Category: Prenatal

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/

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The One Solution Myth

12/15/2025

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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.

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Ferritin

8/15/2025

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Iron deficiency is a condition far more common than many realize, especially for women, and especially during pregnancy. You've likely heard of anemia, a condition where your body doesn't have enough hemoglobin. Hemoglobin is used by your red blood cells to carry oxygen to every part of your body. When you're anemic, your body isn't getting enough oxygen.

There are two components to iron levels:
• Hemoglobin: This tells you how much oxygen your red blood cells are carrying right now.
• Ferritin: This is your body’s iron stores. It’s what you have in reserve for your body to pull from to make hemoglobin.

Anemia is the end-stage result of iron deficiency. Your body prioritizes making sure your red blood cells have enough iron for hemoglobin.This means that iron deficiency can progress through multiple stages before your hemoglobin levels actually drop and you become anemic. Your ferritin stores could be close to empty, even while your body is still trying its best to keep your red blood cells supplied with enough hemoglobin. Once you no longer have ferritin, you will become anemic. Because your body prioritizes hemoglobin production, a standard hemoglobin test isn't sensitive enough to catch iron deficiency in its earlier, non-anemic stages. Simply put, your hemoglobin may be fine, but your ferritin can be low. Checking your hemoglobin level is not enough. Checking both hemoglobin and ferritin is necessary to give a complete picture of your body’s iron status.

Ignoring low ferritin, even when you're not yet anemic, carries significant risks for both Mom and baby:
• For Mom:
◦ Increased fatigue.
◦ Higher risk of developing iron deficiency anemia later in pregnancy.
◦ Associated with abnormal placenta growth and hypothyroidism.
◦ Increased risk of postpartum depression.
◦ More difficult to fight infections.
◦ Increased risk of preterm delivery, low birth weight, and hemorrhage after birth. • For Baby:
◦ Greater risk for anemia later in infancy.
◦ Fetal iron deficiency which can negatively affect the baby's brain development.

I want my clients to have a healthy pregnancy and feel their best throughout pregnancy. Because ferritin is so important to Mom’s and baby’s health, I like to check it when we start care, and again around 30 weeks gestation so if we need to take steps to address low ferritin, we have time to make changes that will be beneficial.

Sources:
https://www.ajog.org/article/S0002-9378(20)30328-8/fulltext
https://pmc.ncbi.nlm.nih.gov/articles/PMC9669178/
https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/anemia-during-pregnancy/art-20114455

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Measles and Pregnancy

4/15/2025

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The United States is currently experiencing a measles outbreak in several states, including Kansas. Measles is a highly contagious viral illness that can lead to serious complications, especially for pregnant women and infants. If you are expecting, it is important for you to understand the risks and what you can do to minimize those risks.
What are the risks?
Measles during pregnancy poses significant risks to both the mother and the developing baby.

Increased Risk of Complications for the Mother: Measles during pregnancy has been associated with an increased maternal risk of hospitalization, pneumonia, need for oxygen support or mechanical ventilation, and even death.
Risks to baby: Measles infection during pregnancy can lead to serious outcomes for the baby, including miscarriage, premature birth, low birth weight, baby having a measles infection at birth if Mom contracts measles near the time of birth, and stillbirth.

How can I find out if I have immunity to measles?
Your doctor or midwife can order a blood test to check for measles antibodies if you don’t have any records of vaccination.
What Can I do to reduce exposures to measles if I'm pregnant?
If you are pregnant and not vaccinated against measles, it's essential to take extra precautions during an outbreak:

Avoid Exposure: Try to avoid contact with individuals who have or may have measles. Limit time spent in crowded public places where the risk of exposure might be higher.
Practice Good Hygiene: Wash your hands frequently with soap and water for at least 20 seconds. Avoid touching your face.
Wear a Mask: Since measles is spread through the air and can linger in the air for up to 2 hours, consider wearing an N95 mask in public places to reduce the likelihood of inhaling the virus.

What if I get exposed to measles while I’m pregnant?
If you are exposed to measles while you are pregnant, it’s important to let your midwife or doctor know as soon as you are aware you’ve been exposed. Calling is preferred so you are not running the risk of spreading measles. Your doctor may recommend immunoglobulin (antibodies) treatment within six days of exposure to help reduce the risk of developing measles.
Should I get a measles vaccination while I’m pregnant?
No. The vaccine uses live virus and is not recommended for pregnant women because it could harm baby. After baby is born, it is considered safe to get vaccinated even if you are breastfeeding.

