Tuesday, March 30, 2010


A lot of people may have heard about preeclampsia following Josie Duggar's extremely premature birth at only 25 weeks gestation, and wondered what this condition is.

According to the Preeclampsia Foundation,

"Preeclampsia is a disorder that occurs only during pregnancy and the postpartum period and affects both the mother and the unborn baby. Affecting at least 5-8% of all pregnancies, it is a rapidly progressive condition characterized by high blood pressure and the presence of protein in the urine. Swelling, sudden weight gain, headaches and changes in vision are important symptoms; however, some women with rapidly advancing disease report few symptoms.

Typically, preeclampsia occurs after 20 weeks gestation (in the late 2nd or 3rd trimesters or middle to late pregnancy), though it can occur earlier. Proper prenatal care is essential to diagnose and manage preeclampsia. Preeclampsia, Pregnancy Induced Hypertension (PIH) and toxemia are closely related conditions. HELLP Syndrome and eclampsia are other manifestations of the same syndrome."

The website estimates it to "cost the US over $7 Billion alone" per year. The exact statistics are shocking. The FAQs offer answers to many questions about this condition, but the one I want to focus on in this post is the question: What causes preeclampsia? Can it be prevented?

First of all, I would like to say that I am not trying to "blame" anyone if they suffered preeclampsia, or any of its related conditions. I am not at all trying to say that it was their fault, or that they brought it on themselves. I am not saying that all cases are preventable. I am merely stating what I have learned and experienced from having had five healthy pregnancies and births (four at home), from reading about this subject in depth, and from learning from midwives and other natural birth supporters. Of course, I am no medical doctor, so please do not view this as medical advice. It is your responsibility, and yours only, to educate yourself about your health and that of those you love and care about. No doctor in the world will ever care more about your well-being than you yourself will.

Among most midwives, it is usually common knowledge that preeclampsia is caused by a lack of protein. It is, in short, a nutritional deficiency. They often admonish expectant moms to follow the "Brewer Pregnancy Diet", developed by Dr. Brewer, a doctor who long held that moms who followed this nutritional advice never got preeclampsia, and also warded off a whole host of other possible pregnancy-related issues. Please click here to go to a website that explains the diet in detail and offers much information and scientific backup.

The medical society, by and large, has rejected this explanation. Maybe it sounds too simple, but scurvy was caused by a lack of vitamin C, the plague was caused by a lack of sanitation, and child-bed fever was caused by doctors going from patient to patient without washing their hands. The solutions to all of these problems were discovered decades before they became standard practice, because they were all dismissed as being too ridiculous to accept. Or maybe, as in everything, the love of money is behind all this. Did you know that on average, 80% of hospital profits come from the labor and delivery department? I just learned that last week. Think about that for a minute. There's just not a whole lot of money in a normal, natural birth that doesn't require anyone to be there except mom and baby.

Some time back I read that there had been a study comparing the pregnancy outcomes of expectant moms on high protein diets, and moms who just ate a "normal" diet. There was no significant difference between the groups with regard to preeclampsia. However, it should be noted that the women in the study did not consume protein from whole foods (both animal and plant based), but rather from protein shakes. This study is largely responsible for most doctors dismissing the "protein deficiency theory". However, nutritionally speaking there is a massive difference between consuming whole foods, and consuming a highly-processed supplement.

In fact, many midwives have witnessed cases of beginning preeclampsia reversed after the mother made a conscious effort to eat an extremely high protein diet in an attempt to turn her condition around. Under careful monitoring, this is often successful, and definitely beats having to tear a baby out of the womb prematurely to save its life and that of the mother.

If you are pregnant, unless you are counting protein grams, you are probably not getting enough. And not just proteins, but proteins from different sources such as eggs, milk products, meat, beans, and whole grains. If you have a family history of preeclampsia, you should be extra careful to make every bite you eat while pregnant count.

