One of the questions that I am most frequently asked by women with PCOS who are finally pregnant is, “How should my diet change now that I’m pregnant?” I can totally understand the need to ask the question. It’s taken forever to fall pregnant and now that you are, you want to do everything within your power to nurture your little bean so that 9 months down the line you’ll have a beautiful, crying sleeping miracle baby in your arms.
So, I’m going to give you some information based on my own experiences and some of the research that I have done. But before I do, I just want to remind you that I am not a doctor and if you have any questions at all about your diet or pregnancy, you need to speak to your doctor.
Why diet is so important in pregnancy?
Diet is crucial for any woman who is pregnant, whether they have Polycystic Ovarian Syndromeor not. Your body provides all of the nutrients needed for that little life to grow and develop. You need to make sure that you create just the right environment for your little one to thrive. This role will not end in pregnancy but will carry on until your little one is not so little any more.
How does PCOS impact on your Pregnancy?
I’m sure you’ve done the research on the potential pregnancy complications when living with PCOS. I’m going to break it down for you but I must warn you that it doesn’t make for happy reading. There is some hope, though. You don’t have to suffer from any of the complications and both of my pregnancies were wonderful with no complications at all. So, here goes:
Gestational Diabetes:
This is the type of Diabetes that is diagnosed whilst you are pregnant and often goes away once the baby has been born. It is often treated through diet and exercise or with medication if needed (1).
Preeclampsia:
This is when your blood pressure is too high, particularly after the 20th week of pregnancy. It can impact on your kidneys and other organs and symptoms include: sudden increased swelling in hands and feet, headache and increase in blood pressure (2).
Premature birth:
Many women with PCOS also have babies born pre term (mine were both 2 weeks late).
So, as I said, that’s doesn’t make for happy reading. You’ve waited to long for this little one and now you could be faced with a rocky pregnancy. Well, there’s good news and this is not the end of the story.
PCOS may not be the cause
One really interesting piece of research I came across is one that compared women with PCOS and those without but they matched age and weight as well (3). What the research showed is that many of the above complications may not be directly linked to PCOS but rather to the women’s weight. Being overweight leads to all of these complications as well. Women with PCOS who were lean, did not suffer from these complications.
So, there’s even more reason to get your PCOS symptoms and weight under control before you get pregnant.
Okay, so you’ve fought long and hard for this baby. Now, how can you give them the best possible start by eating well?
Your Diet During Pregnancy
As we have already said, your diet is crucial during pregnancy and your PCOS still plays a role and needs to be considered. There are a couple of elements that need to be considered.
Calories
If you are overweight with PCOS and have been following some kind of calorie controlled diet prior to falling pregnant, you may have some questions about how many calories you need. Well, you may be eating for two but that doesn’t mean you need twice the calories. If you are a healthy weight, you don’t need to have any extra calories during the first trimester, about 300 extra calories per day in the second trimester and 500 calories in the final trimester. Both you and your baby need the energy and calories for all of the growth that is taking place (4).
Protein
Your protein intake also increases slightly during pregnancy. The type of protein you eat is also really important. You want to aim for good quality protein. If you’re eating animal proteins, the best type of meat to go for is grass fed organic meat. It is more expensive but it is the healthiest type of meat. If you can’t afford it or can’t get access to it, try for organic meat.
Also, oily fish like salmon are a good source of protein as well as Omega 3 so try to incorporate it into your diet. One serving a week is fine. Be careful of shellfish, marlin and swordfish.
Another huge advantage of having good quality animal protein is that it is also a good source of iron and will help to avoid anemia which is often prevalent during later pregnancy.
Fats and Lipids
Fats are really important for our own hormone health, as well as the growth of your baby. Your baby’s brain and neurological system is made largely of lipids and it is also essential for the development of the eyes (4). It’s really important that you eat good healthy fats from sources like avocados, nuts, coconut oil or milk and eggs. You should also think about taking an Omega 3 supplement.
Carbohydrates
The standard recommendations for healthy women is 170g per day of carbohydrates during your pregnancy (4). If you have been following a PCOS Diet that is relatively low carbohydrate, you should think about increasing the amount of carbs you have per day.
Just a word of caution. Your PCOS is still very real even if you are pregnant and your body still has difficulty processing carbohydrates so you need to make sure that you are making good decisions in terms of the types of carbs you are eating. Having carbohydrates with a low glycemic load is still crucial when you are pregnant. You could get your daily carbohydrate requirement from healthy vegetables or gluten free sources of grains and legumes. Some of these include beans, brown rice, quinoa, lentils. I would still recommend avoiding refined carbohydrates like pasta, white breads and pastries.
A Word on Dairy
We know that dairy should be avoided as part of our PCOS diet (see this article for more on why). However, during pregnancy women are prone to candida and yeast infections. During my last pregnancy I had thrush for 8 weeks and it really wasn’t pleasant! One way to combat this is by making sure you’re having good probiotic yoghurt. I frequently had greek yoghurt with a little bit of honey to ward off these infections. The fermenting process destroys some of the unhelpful IGF-1 so it is fairly safe for PCOS. Also, try to make sure you have an organic yoghurt.
Supplements
Supplements are also an essential aspect to a healthy pregnancy. You should check with your doctor to make sure that you are taking the correct doses and types of supplements. These are the supplements that I took during my pregnancy:
- Prenatal Vitamins – Prenatal vitamins give you most of the vitamins you will need during your pregnancy but the should not replace a healthy diet.
- Omega 3 – I was taking Omega 3 prior to falling pregnant as it in an important supplement for women with PCOS. This can be continued during pregnancy.
- Vitamin D – Vitamin D is an important vitamin for women with PCOS and this continues during pregnancy. There are many advantages to supplementing with Vitamin D during pregnancy, including: lower risk of postnatal depression, decrease in insulin resistance during pregnancy, improved Apgar score at birth, stronger muscles for baby (5). The Vitamin D council recommends taking 4000-6000 IU per day for pregnant women (6). I’m sure that is much higher than what is provided for in your prenatal supplements!
- Inositol – Inositol is a vital supplement for women with PCOS. Research has shown that it lowers miscarriage rates in women with PCOS and improves fertility. Some research suggests that it is safe to continue to take 4000mg per day for the duration of your pregnancy (7). It’s use while breastfeeding has not been safely determined so I stopped taking it while breastfeeding. You should be getting your 400mcg of folic acid with your prenatal multivitamin so there is no need to take additional folic acid with your Inositol.
Summing it Up
So, let’s sum up your new PCOS pregnancy diet.
- Firstly, your risk of pregnancy complications is related to your pre pregnancy weight, not necessarily your PCOS. So, getting pregnant at a healthy weight is recommended. If you’re struggling to lose weight with your PCOS, why not check out our monthly meal plans to help you reach your pregnancy weight goals?
- Your daily caloric needs do go up during the course of your pregnancy, particularly in the second and third trimesters.
- You should make sure that you are following a healthy diet of whole foods with unrefined, foods. Avoid processed, sugary foods and focus on foods that will give your little one all of the nutrition it needs to grow healthy. You still need to watch your carb intake and make sure that you’re eating carbs with a low glycemic load to manage your insulin and testosterone levels.
- Your supplements continue to play an important role in your PCOS diet and you should keep taking them.
If you are pregnant while you’re reading this, I wish you the most magical pregnancy! If you’re still waiting for your little miracle, I wish you a very short wait. If you’re holding your little miracle, I wish you all the joy that motherhood entails!
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