Preconception
The health of a mother and baby is influenced not only by diet during pregnancy but also by diet before conception. Eating a healthy diet before pregnancy will give your body a good store of nutrients for the baby to draw on during pregnancy. The foetus is most susceptible to nutritional imbalance during the first few months of pregnancy because this is the time of most rapid development.
If you are very underweight or overweight, you should try to achieve an acceptable weight for your height by a sensible and well-balanced diet.
If you take the contraceptive pill, it is a good idea to come off and use an alternative method of contraception a few months before conceiving. This is because the pill can alter levels of some nutrients, particularly vitamin B6, folate and zinc. Ensure that you have a well balanced diet with plenty of fresh fruit, vegetables (especially green vegetables) and wholegrain cereals. Try to avoid fatty foods, sweets, biscuits and cakes.
Now is the time to make other healthy lifestyle changes and so stop smoking, cut down on alcohol and drinks containing caffeine such as tea, coffee and cola. Try a barley drink such as Barley Cup, or herb and fruit teas instead.
If you find you are pregnant before you have had time to think about preconception, then don't worry, there is still plenty of time to make healthy changes to your diet.
Pregnancy
Pregnancy is a time when good nutrition is vital, for vegetarians and non-vegetarians alike. It is a time of readjustment as well as growth. The nine months are divided up into three divisions of three months each called trimesters. Many women experience changes in mood, activity and appetite with the different stages of pregnancy.
There is no truth in the old saying that pregnancy means eating for two. The extra energy needed is only 200-300 calories a day for nine months. This is equivalent to two slices of bread with margarine or a jacket potato with baked beans or cheese. Some women do feel a lot more hungry than this and if they are gaining weight at the right rate, they should eat according to their appetite.
0-3 Months
Women usually feel different and may experience tiredness as well as a feeling of sickness particularly in the morning (see advice on morning sickness). Calorie needs are only about 100kcal more in the early stages of pregnancy and some women do not experience much increase in appetite until the end of this period.
3-6 Months
Appetite usually increases after the first three months and this period requires about 300-400kcal extra calories a day. Extra calorie needs should be met by cereals, pulses, nuts and seeds, dairy products (unless vegan) and starchy vegetables such as potatoes.
6-9 Months
The baby is maturing now and this is a time for easing up on activity and preparing for the birth. The baby takes up a lot of space and may press on the stomach, reducing the capacity for food. Many women feel they need to eat small meals more frequently at this stage. Normal weight gain during pregnancy is about 22 to 28 pounds or one and a half to two stones (10-12.5kg). Weight gain often slows down during the last few months of pregnancy.
Exercise
It is a good idea to do some form of exercise during pregnancy. Antenatal clinics normally advise on appropriate exercise. Swimming or gentle yoga are often recommended.
Nutrients

