one non-diet registered dietitian’s take on intuitive eating during pregnancy.
When I was first pregnant with Owen, I read all the standard books and in most of them, there are a lot of “do’s” and “don’ts” with regard to diet and weight gain.
While I absolutely believe in the importance of a nutrition during pregnancy, what I came to realize was that putting black and white rules around the diet can start to feel very similar to diet culture messages. I found myself with increasing anxiety over every bite (was it safe to eat? was it too much? too little?), fretting about weight (am I gaining too much, too little, just the right amount?) and trying to force myself to eat foods that I frankly just didn’t like or feel like, all for the health of the baby.
I was luckily able to shake myself out of it fairly quickly (and stop reading those books!), realizing that any time there are black & white rules around eating, weight gain or movement, it’s not an approach I want any part of. Getting back to my usual intuitive eating approach made for a much happier and healthier rest of my pregnancy.
So if you’re asking yourself, can I eat intuitively during pregnancy and still protect both my health and my growing baby’s? My answer is yes.
Of course there are some foods that can be more risky during pregnancy (though not as many as you might think – more on that later) but otherwise, you can absolutely still eat intuitively while pregnant.
The idea behind intuitive eating is that you can trust your very wise body to signal you when you need something. Whether this is increasing your thirst to motivate you to drink, causing a craving for a quick source of energy when you need a boost or bumping up your desire for protein when you’re low. Our bodies know what’s going on with all our internal systems better than any outside source. So, just as you can when you’re not pregnant, you can continue to trust your body’s signals for the most part (we’ll talk in a minute about what to do when maybe those signals are interrupted by pregnancy symptoms).
It can also be easy to forget that our bodies are highly adaptable and very smart. They’re fairly capable of making use of whatever fuel we give them to meet our most important needs. So even if you go the whole first trimester without a single vegetable, your body can adapt the nutrition it is getting to make up for that. Remember that nutrient deficiencies take a very long time to occur, so a trimester or two without a perfect balance of nutrients will not harm the wellbeing of you or your baby.
Stressing over every meal, nutrient and thing you are or are not eating puts you and your baby at much greater risk than missing out on certain individual nutrients.
Not to mention, if you are taking a prenatal vitamin, this can help fill in any gaps.
For me, I thankfully had a pretty smooth & easy pregnancy with Owen and this one has been much of the same so far. That said, that’s not always the case. Morning sickness, food aversion, and more can interrupt your connection to your internal signals; but a small shift to a self-care eating framework can help during these times.
There may be moments during your pregnancy when you’re just not sure what your body is trying to tell you or you can’t access your usual cues of hunger, fullness or satisfaction. In these instances, just as when these signals go offline when not pregnant, eating then becomes an act of self-care.
When you can’t access your regular cues or having a hard time understanding them (hello pregnancy hormones!), work to put something you can tolerate into your body every 2-3 or 3-4 hours (depending on how much you’re able to tolerate and what works for you).
In a world where you felt well and able to eat anything, I would encourage you to find something with carbohydrate, protein, fat and maybe some fiber. In a world where food aversion and morning sickness can run rampant, it should truly just be whatever you can tolerate. The energy at that point is more important than the nutrient spread. Remember that our bodies are capable of utilizing the fuel we give them. There are plenty of compensatory mechanisms in place to help make up for a less than fully-balanced diet short-term.
A note on “risky foods” during pregnancy: it’s important to note that outside illicit drugs and alcohol, food is not going to have a guaranteed toxic effect on the health of you or your baby. But there are foods which are considered “riskier” during pregnancy such as raw or unpasteurized dairy or soft cheeses (think brie, feta, camembert, etc.), any undercooked or raw meat, seafood or eggs, high mercury fish (such as shark, tilefish, swordfish and king mackerel) and deli meat.
That said, most of the recommendations to completely avoid these items all together are not necessary. The majority of the dairy in the US is pasteurized. To be certain, just check the ingredient label and ensure “pasteurized” makes an appearance and avoid anything that specifically states “raw.”
Listeria (a bacteria that can live at fridge temperatures) is the concern with deli meat. However, if heated to an internal temperature of 165°F or until steaming hot just before serving, this should kill the bacteria and reduce your risk.
There’s really no work around for undercooked meat, seafood or eggs. Justensure these foods are well cooked. Eggs are best served hard boiled or “over hard” (meaning the yolk is cooked through).
Finally, fish is a great source of fatty acids which is great for your baby’s brain growth & development. If you like fish, there’s no need to avoid ALL fish – salmon, shrimp, chunk light tuna, scallops, catfish, cod, haddock and many more are all perfectly safe when well-cooked (here’s a helpful chart if you need it!). Of course, it’s ultimately up to you and what you feel best doing!
