What health recommendations for during pregnancy can be made to vegans? Many doctors recommend eating fish and/or meat. How could a pregnant person get the necessary nutrients on a vegan diet?
I've never seen a doctor recommend meat for pregnant women, even non-vegans/non-vegetarians. Meats have above-average rate of food poisonings, and most farm animals are raised with hormones. If anything, eating meat during pregnancy is a liability and should be done with caution for every mother-to-be. NHS has a whole guide on foods to be avoided and, other than alcohol and caffeine, all of them are from animal sources.
Other than the usual, pregnant vegans should make sure to get enough protein, omega 3/6 fats, B12 and D vitamins. None of those are new concerns for vegan/vegetarian people. In fact, if you are pregnant, your overall diet will not be dramatically different from your normal eating pattern.
I would try an answer from the medical point of view.
This short article (a free account is required in some countries) summarizes the risks that a vegetarian/vegan lifestyle poses during pregnancy.
- B12 deficiency during pregnancy can lead to "infants having developmental delays even with repletion of B12".
- long-chain omega-3 fats deficiency
Dietarily, these only come from fatty fish and seafood. They are bioconcentrated. They start in algae, but they get bioconcentrated in our food supply via seafood. It is very hard to get those during pregnancy.
If someone is not going to get those in their diet but has a history, risk, or propensity toward mood disorders, think about supplementation. Some data show that women with higher intakes of fish or higher levels of DHA tend to have a much lower risk for postpartum depression.
- Iron deficiency - according to this article, there is a slight increased chance for Iron deficiency
The nine studies that focused on nutritional deficits were somewhat more consistent, suggesting that pregnant women who are vegetarian/vegan may have higher levels of folate and magnesium relative to their omnivorous peers, but may also have an increased risk of vitamin B12 and iron deficiency — two of the nutrients vegetarians and vegans are generally advised to watch our for, whether or not they're pregnant.
- Vitamin D deficiency (source)
Low vitamin D levels have been observed in some vegan populations at northern latitudes.[6,26,28] Vegans have been found to have lower average intakes of vitamin D than lacto-vegetarians and omnivores.
Vitamin D deficiency during pregnancy is associated with several disorders of calcium in both the mother and infant, including neonatal hypocalcemia and tetany, infant hypoplasia of tooth enamel, and maternal osteomalacia.
- Calcium deficiency
Pregnant women who ingest sufficient calcium during the second and third trimesters of pregnancy have a higher bone mineral density, as do their children
Now, coming back to the main question.
How to be healthy during pregnancy
This long article deals with coping with deficiency for each major element of nutrition:
- vitamin B12
A vitamin B-12 supplement is recommended for both lacto-ovo vegetarian and vegan mothers. Foods fortified with vitamin B-12 include meat substitute products, soymilks, tofu, cereals, and nutritional yeast. Seaweed and tempeh are generally not reliable sources of vitamin B-12. Four servings daily of vitamin B-12 fortified foods are recommended in pregnancy and lactation.
- vitamin D3 deficiency, besides the food, is also related to exposure to sunlight and skin color ("dark-skinned people require longer exposure to obtain sufficient amounts")
Women who have regular sunlight exposure do not need any extra vitamin D. However, in the absence of adequate exposure to sunlight, 5 mcg/day or 200 IU in the form of cholecalciferol is recommended. There is no increased requirement for vitamin D during pregnancy and lactation.
Vegans must rely heavily on ultraviolet B rays -- the band of ultraviolet which causes synthesis of vitamin D-3 -- from direct sunlight to obtain sufficient D-3. Good sources of vitamin D are found in fish liver oils, fatty fish, and egg yolks, but vitamin content in these foods varies by the time of year. Vitamin D-fortified foods include cow's milk, some soy milk products, and some breakfast cereals. Vegetarians may also choose vitamin D supplements.
Because of possible decreased intake and absorption in a plant-based diet, vegetarians and vegans should consume 1200 to 1500 mg/day of calcium, which is about 20% more calcium than that recommended for omnivores.[...] food choices should include low-oxalate (high bioavailability) foods such as bok choi, broccoli, Chinese cabbage, collards, kale, okra, turnip greens, and soy products. Other choices with slightly less calcium bioavailability are fortified soymilk, sesame seeds, almonds, and red and white beans.
Plant sources of iron have decreased bioavailability compared to animal sources, and are more sensitive to interactions with other nutrients that can facilitate or inhibit absorption. Inhibitors of iron absorption include calcium, coffee, and fiber. Vitamin C can help enhance absorption by reducing the inhibitory effects of phytate. Both pregnant and lactating women are encouraged to eat plant-based foods high in iron, such as soy products, tofu, beans, lentils, spinach, molasses, whole wheat breads, peas, dried apricots, prunes, and raisin
- Protein requirement is significantly increased during pregnancy
Protein requirements during pregnancy and lactation are increased to 71 g/day compared to 46 g/day for the nonpregnant woman. [...] Sources of protein include legumes, **nuts, tofu, and eggs. Isolated soy protein can meet protein needs as effectively as animal protein**
Try sunflower seeds and peanuts http://www.nutrition-and-you.com/nuts_nutrition.html (source USDA) , theres also herbs with high calcium such as Marjoram
For other b vitamins including b12 , theres deactivated yeast that packs alot of b vitamins. You can easily get 100% or close with only 2 tablespoon.
You need to find Iodine from food/herb source and stop taking Fluoride (including non organic wheat,which has alot of fluoride pesticide residue,alot more than the toothpaste or water. For the water theres activated carbon blocks near 1 micron and then 0.0001 micron reverse osmosis but it needs to be a absolute value , not nominal but it would still be better than nothing.