Gut Health and Your Pregnancy

Did you know that your digestive tract can impact your physical and mental health? Scientists and doctors are just beginning to discover how closely connected our gut health is to our overall health. An explosion of research examining the role that a healthy gut microbiome plays in fertility, pregnancy, and infant health may provide ways for you to have a healthier pregnancy and baby. The Pulse will help summarize what we know about the connections between health, pregnancy, and the gut microbiome. We’ll also offer tips for keeping your gut healthy and happy during your pregnancy and postpartum.

What is the gut microbiome?

The gut microbiome is the collection of trillions of bacteria, viruses, and fungi in your intestinal tract (small and large intestine). Collectively we call these bacteria, viruses, and fungi, microbes. It turns out the microbial genetic material (their DNA), hormones, chemicals, and neurotransmitters they release all can impact your health.

How do microbes get into your gut?

All of the food or beverages we consume contain a mix of bacteria, fungi, and viruses. The gastric acid and digestive process that starts in our stomach kill harmful microbes. The harmless and even good-for-you microbes then pass from your stomach down to your small intestine and large intestine, getting down to the business of keeping you healthy.

Your gut health is your body’s health

Gut health is an essential element of your overall physical and mental health. So necessary, in fact, that health providers sometimes refer to your gut as your second brain.

Certain gut microbes can produce small molecules or help synthesize specific vitamins, enzymes, and hormones your body needs to function correctly. Your gut microbiome plays a role in digestion, metabolism, and inflammation. The intestinal tract is also the largest immune system organ, with about 80 percent of your immune-producing cells living there. Diabetes, obesity, inflammatory bowel disease (IBD), and irritable bowel syndrome (IBS) are all medical conditions linked to shifts in gut health. In this way, gut health plays a massive role in overall health because it impacts our risk of chronic conditions, our ability to manage weight, and our immune system function.

Research is ongoing on how the gut microbiome works in tandem with parts of the body like your brain, heart, liver, and lungs. Scientists are also exploring a connection between gut health and mental health (remember the second brain). Doctors have observed that people with some mental health issues or mood disorders have alterations in the composition of their gut microbiome and its healthy function.

What can cause a change in your gut health?

Your gut’s mix of microbes can shift. Sometimes you can have an overgrowth of only one or two varieties. An imbalance of healthy and unhealthy microbes is known as gut dysbiosis. Gut dysbiosis is not healthy for you or your pregnancy.

Imagine a garden with a mix of plants, flowers, and vegetables that all grow well together, creating some shade, root systems trapping water, and returning nutrients to the soil – all keeping each other healthier than they would be on their own. Now picture several invasive weeds and vines outgrowing and killing all of your healthy garden’s plants. The same shift towards an unhealthy mixture of microbes can happen in your gut microbiome.

Some common causes of gut dysbiosis are:

  • Taking oral (by mouth) antibiotics
  • Getting sick (especially with a gastrointestinal infection)
  • Changing your diet
  • Pregnancy

How does being pregnant affect your gut health?

Pregnancy also causes a shift in the natural balance of gut bacteria, viruses, and fungi living in your gut. Scientists attribute these changes both to pregnancy hormones and a shift in metabolism in pregnancy to higher blood sugar levels and higher blood cholesterol levels. Overall, there is a decline in the total number (or variety) of different kinds of gut bacteria, especially in the first and third trimesters. These shifts typically do not impact pregnant women’s health and in fact, appear to help babies grow bigger and better nourished in the third trimester.

Pregnant people normally have changes in their gastrointestinal tract and bowel patterns. This makes it hard to tell if the bowel changes you have while pregnant are really gut dysbiosis. Some common symptoms non-pregnant people with gut dysbiosis report are:

  • Constipation
  • Diarrhea
  • Bloating
  • Fatigue
  • Acid reflux or heartburn

The connection between your gut health and your baby’s health

Another unique and healthy mix of microbes (bacteria, viruses, and fungi) live in your vagina, called, you guessed it, the vaginal microbiome. Researchers have made connections between the makeup of the vaginal microbiome and both the success of in vitro fertilization and miscarriage. There is also evidence pointing to a connection between the vaginal microbiome and your risk for premature rupture of membranes (breaking your water before 37 weeks) and preterm labor.

