Keto and Pregnancy
Is It Safe When You’re Expecting?
Let's get something out of the way right off the bat: ketosis is a natural state. The body metabolizes energy typically from carbohydrates. But if it is deprived of carbs, it will naturally revert to its backup energy source: fats.
To do this, it creates what are called "ketone bodies" which enable the fat to be metabolized. Anyone can trigger ketosis simply by fasting.
As such, there is no reason for pregnant women or those who may be planning a keto pregnancy to fear the low-carb diet.
But that doesn’t mean there aren’t certain things you’ll need to keep in mind regarding the lifestyle and your own particular nutritional needs.
Is Keto Safe During Pregnancy?
Yes. Unless there are specific extenuating circumstances regarding a particular woman, the ketogenic diet in and of itself should pose no particular threat to pregnant women or their developing baby. 
As some have pointed out, pregnant women in ancient times were almost certainly in a state of ketosis on a fairly regular basis as high carb foods were not always easy to come by.
Today, many women go through their entire pregnancy and the childbirth process while on the famous low-carb lifestyle with no adverse effects. 
So how do they accomplish this? Let’s take a look.
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So, Ketosis and Getting Pregnant
Women who indulge in the standard Western diet of high-carb, high sugar foods (learn more) while pregnant are not usually doing themselves or their baby any favors.
It's been medically proven that the diet of the mother during pregnancy, as well as lifestyle habits like smoking and drinking, can have serious long-term repercussions on the health of the child, not just in infancy, but as your baby progresses through all stages of life.
"You are what you eat" is as true today as it ever has been, and with pregnant women that saying can be expanded to read "Your baby is what you eat."
The low carb diet then is not only safe if appropriately managed but may be preferable to the standard Western style of the early 21st century when it comes to pregnant women.
The important thing to keep in mind is that your overall diet has to be balanced and not lacking in any of the vital nutrients you would usually get from carb-rich food sources.
This is a common mistake made by people who are new to keto. If you cut out all the high-carb veggies and fruit and don’t replace all the essential vitamins and minerals, then you can quickly become deficient in vital nutrients.
While it might sound easy to simply change the balance of carbs, protein, and fat, there is a lot more to it that you have to plan for carefully. 
Some Pregnancy Myths and Misconceptions
Most of the hand-wringing around keto and pregnancy tends to derive from a state called diabetic ketoacidosis or DKA.
There is no doubt that DKA can be a hazardous and harmful condition, particularly for a pregnant woman. However, the fact that "keto" appears in the name diabetic ketoacidosis does not mean it has anything to do with the keto diet.
The lifestyle is designed to tip the body over into its natural backup state of deriving energy from fats rather than its default state of acquiring energy from carbohydrates.
When appropriately practiced, the diet typically results in normal, stable blood sugar levels, low ketone levels, and a healthy acid-base balance.
As such, it enables the body to run much more efficiently and effectively and can increase both physical and mental acuity.
Diabetic ketoacidosis, however, is a very different and unrelated animal.
DKA is a condition that affects people with diabetes who have done a poor job of managing their blood sugars.
In such cases, ketone levels in the blood become elevated and are accompanied by extraordinarily high blood sugar levels.
Together, these two states generate an acid-base imbalance that is potentially deadly.
In this case, a ketosis-like state is prompted by the fact that the person with diabetes cannot create enough insulin to handle all the blood sugar, so their body instead starts to generate ketones.
The result is a confused state where the body is not short on carbs but is producing ketone bodies anyway.
Symptoms of this condition include stomach aches and vomiting, a fruity odor to the breath, confusion, fatigue and respiratory distress.
DKA can also have a negative effect on fetal brain development.
However, the misconceptions around keto and pregnancy tend to arise naturally because DKA has "keto" in its name so people naturally assume that if DKA is bad, then the keto lifestyle must also be bad, especially for pregnant women.
But that's rather like assuming the heart is bad because the phrase "heart attack" has the word “heart” in it.
It’s Only a Natural Process
It's no secret that a well-balanced diet often suffers during the early stages of pregnancy.
That's largely because of morning sickness, a general sense of nausea and various food aversions that seemingly come out of nowhere that can affect appetite.
As such, it's all too common for women to eat sporadically and even then not particularly well during the first months after conception.
The result is that many pregnant women dip in an out of ketosis on a fairly regular basis without even knowing it.
The kicker is that during those times of ketosis, women can actually feel a lot better because blood sugars are stable, their minds are clear, and they tend to have more energy.
The fact that many pregnant women feel worse after resuming their regular carb-heavy diet while pregnant should be enough to seriously reconsider their diet.
While some will point to the fact that there have been precious few health studies done on the subject of keto and pregnancy we respectfully suggest that misses the point. Studies on the matter are not necessary because women have been naturally going through ketosis while pregnant for eons.
Exercising Your Common Sense
With all of the above said, and with a long established history between pregnant women and ketosis in place, there are still some common sense considerations that need to be touched upon when it comes to the keto diet and pregnancy.
Frequently Asked Questions
Is keto safe for breastfeeding?
Yes, keto is safe while breastfeeding as long as you don’t take it to extremes.
Many people are able to lower their carb intake to just 20 grams per day once they hit optimum ketosis. However, this can impact your milk supply, so it’s recommended that you aim for a slightly higher level of 50 grams per day. 
Does keto help with fertility?
Yes, the keto diet can help with fertility in women due to its impact on insulin and overall hormonal balances.
Once you achieve full ketosis, blood sugar levels will stabilize, and insulin production will not be in a constant state of highs and lows. This doesn’t just have a positive impact on your blood sugars but also on reproductive hormones.
Can you take ketones while pregnant?
Yes, you can take ketones during pregnancy, but they should be kept to a minimum.
The reason is that excess amounts of ketone will be removed through your urine, and this can lead to a condition known as ketonuria.
This condition is common during a normal healthy pregnancy, but adding to the risk can in extreme cases lead to ketoacidosis which would be dangerous to the mother and the baby.
Can ketones hurt my baby?
Yes, excessive amounts of ketones can hurt your baby and potentially cause reduced brain development.
However, a balanced keto diet should never result in excessive amounts of ketones, even when you’re not pregnant. Monitoring your ketone levels during pregnancy requires just a simple urine test strip and should be done regularly.
Can you get pregnant in ketosis?
Yes, you absolutely can get pregnant while you’re in ketosis, and the state can even help you conceive more easily.
As mentioned above though, you don’t want to continue with a weight loss goal, as feeding your baby will be a much higher priority at that stage.
What is ketones in urine during pregnancy?
Ketones in your urine during pregnancy are actually quite common.
This elevation of ketone levels is even possible in women who don’t practice the keto diet, but it is something that has to be monitored. If the levels rise too high, then it could cause problems for you and your baby.
Is it okay to lose weight when pregnant?
Generally speaking, it is not OK to lose weight during pregnancy.
In some cases where the mother has a dangerous level of obesity, it may be advisable, but this should only be done under the supervision of a doctor and/or dietician.
During pregnancy, it is far more important to make sure you and your baby get all the nutrients necessary.
There will be plenty of time for weight loss once your baby is born.
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So, What Are Our Final Thoughts On This?
While women need to use common sense while on the keto diet during pregnancy, there is no evidence that ketosis itself poses any danger to pregnant women or women who intend to breastfeed after giving birth.
There is plenty of evidence that suggests the keto diet has positive impacts on fertility as well as the overall health of a woman during pregnancy.
As long as the diet plan is set up in a way that maximizes micro and macronutrients intake, there should be no health risks to mother or baby.
However, if you have any underlying health risks or pregnancy related complications, then a conversation with your doctor is always recommended.