A healthy blood volume prior to pregnancy is around 5 liters (5,000 cc or about 20 cups).  In the first trimester, we can help determine a healthy blood volume by doing lab work and seeing a Hemoglobin between 12 and 16 (somewhere around 14 is excellent for women where I serve in the Mid-Ohio Valley) as well as other markers of blood health.  During pregnancy, in order to nourish her growing organs, the placenta, the developing baby, and accommodate fluid loss at birth, a mother’s blood volume must expand by close to 60%.  This is around an additional 3 liters (3,000 cc or 12 cups), making the total expected blood volume prior to birth approximately 8,000 cc (or 32 cups) of blood for a well-nourished woman.  We can reassess Hemoglobin around 28 weeks and expect to see a drop by approximately 2 points, which may indicate adequate blood volume expansion.  An unchanged, or rising, hemoglobin without drastic nutritional or supplemental measures is one of the first indications of pre-eclampsia, prior to many common symptoms being noticed.  End of pregnancy Hemoglobin should not be less than 10, and more ideally somewhere around 12 for energy & healing, when early pregnancy numbers were higher.

In order to have a healthy blood volume at conception, and to build this much blood throughout pregnancy, a mother must be well-nourished.  Nutrition and hydration during pregnancy (and throughout all your life) is the foundation of preventative health, and treatment of dis-ease.  While supplements can make up for what we don’t get in our food choices, supplements can’t replace high quality nourishing balanced food choices.  This includes ample amounts of dark leafy greens, fresh vegetables and fruits of all the colors of the rainbow, mineral salt, minimally processed foods, adequate hydration, and enough calories to provide energy and nutrients (eating a balanced meal or snack every 3 hours during the day).  The more carbohydrates a mother eats such as: bread, pasta, sugar, cake, casseroles, corn, potatoes, rice and other processed foods – the more protein a mother must eat to balance her blood sugar levels and to nourish her body to make plenty of blood for her and her baby.

These choices help to prevent, and treat, pre-eclampsia – a disease indicated by rising blood pressure (140/90 or higher) and protein in the urine, or a Hemoglobin that doesn’t drop, or increases, by 28 weeks.  This disease can cause headaches, nausea, seizures in the mother, or maternal or neonatal death.  A rising blood pressure, protein in the urine, or a hemoglobin that does not change (or rises in pregnancy) is not something to ignore.

While blood pressure can fluctuate, and even some women experience a 140/90 or higher blood pressure without having any other complications, it is important to determine if this higher blood pressure is caused from a previous illness, stress, or other benign cause that might be treated with simple herbs and lifestyle changes, or if a rising blood pressure might be caused from pre-eclampsia.  A rising blood pressure above 140/90 on two separate occasions at least 6 hours apart may be a reason to have more lab work, or seek out additional Obstetric evaluation.  If blood pressure rises to 140/90 during labor, steps to help relax the mom and provide nourishment that she may be missing will be necessary.  A blood pressure of 150/100 that does not reduce in at least 15 minutes is a reason to immediately transport to the hospital if transport has not already occured.

Signs that pre-eclampsia may be developing are almost always nutritional imbalances, and may include:

• Swelling, especially when it doesn’t go away by morning and when it starts to be noticeable in the hands and face
• A trace amount of protein in the urine
• Unchanged or rising hemoglobin
• A rising blood pressure
• Headaches, nausea, or dizziness

When these signs are noticed early, and food choices are adequately addressed, we can usually prevent further symptoms from arising when pre-eclampsia is caused from nutritional imbalance.  (Some pre-eclampsia is caused at conception and nutrition doesn’t change it).

It is great to start with a week-long lifestyle journal prior to conception or in early pregnancy.  Write down everything you eat (and drink) and the times you eat, sleep, and move or exercise.  Learn your habits and notice where you might improve, then make changes before you ever start clinical monitoring are notice swelling.  If you’d like some nutritional guidance, reach out over at MOV Birth for a wellness visit and start prenatal care early (even if an early visit is just to receive wellness counseling or lab work before establishing regular prenatal care).