Sources:
https://s3.amazonaws.com/cdn.smfm.org/attachments/1318/f3d6ed022bb2ecc5eaee0e1ce3dbe4af.pdf

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Pregnancy and Thyroid

3/1/2025

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The thyroid gland, a butterfly-shaped organ located in the neck, is a vital part of the endocrine system. It produces hormones that regulate the body's metabolism, which is the process of converting food into energy. Here's how it works:

The thyroid gland produces two main hormones: thyroxine (T4) and triiodothyronine (T3).
T4, or thyroxine, is like a storage form of thyroid hormone. It circulates in your blood, but it's not the active form that your cells can use. To become active, T4 needs to be converted into T3. This happens mainly in your liver and kidneys, but also in other tissues throughout your body.
The conversion process involves removing one iodine atom from the T4 molecule. This is done by enzymes called deiodinases. There are different types of deiodinases, and they work in different parts of the body to regulate how much T3 is produced.
Once T4 is converted into T3, it can enter your cells and bind to receptors, triggering all sorts of important metabolic processes.

Why is the thyroid so important during pregnancy?
Your thyroid produces hormones that regulate metabolism, which is essential for energy production and overall body function. During pregnancy, your body's demand for thyroid hormones increases significantly. This increased demand is driven by several factors:

Baby's Development: Your baby relies on your thyroid hormones for healthy brain development, especially in the first trimester when their own thyroid isn't fully formed. These hormones are crucial for neurological development, impacting everything from intelligence to motor skills.
Maternal Health: Adequate thyroid hormone levels are essential for maintaining your own health during pregnancy. They play a role in energy levels, weight management, mood stability, and preventing complications.
Placental Function: The thyroid also supports the healthy function of the placenta, which provides essential nutrients and oxygen to your baby.

What happens to the thyroid during pregnancy?
During pregnancy, several changes occur to ensure adequate thyroid hormone levels:

Increased Hormone Production: Your thyroid gland naturally increases its production of thyroid hormones to meet the demands of pregnancy.
Increased T4 to T3 Conversion: The body becomes more efficient at converting T4 (the storage form) to T3 (the active form) of thyroid hormone.

What are the most common thyroid problems during pregnancy and what issues are associated with them?
Hyperthyroidism: This condition occurs when the thyroid gland produces too much thyroid hormone, speeding up many bodily functions. In pregnancy, hyperthyroidism is most often caused by Graves' disease, an autoimmune disorder where the immune system produces antibodies that stimulate the thyroid to make excess thyroid hormone. During pregnancy, untreated hypothyroidism can lead to complications such as preeclampsia, premature birth, low birth weight and neurological issues in baby.
Hypothyroidism: This condition occurs when the thyroid gland does not produce enough thyroid hormone, causing body functions to slow down. The most common cause of hypothyroidism is Hashimoto's disease, an autoimmune disorder where the immune system attacks the thyroid, impairing its ability to produce thyroid hormones. Untreated hypothyroidism is associated with an increased risk of miscarriage, preeclampsia, placental abruption, postpartum hemorrhage, premature birth, low birth weight, stillbirth and transient or permanent hypothyroidism in baby.
What are the treatments for thyroid problems during pregnancy?
Levothyroxine is used to treat hypothyroidism during pregnancy. If you are already taking Levothyroxine, you may need to increase your dose. Thyroid levels should be checked every 4 weeks during pregnancy.
Natural thyroid hormone options like Armour Thyroid, which contain T3, are not recommended during pregnancy because they can cause lower levels of T4 in the maternal blood stream. Baby needs T4 so having lower levels will lead to decreased T4 available for baby and can lead to baby having hypothyroidism.
What can you do to support healthy thyroid function during pregnancy?

Ensure adequate iodine intake: Follow your doctor's recommendations regarding iodine supplementation. Prenatal vitamins often contain iodine. Include iodine-rich foods like seafood (in moderation), dairy, and iodized salt in your diet. However, it's important not to overdo it with iodine, as too much can also be problematic.
Maintain a balanced diet: A healthy diet rich in essential nutrients supports overall health, including thyroid function.

Sources:
https://www.hopkinsmedicine.org/health/wellness-and-prevention/anatomy-of-the-endocrine-system#:~:text=The%20thyroid%20plays%20an%20important,of%20the%20body's%20calcium%20balance
https://www.ncbi.nlm.nih.gov/books/NBK500006/#:~:text=The%20thyroid%20hormone%20is%20well,and%20many%20other%20bodily%20functions
https://www.ncbi.nlm.nih.gov/books/NBK537039/#:~:text=The%20thyroid%20produces%20approximately%2090,%2C%20or%20triiodothyronine%20(T3)

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Vitamin D and Pregnancy

The One Solution Myth

Ferritin

Measles and Pregnancy

Pregnancy and Thyroid

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