Once you are in labor, your baby is exposed to those microbes. Before you get grossed out, try to keep an open mind because those microbes form the foundation of your infant’s healthy immune system.

Even before you go into labor, however, your gut microbiome may be impacting the development of your baby’s nervous system and immune system in utero. Emerging science indicates that some of the neurotransmitters (chemical messengers), enzymes, molecules, and hormones your gut microbes produce may play a role in in fetal development and your pregnancy health. Your gut microbes also act as a significant detoxifier – supercharging your digestive tract to filter out things like pesticides or other harmful chemicals. So if you have a healthy gut microbiome, your baby may benefit from less exposure to these potentially harmful chemicals and compounds.

Breastfeeding for at least six months, if you can, is another important way your gut impacts your baby’s health. While your baby’s microbiome begins to develop in utero, it continues to evolve after birth. During the first two years of life, your infant’s microbiome is continuously developing. Studies show that infants fed formula have a different makeup of microbes in their gut than breastfed infants. Researchers hypothesize that this change in the gut microbiome may be connected with the higher rates of allergies, obesity, and other health conditions observed in formula-fed infants compared to breastfed infants. That is why it makes sense to try to get your pregnancy gut microbiome in tip-top shape before your delivery and trying to breastfeed.

Tips for Keeping Your Gut Microbiome Healthy During Pregnancy

Just as there is no one diet for all the people and animals in the world, the trillions of microbes in your gut also require a wide variety of nutrients to survive. Remember, everything you eat, feeds the organisms living in your gut. Although it can be tough in pregnancy sometimes to eat a range of different foods, especially if you are fighting nausea and vomiting, try to focus on eating a well-balanced diet – not just one or two foods. If the majority of your nutrients come from plant-based foods, your gut will stay healthier through pregnancy. Beyond eating a variety of foods, other recommendations for a healthy gut microbiome during pregnancy are to:

  1. Try fermented foods like kimchi, kefir, sauerkraut, kombucha, and yogurt (which contain natural probiotics)
  2. Eat whole grains (brown rice, quinoa, oats and buckwheat).
  3. Supplement with some probiotics (after reviewing them with your pregnancy-care provider).
  4. Consider trying prebiotic foods – foods that promote the growth of gut bacteria such as garlic, onions, asparagus, bananas, and cocoa.
  5. Eat more fruits, vegetables, legumes (garbanzo beans, lentils), and beans especially raspberries, apples, artichokes, blueberries, almonds, and pistachios which have been shown to increase numbers of helpful gut bacteria.
  6. Limit saturated fats and processed foods which can kill good bacteria and can create toxins in your body.
  7. Focus on getting plenty of fiber. Not only does fiber help prevent constipation, it also promotes the growth of many beneficial gut bacteria.
  8. Add in polyphenol-rich foods like cocoa and dark chocolate, grape skins, green tea, almonds, onions, blueberries, and broccoli – polyphenols have been shown to increase healthy kinds of gut bacteria and prevent the overgrowth of harmful strains.

A Healthy Gut Is An Investment In Your Family’s Future Health

Your gut plays a crucial role in your metabolism, immune system function, and overall health. When pregnant, your gut microbiome is vital for a healthy pregnancy – and a healthy baby. But being pregnant can cause changes in the microbes that call your digestive tract home.

Some small steps may help you maintain the healthiest gut microbiome through pregnancy and beyond. Eating a variety of foods, adding in more plant-based foods, judicious use of antibiotics, and maybe adding prebiotics and probiotics during your pregnancy (after checking with your pregnancy care provider) are some gut-friendly strategies. Taking care of your gut health during pregnancy is one way to invest in your health and your growing baby’s lifelong health.

Amy Harris
Amy Harris is a certified nurse-midwife with a Master's Degree in Maternal and Child Health from Harvard Chan School of Public Health. Her passions are health literacy and women's reproductive health. A recent two-year sabbatical with her family in Spain was the impetus for becoming a freelance women's health writer. An exercise nut, she is happiest outdoors and on adventures abroad.

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