The characteristic high blood pressure and swelling in the face and sometimes hands are late warning signs of preeclampsia. A much earlier warning sign is protein in the urine, a sign that the mother's body has started breaking down her own muscles and other protein stores in order to make it available to the baby. At this point, focusing on healthy proteins would almost always avert the full-blown condition in the mom. Unfortunately, most "pee sticks" that OBs offer at prenatals do not check for protein in the urine, whereas midwives use sticks that test for almost a dozen different warning signs that may be present in a sample.

The philosophies of doctors and midwives are vastly different in that the first will wait for a problem to crop up, and then go at it with the big guns, while the latter focus mostly on preventing any complications from arising in the first place.

Taking a prenatal is NOT a substitute for proper nutrition. In fact, it may make things worse. A recent study linked taking folic acid supplements during the last trimester to a number of adverse conditions in the babies, while consuming the same amount of folic acid in natural form (i.e. leafy greens, asparagus, whole grains, eggs) only showed beneficial effects.

In any case, eating healthily never hurt anyone, so the Brewer Pregnancy Diet can safely be recommended to all expectant moms.


  1. While I agree with much of what you have written, I have to point out three things:

    1. It is my understanding that The Plague was caused by flea bites from fleas that had been on infected rats. The rat population during that time was high because people killed off the cats, thinking they were evil, portents of witchcraft, etc. I looked and found plenty of documentation for the flea part but not the cat part. Do you have any documentation that shows that The Plague was caused by poor personal hygiene?

    2. A lot of hospitals are closing down their maternity wards because of the high volume of medical malpractice suits. I don't see this happening if they get 80% of their profits from that department. Do you have any documentation for this claim?

    3. I had four children in four different states and obviously four different hospitals and each one routinely checked for protein in the urine. I assume that is standard practice, but don't know what goes on in every OB office around the country. Again, do you have documentation that most OBs do not do that?


  2. Bakershalfdozen,

    Thank you for your constructive criticism. To answer your questions:

    1. You are right, the plague was largely spread by rats, who lived in the streets where they ate the trash that people simply threw out of their windows, rather than taking it to a trash dump outside of their towns/villages as the Bible commands. I have edited my original post and substituted "sanitation" for "personal hygiene", which is what I meant all along.

    2. I don't know of any hospital in our area that has closed their maternity ward. In fact, they are always expanding and remodeling them to make them appear more like a natural birth center. Malpractice suits affect all areas of medicine, not just obstetrics, so by that logic all departments would be closing.

    3. Of the three OBs that I saw between my first 2 pregnancies, not one of them checked for anything beside sugar in the urine. This also seems to be the experience of many other natural birth supporters I know who had previously used OBs. Maybe you just have a knack for picking great OBs. Even if a doctor notices high blood pressure or protein in the urine, they are very likely to simply make a note of this in the patient chart and not tell her as to not worry her, since in their book there is no "cure" for preeclampsia other than emergency cesarean in severe cases.

    All that aside, the main point of this post was that preeclampsia is mostly preventable, and that it is the mother's responsibility to ensure her baby's wellbeing, not that of the doctor.

  3. Hi again,

    I understand the point of your post and agree with it. Doctors are not gods and women should self-educate as much as possible. Doctors do have their place though. I hope you never have to eat your words. I just don't agree with broad brushing. Usually someone will come along and describe an opposite experience.

    I didn't pick great OBs. Most of my hospital experiences weren't that great. If I had it to do over again, I might pick a home birth.

    Also, all the medical sites I have browsed indicate that checking for protein as well as other problems is standard practice now. Maybe it wasn't when you had your first pgs.

    Your area hasn't seen any OB ward closures but the Philadelphia area has seen 16 such closures because of malpractice suits and low reimbursement. A couple in my area have. Again, broad brushing. I broad brushed when I said a lot are. I should have said some around the country are.

