All Categories

Vitamin D and Pregnancy

1/15/2026

What is Vitamin D?
While we often call it a vitamin, Vitamin D actually functions as a hormone within the body. It is essential for bone and tooth health, immune function, brain health, and the regulation of inflammation.

Why is Vitamin D important during pregnancy?
This nutrient is involved in numerous processes that ensure a healthy pregnancy, from aiding implantation to promoting the maturation of fetal lungs.
Benefits for Mom:
Maintaining adequate levels is linked to a lower risk of several complications, including:

Preeclampsia
Gestational Diabetes
Bacterial Vaginosis
Intrahepatic Cholestasis of Pregnancy (ICP): While not a known cause, there is a correlation between low levels of Vitamin D and this rare liver issue.

Benefits for Baby:

Skeletal Development: Vitamin D helps the body absorb calcium and phosphorus, which are critical for building healthy bones.
Reduced Risk of Preterm Birth: One study showed that mothers with adequate levels had a 60% lower risk of preterm birth.
Long-term Health: Proper levels can protect your child from cavities, lower bone density, and potentially autoimmune diseases later in life.

Why is deficiency so common?
Deficiency is an epidemic, affecting up to 95% of pregnant women in some areas. Several factors influence this risk:

Latitude: If you live north of the 37th parallel (Kansas is just above the 37th parallel), your skin cannot synthesize enough Vitamin D from the sun during winter and spring.
Skin Color: Melanin acts as a natural sunscreen. Those with darker skin tones may require up to six times more sun exposure to produce the same amount of Vitamin D as those with lighter skin.
Modern Lifestyle: Spending time indoors and using sunscreen (SPF 30 blocks 95–98% of Vitamin D production) prevents the skin from synthesizing Vitamin D when exposed to sunlight.
Body Weight: High levels of body fat can sequester Vitamin D, making it less available for the body to use.

How will I know if I am Vitamin D deficient?
As part of your prenatal care, your midwife will order a test called Vitamin-D 25 hydroxy to check your level at the start of care, and again around 30 weeks gestation.

What can I do to ensure I’m getting enough Vitamin D?
While food is a great starting point, it is difficult to get enough Vitamin D from diet alone.

Research shows that 4,000 IU of Vitamin D3 daily is safe and effective for reaching functional levels in both mother and baby.
Look for Vitamin D3 (cholecalciferol) rather than D2, as it is more effective at sustaining blood levels.
Vitamin D works best when taken with fatty foods and paired with nutrients like Magnesium, Vitamin K2, and Vitamin A 28.
If feasible, aim for mid-day sun (10:00 AM to 2:00 PM) without sunscreen for a short period (20 minutes or so), taking care not to burn.
Include fatty fish (salmon, mackerel, tuna), egg yolks, beef liver, and fortified milks in your diet.

Sources:
https://pmc.ncbi.nlm.nih.gov/articles/PMC7905986/
https://www.medicalnewstoday.com/articles/161618
https://nutritionsource.hsph.harvard.edu/vitamin-d/
https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-d-deficiency/faq-20058397
https://lilynicholsrdn.com/vitamin-d-pregnancy/

0 Comments

Continuing Ed

1/1/2026

0 Comments

One of my favorite things about being a midwife is that there will always be a need to continue learning. As we understand more about pregnancy, and birth, there is always something new to be learned. This past year I took a few courses to stay current on evidence based guidelines for care, and to learn more about things some of my clients were experiencing.

I completed a course on iron and ferritin. As a result of what I learned, I’ve added some labs to what I check. Checking on ferritin levels, total iron binding capacity, Vitamin B12 levels along with a few more new labs helps me better evaluate hemoglobin, ferritin and what needs the body may have where ferritin is concerned.

I took a course covering hepatic cholestasis of the liver. Understanding ways we can support the liver well with supplements, and what to watch for if there is cholestasis of the liver has been invaluable for the clients I have served this year who have developed this complication or had it with a prior pregnancy.

I also took a course on handling hemorrhage in the immediate postpartum period. There have been some changes to how to best treat a hemorrhage since I started my practice 6 years ago. It was good to learn the changes so I can update my protocol with the current recommendations and guidelines.

I continue to learn from my clients, which I absolutely love. Whether it’s how to use scan and go at Sam’s Club, or about Idiopathic Postprandial Syndrome, my clients continue to helpe me learn and grow as a midwife and in my daily life.

0 Comments

The One Solution Myth

12/15/2025

0 Comments

One of the things that frustrates me, especially when it comes to health is a “one size fits all” solution for health problems. “It worked for me, and for members of my family, my friends etc so it will work for everyone”. This drives me up the wall. We are all unique individuals and what works for one person may or may not work for someone else. So, I have problems with someone claiming they have THE solution for a health problem.