Fluid
You may find that you are more thirsty during pregnancy. This is natural as fluid intake should increase. Never allow yourself to become over thirsty and include plenty of fresh water, dilute fruit juices, milk (soya or cow's) and herb teas. Drinks containing caffeine (tea, coffee and cola) should be limited and alcohol should be avoided altogether if possible.
Protein
Increased protein needs in pregnancy are usually met simply by the extra calories from more foods. Protein can be found in milk, cheese, eggs, soya milk, tofu, cereals, nuts and pulses. A normal variety of these foods will provide adequate protein.
Intake of dairy products and eggs should not increase dramatically. Some people believe that excessive amounts may sensitise the baby in the womb to allergies towards these foods.
Iron
The need for iron is increased during pregnancy, especially during the later stages. Anaemia, due to iron deficiency, is common in pregnancy whether you are vegetarian or not. Vegetarians should be especially careful to include plenty of iron in their diet as vegetable sources are not as well absorbed.
Good vegetarian sources of iron can be found in wholegrain cereals, pulses, green vegetables and dried fruits. Iron absorption is increased if taken with a good source of vitamin C, which can be found in fresh fruit and vegetables. Tea contains tannin which can inhibit iron absorption and should not be taken an hour before or after a meal.
Many doctors routinely prescribe iron tablets for pregnant women. Iron tablets may not be needed unless a blood test demonstrates anaemia. Iron levels normally decrease during pregnancy as the blood becomes more dilute. Some women prefer to take a natural iron supplement, such as Floridix, which is available from health food stores.
Calcium and Vitamin D
The body needs extra calcium during pregnancy, especially in the later stages, to enable the baby's bones to develop. Calcium absorption from the gut is more efficient during pregnancy and this should provide enough to meet requirements. Vegans and vegetarian women who consume few dairy products need to be particularly careful to ensure adequate calcium in the diet. Some vegan women, especially if they intend to breast-feed, may decide on a calcium supplement as a wise precaution, although with a good vegetable intake of calcium, it may not be necessary.
Good sources of calcium include green vegetables, almonds, sesame seeds or tahini, cow's milk, tofu, cheese, yoghurt, wholegrain cereals and pulses.
Vitamin D is essential for calcium absorption and can be obtained from sunlight, margarine and dairy products.
Folate
Folate is one of the B vitamins needed in increased amounts during pregnancy. Research has shown that a deficiency of folate during pregnancy can lead to birth defects. Vegetarians should not be at risk as the best sources of this vitamin are green leafy vegetables, fruit, peanuts, yeast extract and wholegrain cereals.
Vitamin B12
Vitamin B12 is essential to the growth and development of your baby. If adequate amounts of dairy products, eggs and fortified yeast extract are included in your diet, then you should have enough vitamin B12. It is especially important for vegans to include a reliable source of vitamin B12 in the diet during pregnancy. Some vegan foods, such as certain brands of soya milk, margarine and soya products are fortified with this vitamin. If the vitamin B12 in your diet is unreliable, then a supplement is recommended.
What Foods and How Much
The table below should be used only as a guide. A serving refers to a normal sized portion that you would have for a meal or a substantial snack. For example, a cereal serving can be two small slices of bread, a portion of pasta or a large potato. A fruit serving is equivalent to one whole piece and a vegetable serving is about 3.5oz (100g). A large portion of nutloaf could be counted as a cereal and a nut serving. If you are gaining weight normally, the size of a serving can be based on appetite.
It is a good idea to avoid sweets, cakes, sugar and soft drinks as these provide extra calories without giving much in the way of nutrients.
During pregnancy over-the-counter medicines and tablets should be avoided unless prescribed by your doctor. A vitamin and mineral supplement should not be needed if a good balanced vegetarian diet is followed, but will not cause any harm if taken as a precaution.

General Advice

Morning sickness
Studies show that about three quarters of all women experience nausea and vomiting during pregnancy. Nausea normally occurs in the first few months although it can last throughout pregnancy.
Morning sickness can be relieved by having a dry biscuit or toast before getting up. Avoiding long intervals between meals helps, as nausea often occurs at the same time as hunger. Starchy foods, such as bread and potatoes, should be eaten regularly as they help maintain blood sugar level and fill the stomach, helping to relieve the sickness.
Food safety
Pregnant women are advised to avoid soft cheeses such as Brie and mould ripened cheese such as Stilton, because of the risk of listeria. Cottage cheese or hard cheeses, such as Cheddar should be used instead.
Even free range eggs have been found to contain Salmonella. Raw or lightly cooked eggs should be avoided.
Heartburn
Heartburn is very common in the later stages of pregnancy. It can be prevented by avoiding large meals and instead choosing small frequent meals or snacks. It can help to sit up very straight when eating and avoid activity just after a meal. Spicy and fatty foods, fizzy drinks and citrus fruits can make the problem worse.
Constipation
During pregnancy, the digestive system absorbs nutrients more efficiently and this can contribute to constipation. Iron tablets often make the problem worse. Constipation can be relieved by increasing fluid intake and including plenty of wholegrain cereals, pulses, fruits and vegetables in the diet.
Food cravings and aversions
Many women experience altered taste preferences during pregnancy which vary considerably. Some experience very strong cravings for particular foods such as fruit, salad vegetables, nuts, starchy foods or chocolate. Aversions to fatty foods, alcohol, tea and coffee are also common.
Conclusion
A Healthy Vegetarian Diet (http://www.vegsoc.org/info/basic-nutrition.html) can provide you with all the nutrients you need during your pregnancy and give your baby the best possible start in life.
Further Information
· Books: Vegetarian Children and Babies
· The Leisure and Lifestyle Directory (http://www.vegsoc.org/directory/) - for all commercial products and services related to vegetarianism.