  4. What an informative, practical post! I agree that often the solutions we need are simple and natural, and that each individual needs to be his own best health advocate. Doctors in my state are very "by the book" and do not like to entertain natural or alternative health notions. A friend of mine had a premature baby girl a year and a half ago due to preeclampsia, except she called it something different, saying that it's the more recent title for the condition. Having read your posts about this before, I questioned her about her protein intake. She had eaten hardly any protein during the pregnancy, mostly just starches. Again, I don't know if it could have been prevented, but I am sorry to say that not only did she have this horrible experience with her baby (and they pressured her to abort the baby on the day the emergency c-section was scheduled!) but also she has been told by her doctor, whom she believes, that it is hereditary and that all future pregnancies would result in this, causing her to decide to be altered against ever bearing a child again. It is shameful that some of those our society entrusts with our health know so little about their jobs.

  5. I agree....WIth my second pregnancy my Ob (I had a home birth but went in for my prenatals) said I was spilling protein in my urine and that was a early sign of Preclampsia she said she would keep an eye on it. I told my mom (who knows a ton about nutrition and used to be a lay midwife) and she said I needed to up my protein. So I did what she told me I ate a ton of protein (in healthy forms) and at the next appointment my OB was quite surprised and said there was no protein in the urine!! AFter that I have always made sure to get and adequate amount of protein while pregnant.

  6. This comment has been removed by the author.

  7. My mom (a midwife) approves of this post! One thing I must blame this on is the lack of contact between the woman and her OB. When my mom sees women for a check-up, she talks with them extensively! And yes, you are correct about those urine tests; at my mother's birth center, they definitely do test for protein (my knowledge of that is the result of many boring hours there when I had nothing else to do at home, lol). But OB's? They see women for maybe 5 minutes tops, and then they send them on their way! There's no way a woman can be more informed of her body with an OB than with a midwife.

    Heck, even when my mom does pelvic exams, they test for absolutely everything you can imagine, whereas if you go to a gyno, they only test for what you ask for! Crazy, isn't it?

    God Bless,

  8. One comment regarding plague and hygiene - because the Jews followed God's laws on cleanliness, they did not suffer from the plague the same way the rest of the population did - and that ended up costing them dearly as they were persecuted for "causing" it, or for witchcraft for avoiding it.

  9. I've been expecting (pun intended) to see a "we're expecting #6" announcement from you.

  10. EIDITING MY ORIGINAL COMMENT: Awesome post. I have had two TWIN pregnancies. The first, I didn't pay much attention to my diet. I gained 80 pounds had high blood pressure was boarderline pre-e during my last few weeks and was very swollen all over, I carried them for 37 weeks and then had to be induced due to very low amniotic fluid.

    The second time around we were introduced to the Brewer Diet in our Bradley classes. I followed this to a T. Being pregnant with twins I did have to increase my protien intake from that of a singleton pregnancy. This time, I only gained 38 pounds (1 pound for each week I was pregnant) I had normal blood pressure and a lot less swelling. I was much healthier and had a much better pregnancy.

    Being pregnant with twins is rough as it is. Adding all that extra garbage to it like I did in my first pregnancy, makes it worse.

    I will always recommend this diet to my friends when they are expecting.

  11. Thanks so much for this post. I have had pre eclampsia twice. One ended in a six week early deliver. I was told by two different OB doctors to not have anymore children, BUT I was never told about the protein connection. Why is that? The more I learn, the less I trust doctors. Thanks again.

  12. Thanks so much for this supportive and informative post!

    I would like to add a couple of bits to what you have said...

    --I believe that it's important to note that the Brewer Diet is not just about protein. It is about protein PLUS calories PLUS salt. When a pregnant mother focuses only on the protein, and not so much to the other two legs of this triad, her diet is less likely to work in the prevention or treatment of PE, PIH, HELLP, IUGR, premature labor, placental abruption, and low birth weight.

    --An even earlier indication of a developing case of PE is a rising hemoglobin/hematocrit level, as the blood volume drops or stays the same at a time when it is supposed to be increasing by 60%. You can see more about that through this link...


    --I may be wrong, but I believe that the reason that protein appears in the urine during the PE process is that PE can cause kidney damage. Ordinarily, the filtration system in the kidneys does not allow molecules as large as protein molecules to pass into the urine. But when there is damage in this system, those large protein molecules manage to slip through and show up in the urine.