The one size fits all solution that comes up in midwifery care frequently relates to anemia and low ferritin. There are different types of anemia, each with a different cause. Pernicious anemia is caused by a deficiency of vitamin B12. Other types of anemia can be caused by environmental exposure to toxins, chronic inflammation, genetic factors, autoimmune issues and the list goes on. Telling someone they just need to get more copper or B vitamins in their diet may help some people, but it won’t fix the issue for everyone.

In pregnancy, we don’t necessarily have time to figure out the root cause of anemia or low ferritin. We have to treat the symptoms to prevent IUGR, premature labor, an anemic baby with corresponding IQ loss, postpartum hemorrhage, PP depression, pre-eclampsia and other associated risks. What we can do is focus on what I consider the big rocks. The biggest one in my opinion is diet. By dialing in nutrition with a focus on increasing iron absorption, we will also be including other trace minerals and vitamins needed for absorption such as copper, magnesium, vitamin A, B vitamins and more. Exercise, getting quality sleep, reducing environmental exposures to things such as pesticides, and lowering stress levels are other big rocks to work on. Every one of these things will reduce inflammation and in turn lead to a healthier Mom and help baby to thrive before and after birth. Because of the limited time for improvement, we may need to supplement with oral or IV iron to get ferritin to a healthy place for birth.

Working on nutrition and lifestyle, along with supplements including IV infusions are the tools we have to optimize hemoglobin and ferritin throughout pregnancy, and sometimes we need to use all the tools.

0 Comments

My Ferritin Eye Opener

12/1/2025

0 Comments

In the interests of being as healthy as I can be, as well as being a midwife who practices what she preaches, I decided to test my ferritin. For curiosity's sake I had my husband’s ferritin checked as well. Getting the lab results was eye opening in more than one way.

I’m not going to share my number, but if I was pregnant and a client, I would need to work on getting my ferritin in a better place. I will be making changes to do exactly that.

What was eye opening to me were the differences between acceptable ranges for women compared to men. Lab results will list a reference range for each test. Reference ranges are determined by sampling 120 individuals who are assumed healthy to determine the upper and lower limits of the reference range. The ranges can vary based on if the lab is using a nationwide sample group, or a local group. They can also vary depending on the age, gender and other factors of the people in the sample group. Doctors tend to rely on the reference ranges provided by the lab to determine if someone has an issue and may not be familiar with functional or optimal ranges.

The laboratory I use shows a reference range of 15-150 for females and a range of 30-400 for males. I was shocked at the significant difference between ranges for men and women! While men have more muscle than women and there is a difference in blood volume of men compared to women (men tend to have just under a liter more blood than women), it’s eye opening to see how vast the difference is. Women of childbearing age have regular blood loss through menstruation, men do not, so if anyone needs to keep on top of ferritin levels, it’s women. The reference range recommendations by the World Health Organization have an upper limit for men of 200, and 150 for women, and a lower limit of 30 for both men and women. Functional medicine providers recommend a lower limit of 70.

Testing ferritin in pregnancy is still uncommon, but it needs to be the standard of care for everyone whether pregnant or not. The lack of agreement on what levels should be highlights a fundamental problem in the medical community. Instead of looking at population averages, we should be looking at functional levels. Once someone gets into the functional range, paying attention to how they feel and are functioning will let providers and clients tweak things further to optimize ferritin at the individual level. That is my goal with every client I serve.

0 Comments

Tylenol and Autism

11/15/2025

0 Comments

I’m sure you have seen the recent announcement that Tylenol (which is acetaminophen) use in pregnancy causes autism. That announcement led many organizations, experts, influencers, podcasters etc to weigh in. In the interest of serving Moms and babies to the best of my ability, I want to equip families with evidence based information to make the best decision for Mom and baby during pregnancy. So it’s time for me to share the source I found most valuable as I educated myself more about acetaminophen use in pregnancy causing autism.

I wanted an analysis of the studies referenced in the guidance to avoid acetaminophen use, as well as a deeper understanding of the criteria scientists use to evaluate if something is a cause, or if it’s just coincidence. I also wanted to better understand why it seems autism diagnoses have been on the rise. I found exactly what I was looking for on Dr Peter Attia’s YouTube channel.

Dr Attia does an excellent job of explaining how the scientific community assesses if something may be a cause, as well as explaining the challenges of being able to conclusively determine causes. His analysis of the studies that looked at acetaminophen use was very helpful to me in understanding the issues that I have heard about those studies. I also appreciated that he takes the time to explain other potential factors that may be leading to the increase of autism.

I hope the information in Dr. Attia’s video is helpful in understanding the risks and benefits of using acetaminophen to manage a fever during pregnancy.

And as a footnote to all this, the Secretary of Health and Human Services announced there is not enough evidence to link Tylenol to autism, more than a month after the announcement that Tylenol use in pregnancy causes autism.

0 Comments

<<Previous

Vitamin D and Pregnancy

Continuing Ed

The One Solution Myth

My Ferritin Eye Opener

Tylenol and Autism

Author

Archives

Categories