If you knew there was something you could do to decrease your chances of experiencing birth complications and at the same time increase the likelihood of having a healthy, happy baby, would you be willing to do it? I’m betting you would. Our health care providers are there as a safety net in the event that things go sideways, but it’s in our best interest to take matters into our own hands first to try to avoid needing to employ those rescue services. As parents, we do have some agency to influence outcomes and I’m a big believer in looking out for yourself and your family. When you have a goal of a healthy baby, a healthy mama and a healthy birth, you can’t wait for someone else to do that for you. You gotta take the reins.
So, what’s the magic secret that can help you achieve your best birth outcome? It’s quite simple - the quality and quantity of what you eat everyday. Eating food that meets the dietary needs for a healthy pregnancy is the single and most effective insurance policy for the health and well-being of you and your baby. Many pregnancy and birth complications can be avoided when mothers and their partners are made aware of what they can do in this area of their lives.
Midwives in the out-of-hospital setting often spend time going over nutrition with their clients because they know that this element plays a direct role in keeping the mama and baby in the low-risk category and increases the odds of a natural birth. Obstetricians (a.k.a OB’s), on the other hand, don’t usually pay too much attention to the role of nutrition in preventing the complications of pregnancy. Many of the families who come to my Bradley Method® classes are planning to give birth in the hospital setting with an OB and they are usually quite surprised when they fill out the nutrition tracking sheet and compare it to the nutritional guidelines we cover in Class 2. In the Bradley Method®, we recommend following the Brewer Pregnancy Diet, which is actually more of a nutritional guideline rather than a specific “diet.”
The Brewer Pregnancy Diet is based on the work of Dr. Thomas Brewer, an obstetrician who practiced around the same time as Dr. Bradley. He started his career working in a community hospital where pregnant mothers (mostly low-income and adolescent women) were experiencing very high rates (32%) of pre-eclampsia (symptoms of high blood-pressure, swelling and excess levels of the protein albumin in the urine, which can lead to serious complications such placental abruption, seizures, coma and death). Presented with the suffering experienced by these mothers, Dr. Brewer felt compelled to find a solution to prevent these bad outcomes.
Delving deep into available research on possible causes and nutritional science (then in its infancy), Dr. Brewer discovered that talking with these mothers to find out what they were eating (and not eating) and then creating a simple guideline for them with daily minimums of food intake significantly increased the rates of healthy, full-term births and astonishingly lowered the rates of pre-eclampsia to nearly zero for the mothers who were under his care. (Dr. Brewer is attributed to have attended around 25,000 births in his career). Dr. Bradley, impressed with Dr. Brewer’s work, also advised pregnant mothers to implement the same nutritional advice and this helped them achieve a 95% unmedicated birth rate in his practice with similarly low rates of complications (nearly zero for pre-eclampsia). Dr. Bradley attended over 22,000 births during his time as a physician.
Both Dr. Bradley’s and Dr. Brewer’s combined success in helping pregnant women know what they could do to positively impact their experiences speaks volumes. Mothers need to know what is under their influence so they can have agency and confidence. It’s important to realize that being undernourished or having an inadequate or poor diet can lead to a number of undesirable consequences that might be preventable. Not eating well or enough increases the risk of the following complications:
Anemia (low iron in the blood which impacts the ability to fight infection; decreases strength and stamina available for the labor; increases the risk of hemorrhaging; negatively impacts development of the baby who is trying to develop their own stores of iron in the last three months of pregnancy)
Premature birth
Low birth weight
Intrauterine Growth Restriction (IUGR)
Pregnancy-induced hypertension
Pre-eclampsia, toxemia, HELLP Syndrome (these are variations of degree of the condition of pre-eclampsia).
Placental abruption
Prolonged or difficult labor
Cesarean birth
Birth defects and neurological dysfunction
Stillbirth
I know that’s a scary list to read, but you can lower your chances of experiencing those unwanted outcomes by taking positive action such as taking stock of what you eat and making nutrient rich food a priority. And remember, making something a priority doesn’t mean it needs to be perfect. There is no need to get stressed or start beating yourself up.