    --If anyone gives you a list of reasons why they believe that the Brewer Diet does not work, you can check my "Inaccuracies" page for my responses to the most common misconceptions that are being passed around on the internet.


    Thanks again!

  13. I was recently at my OB and have had my urine routinely checked for protein. She just informed me this past visit that I have had trace amounts since about 18 weeks. (I also have Lupus which could also be a culprit). This past visit though, it was a little higher than normal. Thanks for the advice about eating more protein...I do not think I am getting enough. My blood pressure has been fine and I have not had any swelling either, for which I am thankful. In fact, when I am pregnant my wedding rings are looser than normal!!

    I have also heard of the Brewer diet and really need to look into that. Thanks again! :)

  14. As a nurse who works in an OB/GYN office, I must disagree
    We ALWAYS check for protein, sugar,specific gravity,blood, and leukocytes or white blood cells. If a pt. has an increase no matter how small she is informed and options are discussed. If she is pre-preelcamptic then labs would be ordered and she needs to come in for a BP check daily for a week along with urine checks.
    It is taken very seriously and sometimes delivery is the only option as we don't want mom to stroke out if BP gets too high.
    If your OB doesn't check for these things then PLEASE I implore you to change OB's!!

  15. What a blessing that you have never had to deal with preeclampsia! I have 2 children, both of whom I had preeclampsia with during pregnancy. I am days away from delivering #3 and have been dealing with preeclampsia for 5 weeks now. When not pregnant, I am at a very healthy weight, exercise daily, and have no health problems. So, why did I get it and not you? I eat something very similar to the Brewer diet too! Be careful about what you write. I would give anything to have a "normal" pregnancy and childbirth experience. Wouldn't it be nice if everything was within our control?

  16. Obviously those who have never experienced preeclampsia before do not know what they are talking about. I had to have an emergency c-section at 24 wks and if I had any control over it believe me I would not have given birth that early. Learn the facts lady.

  17. in first pregnancy i did not follow the brewer diet, but did take low dose aspirin bc my fertility doc routinely prescribed it in the first trimester for all his patients. i had a strong, healthy , full term baby. For my second I took a bradley class and as directed, followed the brewer diet. I developed severe, early onset pre-eclampsia and my baby and i nearly died. she was under three pounds when she was born ten weeks early. the World Health organization now recommends that women with any risk factors for pre eclampsia take low dose aspirin during pregnancy in consultation with their health care providers. Unlike the Brewer diet, this approach is based on peer -reviewed studies, not anecdotal evidence. Also, all that protein I was eating probably strained my kidneys even more while I was developing pre-e with my second. I know you mean well, but your advice could be deadly to someone with early pre-e who starts eating protein like crazy.

  18. I am curious what the diagnosis is for a woman who reads trace levels of protein steadily throughout her entire pregnancy. From what I have read, pre-e protein usually appears after 28 weeks. If a woman has shown trace protein since before week 12, and levels remain the same despite dietary changes, I wonder if it would be more a symptom of kidney damage prior to pregnancy. Recent studies regarding food lectins have indicated that agglutinating lectins in tomatoes and wheat can cause kidney damage resulting in eventual proteinuria. Any thoughts on this?

  19. This is appalling. I ate organic, grass fed beef, eggs and chicken several times a day during my pregnancy. My BP and protein were perfect at each appt until one day they were not - and I thank God every day that I had a DOCTOR with me because he made the call for the emergency c-section when my LO's heart rate started to drop and my BP was still 210/99 despite treatment. They were able to help prepare his lungs for early delivery and he is thriving now. I'm so glad you had normal pregnancies and decided to dip your toes in this issue for, like, two minutes and blog about it like you know what you're talking about. But you don't. Trust me, you don't. Please stick with what you know. If protein or nutritional deficiency was my problem then I should be dead by now as I eat whole, natural foods and ate plenty of them during my pregnancy.


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