient on your hands!  And who wouldn’t want a brainiac baby? 

Please pass the cheesy eggs.

**Important medical disclaimer** I wish you to know that I do not possess any medical qualifications in the subjects presented here. The information results from my own experience, or experiences I have studied. The reader is therefore personally responsible for ensuring the safe application of anything described herein.  This should not be substituted for the knowledge and/or advice of your medical caregiver.  Underlying medical conditions may make these suggestions contrary to your situation and as such should be seen in light of that.  In other words,  having six babies does not automatically make me an expert in your pregnancy!

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