Okay, you might be thinking, so I can still trust my body to regulate my intake during pregnancy, but what about my weight? Aren’t I at increased risk for all kinds of issues if I gain too much or too little weight?
Shouldn’t I be stepping on the scale every day to ensure that I’m right where I need to be? My short answer is, no.
Just as you could trust your non-pregnant body to find its set point weight, you can do the same when while pregnant, so long as you’re continuing to eat intuitively and respond to your body’s cues (or work with a self-care eating framework when you can’t hear them).
My longer answer is that, it’s such a nuanced topic and depends so significantly on the individual, where they were health-wise at the start of their pregnancy and how their pregnancy is progressing. If you were generally in good health (note that this does NOT mean if you were at a certain weight or an “ideal BMI,’ but generally healthy in terms of labs, mental health, etc.) before you were pregnant, you can likely continue to trust your body to guide your weight gain during this process.
If you’ve struggled with disordered eating or eating disorders, you may need to be more intentional about ensuring you give your body the freedom to guide you, versus trying to externally control your weight gain (whether through diet or movement). Working with a Certified Eating Disorder specialist trained in Intuitive Eating or a Certified Intuitive Eating Counselor during this time can be extremely helpful – and many are now offering virtual services.
If you are in a larger body and pregnant, it’s likely you’ve been told to monitor your weight. But research in 2014 found insufficient evidence to show any relationship between high BMI and reduced birth rates, no significant difference in miscarriage rates or other pregnancy complications with a high BMI (1). Remember that for most, intentional weight loss is not only unsuccessful, but can ultimately cause MORE harm to your health & wellbeing than the weight itself.
Speaking of which, if you are in a larger body and pregnant or looking to get pregnant without fear & anxiety over your weight, I highly recommend Nicola Salmon’s site & Instagram to put your mind at ease that your weight is not doing a disservice to you or your baby.
Finally, let’s take a look a movement during pregnancy.
Just as you would when not pregnant, you can feel free to partake in ‘joyful movement‘ rather than a militant fitness routine.
Joyful movement is essentially the intuitive eating version of movement. Where diet and fitness culture often promote working out as a means to shrink or change our bodies in some way, joyful movement instead turns the focus inward. It asks you to think about you enjoy doing. What feels good. It also accepts that perhaps that doesn’t include any formal fitness program at all.
It’s not unusual during pregnancy when your body is already going through so many other changes, for different types of movement to feel better than others. I’ve always loved running as a main form of movement, but during my last pregnancy I suffered terrible sciatic pain and wasn’t able to do it for very long. Rather than “pushing through the pain,” I explored other options – I walked, did the elliptical and swam. Whatever I happened to feel like in the moment, I did! And if it stopped feeling good while doing it, I simply stopped. I wasn’t out to hit a certain number of steps, burn a certain number of calories or move for a certain amount of time. I did it when I felt up to it and motivated and felt no issue with resting when I wanted to instead.
This is the same approach I take when not pregnant, and the same thing I’m doing with this pregnancy. There is no question that being active is good for our health. However, when it becomes something we feel bound to, rather than something we enjoy, the negative consequences start to infringe upon the positive.
Over and over we see that health-promoting behaviors (sleeping well, managing our mental health, moving our bodies in a way that feels good, eating in according to our intuitive signals, keeping our stress levels low) improve health regardless of the impact these behaviors have on our weight. You are reaping the benefits of these behaviors no matter what happens to your weight or how militant you are in doing them. Joyful movement promotes moving in a way that simply feels good and in accordance with your desire to be active (in whatever way that looks for you). It pushes back on the idea that exercise needs to be regimented, painful or dreaded in order to provide benefit.
Ultimately, the best thing you can do for the health of your baby is to do your best to relax. There are so many other things to stress & worry about during pregnancy (especially given the current state of the world!), that adding what, when, how much to eat, move and weigh just isn’t needed. You can trust your body can be your guide, and even when your internal signals are offline, you can come up with a self-care eating plan to take over.
Do your best to enjoy this time. While some days it may feel never-ending, it ultimately goes by in the blink of an eye. The less you stress & worry, the better for your baby.
(1) S. Pandey, A. Maheshwari, S. Bhattacharya, Should access to fertility treatment be determined by female body mass index?, Human Reproduction, Volume 25, Issue 4, April 2010, Pages 815 820, https://doi.org/10.1093/humrep/deq013
Disclaimer: Statements in this post are for educational use only and are not intended to diagnose, cure, treat or prevent conditions. Readers are advised to consult with their healthcare providers prior to making any changes to their healthcare management.4