I personally think food and eating are fun and a great pleasure - I hope you do, too. Plus, we feel better when we eat well - every cell in our body relies on the building blocks from what we eat and when we don’t get what we need, we can suffer. When we are pregnant it’s even more important because we are sharing the resources from our food with our baby - who is growing from scratch. You want solid materials to build with - I mean, how do you grow an eyeball from a Cheeto?!
Pregnancy is normal and healthy - it’s something miraculous that we are designed to do as women. At the same time it’s a big load on our body. Eating well is tender loving care for each of us and our babies.
Let’s get to the heart of it. What comprises this amazing Brewer Pregnancy Diet?
The briefest summary of it goes as follows:
Getting enough calories (2600+)
Adequate protein intake (80-120 grams a day)
Salt to taste (don’t restrict salt).
Unrestricted weight gain
Would you like more specifics? Here we go.
As a means to help women achieve the aforementioned goalpost of a healthy, full term pregnancy and uncomplicated birth, Dr. Brewer created a
DAILY minimums checklist for food intake which consists of:
Protein Base: Total intake should be 80 -120 grams of protein rich foods. Some mamas (such as those pregnant with twins or if you are pregnant and still breastfeeding have increased needs - check out this guideline at Dr. Brewer Pregnancy Diet dot com). Protein provides the amino acids necessary for the building blocks of all cell growth and function.
The base consists of:
Dairy/milk products: 4 servings
Whole milk, low-fat milk, cheese, yogurt, cottage cheese, goat cheese, etc.
Milk is a whole food and provides protein, fats and minerals. In the American culture it's a major source of calcium as well as iodine. If you can't eat dairy, you will need to be savvy to cover the base milk products cover - almond milk alone is not going to cut it. Cultures that do not consume dairy generally include bone broth, seaweed and eating all parts of an animals not just the flesh to get a variety of nutrients. For most of us, including dairy products getting the calories and nutrients we need so much easier.
Avoid eating dairy with iron rich foods as calcium competes with iron absorption. I find dairy makes a great snack most of the time.
Eggs: 2 servings
Can be eaten straight cooked any style, or added to recipes, like a custard
This means eating the YOLK. Egg whites alone don't cut it. The yolk has an incredible the nutrients including choline and cholesterol, both of which are important for growing your baby's brain
Protein source: 6 - 8 1 oz portions (or 2 - 3 larger 3 - 4 oz portions)
Meats (beef, bison, pork, boar, etc.), poultry (chicken, turkey, wild game, etc), fish + seafood, beans + legumes, nuts, liver, etc.
Not all protein sources are created equal. Animal foods will give you the biggest bang for your buck (all the B vitamins and zinc; B12 can only be obtained naturally through animal foods including milk and dairy), but it's good to eat a variety of different types of sources here.
Avoid eating iron rich foods with dairy. The calcium in dairy competes with iron absorption.
Fresh leafy greens + green vegetables: 2 servings
Spinach, kale, collard greens, romaine lettuce, swiss chard, bok choy, etc.
Brocolli, cabbage, asparagus, brussel sprouts, etc.
Great source of necessary vitamins and minerals. Leafy greens also contain essential fatty acids. Generally, the darker the green, the higher the nutrient content.
Whole grains + starchy carbs: 4 + servings
The Brewer Pregnancy Diet website lists 5 servings; our Bradley Method materials list 4 (adding more if needed individually). I think anywhere from 3 - 5 makes sense for most regular, healthy women depending on how your individual body tolerates carbohydrates. Just not 0 for regular folks.
Whole grain cracker, whole grain bread (sprouted is great), quinoa, rice, kasha/buckweat, corn tortilla, etc.
I include starchy carbs here because some folks don't eat grains. So you can include potatoes, sweet potatoes in this category.
Vitamin C. rich foods: 2 servings
Berries, kiwi, grapefruit, oranges, lemons, peppers, cauliflower, cantaloupe, etc.
Needed for our immune system to fight off infection, help with iron absorption, tissue strength and integrity (important for birthing baby!) and strong bag of waters
Fats and oils: 3 servings
Butter, olive oil, coconut oil, avocado oil, cold-pressed vegetable oils, etc.
Important for fat soluble vitamins (like Vit D), healthy cell functioning, skin integrity and baby's growing brain.
Other vegetables/fruits: 1 serving
What's your pleasure? Bananas, dates, celery, green beans, peppers, onions, garlic - the list can go on and on. Parsley and herbs count, too.
