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Prenatal Care and Gut Health

Updated: Feb 12

During the pre-natal period, there are numerous changes that occur to the gut. This includes changes in immune response as well as the bacteria that are present.

There are TRILLIONS of bacteria that make up the gut microbiome. These bacteria can be impacted by estrogen and progesterone levels. Changes occur to help support maternal metabolism which regulates weight necessary for pregnancy (1). These changes also help to influence the bacteria in the gut and the vaginal canal to better support the pregnancy.

Why is gut health so important for prenatal care?

The development of the microbiome begins BEFORE birth. During the birthing process, the baby's microbiome continues to be impacted by mode of delivery (c-section or vaginal birth), and continues to be impacted by maternal and infant diet, and environmental exposures.

Neurological Development

Development of the microbiome occurs simultaneously with the nervous system. Significant early-life disruption of the mother's microbiome like major illnesses or high dose broad spectrum antibiotics can lead to chronic disease or mental disorders later in the baby's life (1).

gut brain axis

This is why I discuss the important of gut health with all of my patients prior to conceiving. If you have issues with digestion, food sensitivities, and/or irregular bowel habits, this may lead to a more stressful pregnancy. Doctors tend to be more cautious in their approach for treatment during pregnancy because there are medications and herbs that are safe for the baby and there are ones that are not.

Leaky Gut Increases Risk of Miscarriage

For instance, if a woman is dealing with bacterial overgrowth (SIBO), has other underlying infections, and is dealing with food sensitivities, this can lead to increased intestinal permeability aka leaky gut. Essentially, the walls that separate the intestines from the blood stream become compromised and antibodies, immune cells, and inflammatory cells can migrate out of the intestines and into the blood stream. This is why poor gut health can cause headaches, skin rashes, joint pain, fatigue, weight gain, etc, and this of course can influence prenatal care.

leaky gut

If this same woman becomes pregnant when she has these issues, she is at an increased risk of miscarriage and/or a high risk pregnancy. The blood that flows through the mother's body will also circulate to the developing baby. There are microbes that have been found in amniotic fluid of women who experienced preterm premature rupture of membranes (2). This is referred to as endotoxemia which is a systemic infection.

Changes to the Gut Microbiome

The gut microbiome is influenced by diet, nutritional status, and genetics. Having low levels of Vitamin D can negatively impact a pregnancy. A typical Western diet consists of processed foods (even GF ones), excessive dietary fats and sugars. This type of diet promotes weight gain and a dysbiotic gut (overgrowth of too many bacteria or too much of the same bacteria). This type of diet is highly correlated with adverse maternal and fetal health outcomes.

What should I be eating?

  • Proteins like beans, skinless chicken, lean beef and fish

  • Organic produce like leafy greens, colorful fruits and vegetables, and fresh herbs

  • Unsaturated fatty acids like olive oil, flaxseeds, salmon, chia seeds, avocados

  • Organic whole grains like oats, whole grain bread, rice, quinoa

These foods promote a healthy gut microbiome, improve intestinal permeability, and reduce excessive systemic inflammation (1).

Changes to the Vaginal microbiome

The vaginal canal can be a portal for infections into the uterus. During pregnancy, the vaginal canal becomes dominated by lactobacillus. These bacteria help to protect the uterus from infections and also exposes the baby to lactobacillus during delivery (3). Exposure to different bacteria varies from vaginal birth to c-section. Vaginal birth is the preferred method due to the bacteria the baby is exposed to and how this bacteria helps with the baby's development of their microbiome. However, c-sections are sometimes the only option and in this case the mother can have the vaginal canal swabbed and put on the baby to expose it to even more bacteria following birth.

vaginal and gut microbiome

The Gut and Vaginal Microbiome Connection

Bacteria that makes up the vaginal microbiome has been traced back to bacteria the female was exposed to during vaginal delivery and exposure to bacteria via the rectum. These two systems "cross-talk" meaning changes in one can influence changes in another. This explains why women who have used antibiotics will sometimes end up with a yeast infection later (4). This also explains why food cravings can be so drastic in some women- the bacteria makes them crave foods!

Maintaining a healthy gut microbiome will likely lead to

an easier and lower-risk pregnancy.


Work with me

If you are hoping to get pregnant in the future and want to make sure that your body is healthy and well prepared, you can click here to sign up with a complimentary 15 minute phone call with me. We can discuss your goals at that time and determine whether or not we will be a good fit for each other. During the time before you get pregnant, and during pregnancy, we will discuss necessary nutrients, dietary options, as well as lifestyle and exercise programs catered to YOU specifically.

dr katie zaremba infertility gut health

About Dr. Zaremba:

Dr. Zaremba received her bachelor's degree from Western Michigan University in Biomedical Sciences and minored in Chemistry and Psychology. She completed her doctoral training at Palmer College of Chiropractic. During her time in school, she took post-doctoral training through The Clinic on Disease and Internal Disorders (CDID) earning her a Diplomate from the American Board of Chiropractic Internists (DABCI).


This web site offers health, wellness, fitness and nutritional information and is provided for informational purposes only. This information is not intended as a substitute for the advice provided by your physician or other healthcare professional. You should not rely on this information as a substitute for, nor does it replace, professional medical advice, diagnosis, or treatment, Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or using any treatment for a health problem. If you have or suspect that you have a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read on this web site. The use of any information provided on this web site is solely at your own risk. Nothing stated or posted on this web site or available through any services offered by Dr. Katie Zaremba DC, Dr. Katie Zaremba LLC, are intended to be, and must not be taken to be, the practice of medicine. Information provided on this web site DOES NOT create a doctor-patient relationship between you and any doctor affiliated with our web site. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.


  1. Edwards SM, Cunningham SA, Dunlop AL, Corwin EJ. The Maternal Gut Microbiome During Pregnancy. MCN Am J Matern Child Nurs. 2017;42(6):310-317.

  2. DiGiulio DB, et al. Prevalence and diversity of microbes in the amniotic fluid, the fetal inflammatory response, and pregnancy outcome in women with preterm pre-labor rupture of membranes. Am J Reprod Immunol. 2010 Jul 1; 64(1):38-57

  3. Gupta P, Singh MP, Goyal K. Diversity of Vaginal Microbiome in Pregnancy: Deciphering the Obscurity. Front Public Health. 2020;8:326. Published 2020 Jul 24. doi:10.3389/fpubh.2020.00326

  4. Amabebe E, Anumba DOC. Female Gut and Genital Tract Microbiota-Induced Crosstalk and Differential Effects of Short-Chain Fatty Acids on Immune Sequelae. Front Immunol. 2020;11:2184. Published 2020 Sep 10. doi:10.3389/fimmu.2020.02184




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