Keto and Pregnancy: What You Need to Know

If you’ve recently found out that you’re pregnant then congratulations!  There is a world of excitement and love headed your way.  It’s perfectly normal to be nervous at this time, after all, you are carrying a new life inside of you and that can be a little nerve wracking. 

In your search to have the healthiest safest pregnancy possible you’ll no doubt have concerns about what you can and can’t eat.  If you’ve been doing Keto for a while you’re probably wondering how Keto will affect your pregnancy and your little bundle of joy.  The following article will go over the research on the Keto diet and how it affects pregnancy so that you are armed with all the information you need to have a conversation with your doctor.

The controversy surrounding Keto pregnancies

There is a lot of controversy surrounding whether Keto is safe while you’re pregnant.  One of the main reasons for this is that there is trouble conducting proper studies, so the research is lacking.  Any responsible researcher isn’t going to run tests and studies on pregnant women.  The possible risks associated with enrolling pregnant women in studies far outweigh the benefits in the majority of cases.  This means that a lot of the evidence and research is based on anecdotal evidence instead of controlled studies. 

There have been long-term observational studies on women who are pregnant and their various diets and methods of eating.  These are the only ethical studies that can really be done.  In an observational study, doctors just record and observe how women eat while pregnant and what effects that this has on their babies rather than asking them to eat in one way or another. 

The best research we have regarding pregnant women and their babies actually comes from mice.  This leads the majority of doctors to recommend a “safe” diet of fruits, vegetables and healthy grains.

Some doctors think it’s okay

Despite the lack of availability of controlled studies, there are doctors who believe that eating a low carb or Keto diet can actually aid you with getting pregnant, the symptoms of pregnancy and having a healthy pregnancy from start to finish.  There are also plenty of women who have amazing stories to tell about how their nausea disappeared during their Keto pregnancy and their energy levels skyrocketed. 

It’s considered safest to start your Keto diet at least 3 months prior to conception.  This gives your body time to adapt to the high fat, low carb meals so that it’s comfortable making ketones its primary energy source.  Pregnancy is hard enough without having to worry about making any major dietary changes.  Your best option is to stick to what you and your body already know if you can, which means sticking with Keto if you’ve been doing it for a while.  Think of the stress it would place on your already stressed out body if you were to switch to a high carb diet with a body fueled by glucose if you’ve been eating low carb for a long time!

One of the reasons that some doctors feel comfortable encouraging their patients to stick with Keto throughout their pregnancy lies in our history.  Our ancestors were hunter gatherers and relied on a diet of meat, berries, fish and whatever greens and fruit they could scavenge up.  They didn’t stay put in one place and have the time or resources to farm fields of grain.  Humans lived through these low carb days with healthy pregnancies in the past, so it stands to reason that we can do so in our modern time period.

Babies need to build up fatty tissues in their brain and nerves in order to properly grow.  This is why doctors ask you to eat a diet that’s rich in Omega 3’s and other healthy fats.  The Keto diet is rich in these healthy fats and can encourage proper brain development in the fetus. 

If you’re having a tough time getting pregnant and you’ve struggled with infertility in the past, then there’s a good chance that the Keto diet can help you get pregnant.  Switching to a low carb high fat diet often leads to weight loss.  Obesity is one of the largest causes of infertility among women and doctors often recommend weight loss as one of the first treatments for their overweight patients experiencing infertility.

Gestational Diabetes and Keto

One of the most common and most significant complications that can arise during pregnancy is gestational diabetes.  Gestational diabetes is when your body cannot tolerate carbohydrates and your insulin levels rise to unhealthy levels.  With gestational diabetes your blood sugar rises which is a condition known as hyperglycemia.

Gestational diabetes can cause a host of problems for both mother and child during pregnancy and there’s evidence that babies that are exposed to gestational diabetes have a greater likelihood of developing metabolic conditions later in life. This is why doctors take gestational diabetes so seriously.  Your doctor will test you frequently to see if you’re developing gestational diabetes and at the first sign, they’ll ask you to follow a diet designed to keep your blood sugar under control.

What changes from doctor to doctor is what they consider a healthy diet for lowering blood pressure.  Some doctors believe that reducing your carbs to 60% is sufficient while others ask you to lower your carbs to 40%.  If you’ve been on Keto, then you probably realize that these amounts are still high!  It stands to reason that the Keto diet would be an excellent way to prevent and manage gestational diabetes because it keeps your carbs to 5% of your daily calories or less and it helps stabilize your blood sugar levels.

Some doctors feel it’s not healthy

There are still many doctors that believe that the Keto diet isn’t a healthy choice for pregnant mothers.  A lot of their concern stems from the lack of scientific studies and research-based evidence.  Their concern is understandable.

For the majority of doctors, the main thing they’re worried about when it comes to pregnancy and the Keto diet is a condition known as diabetic ketoacidosis.  Diabetic ketoacidosis can be fatal in pregnancy.  Your doctor will test your urine for the presence of ketones while you’re pregnant and if they see signs of ketones then they worry that you might have diabetic ketoacidosis. 

Ketoacidosis is not the same as ketosis.  In Ketoacidosis your body produces way too many ketones and it turns your blood acidic.  This is not the case with Keto where your body only produces the ketones that your body requires to create energy; however, you can understand why it might frighten your doctors.  True ketoacidosis can only be determined by blood ketone levels, not urine ketone levels.  Your best bet if you want to follow a Keto diet is to let your doctor know that there will be ketones in your urine because you’re in ketosis.

So can you do Keto while pregnant?

The short answer is it depends on you and your doctor.  If you’re already doing Keto when you get pregnant then you have a strong case for continuing to follow a Keto meal plan.  The issue is, there are a lot of doctors that don’t agree with Keto pregnancies.  It’s important that you and your doctor are on the same page and that you’re honest with them.  

This allows your doctor to offer the support and guidance that you need with a complete understanding of what you’re doing during your pregnancy.  If they don’t have all the information, then they can’t properly diagnose and treat any issues that may arise during your pregnancy and that isn’t safe for you or your baby.

You know your body best, so be cautious when making any dietary changes during pregnancy.  Pay attention to how you feel and if anything doesn’t feel right, speak to your doctor right away.  Use what you learned from the above article to make an informed decision that fits your individual needs and make sure that your doctor is a part of the decision.

It might be that you need to do a modified version of the Keto diet, such as intermittent Keto.  Or your body may crave carbs during your pregnancy, and you have to change your net carb limits to fit with your body’s needs.  However you choose to eat during pregnancy know that as long as you honor how your body feels and you’re open and honest with your doctor then you’re doing what’s best for you and your baby.


There has been very little research done on the effects of the Keto diet and pregnancy.  However, you know your body the best and you know when something isn’t working and you’re not feeling well.  Keep up a stream of honest communication with your doctor so that you’re both on the same page and you can come up with a treatment plan together that makes both of you feel comfortable.

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