Provides a variety of minerals and vitamins as well as important dietary fiber (let's keep those bowels moving!)
Orange/yellow pigmented foods for Vitamin A: 1 serving
Sweet potatoes, carrots, pumpkin, butternut squash, acorn squash peaches, cantaloupe, etc.
Provides precursor for Vitamin A as well as other vitamins
Salt to taste
Iodized salt, sea salt, specialty salts (ie. Pink Himalayan Salt), soy/tamari sauce, kelp power
Salt is an ESSENTIAL nutrient. You do not want to restrict salt intake in normal, healthy pregnant women. It is necessary for a protective and healthy increase in blood volume during pregnancy (more on this down below).
In addition, Dr. Brewer suggested to eat liver once a week
Liver is a powerhouse of nutrition - it has DHA, all the essential B-vitamins, highest amount of choline, zinc, Vit A in its most available form. Really everything necessary for pregnancy.
I find more of my European clients eat liver than Americans (because most Americans are less familiar with it.)
Water and fluids to thirst
Filtered water is best
NO soda; drink some mineral water with some juice or fruit if you are weaning yourself off soda or want those carbonated bubbles in your mouth : )
There is a lot of flexibility in the exact food you choose to eat. You get to decide. Remember to eat whole real foods as often as possible. The Standard American Diet which is low in vegetable and fruit intake and high in processed foods has been proven over and over to lead to ill health. I'm not shaming anyone. I'm in the same boat as you. We learned to eat how we learned to eat and by being in contact what's being sold and consumed all around us. Some of us need to learn some new skill sets in the food department - and it can be fun and meaningful. Look out for yourself and your family by learning to eat real food like our great grandmothers cooked.
Remember to eat:
VARIETY: Try not to eat the same thing every day. Variety helps us to get different nutrients, avoid toxins building up and keeps it from being boring, too.
COLORFUL: Different micro-nutrients and protective benefits from whole foods rich in color. Eat the rainbow.
NUTRIENT DENSE: Salmon = nutrient dense; bagel = not so much
PLEASURE: You don’t need to eat spinach if you hate it - there’s plenty of other options. Find foods you enjoy.
When you are pregnant, it’s important to eat something every 2 - 3 hours, especially something rich with protein (that can be for example a handful of nuts, peanut butter with apples or Greek yogurt). Dr. Bradley always recommended this and so do midwives. Stomach space becomes smaller and smaller as your pregnancy progresses and the top of your uterus is pressing on your stomach. So, eating small but frequently is helpful simply for your own comfort. More importantly, spreading your food over the day and not just eating three squares helps you in these specific ways:
Enables you to take in the calories necessary to allow for a needed increase in blood volume. A healthy, well nourished pregnant woman’s blood volume needs to increase and it can do so by up to 50% which protects the pregnancy (full term is the goal) and helps your baby get the nutrients and oxygen they need to grow healthy and strong. Low blood volume is the main factor that increases the risk of those bad outcomes I listed before.
Stabilizes your blood chemistry (especially your glucose levels), especially important when pregnant as our own system programs our baby’s developing system
Keeps stress hormones (such as cortisol) at bay (which can happen when we skip meals) We don’t want our system or our baby’s growing system unnecessarily stressed as it can impact healthy development.
Prevents nausea.
The are so many different ways to eat well in pregnancy and the science of nutrition has grown immensely in the last several decades. If you love learning about nutrition, I recommend reading Real Food for Pregnancy by Lily Nichol's RDN, which shows the most recent nutritional science, much of which supports Dr. Brewer’s original work.
Because there is so much conflicting information out there and some people feel like it's crazy making to try to figure it all out for themselves, having a simple nutritional guide such as Dr. Brewer’s Pregnancy Diet can be very helpful for pregnant women and their partners. It gives a very clear baseline to start from. Dr. Bradley and Dr. Brewer both knew that having the mothers in their practice eat well each and every day helped them achieve the best possible outcome for themselves and their babies. The majority of midwives spend time counseling pregnant mothers on their nutrition because being in a state of ignorance on this subject can lead to unfortunate birth complications. If the goal is a healthy birth, it starts with what you eat.
Eating real, whole food frequently and with delight - this is something doable and achievable. It’s a way of loving and caring for our littlest ones right from the start.
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