Kamal Ghorui
How so ever hard we may try to normalise pregnancy, there is no denying that it brings about a momentous change in a woman’s body. From hormones to blood pressure, blood sugar levels, and all vital organs- almost every system is affected during pregnancy because the body is adapting to support the growth of a new life. Pregnancy is not merely a physical condition—it is a complex biological process that demands continuous adjustments over nine months. Hormonal shifts are among the earliest and most noticeable changes, influencing mood, energy levels, sleep, and metabolism. Women experience thick, lustrous hair during pregnancy, Do you know the reason? Blood volume increases significantly to nourish the developing baby, causing the heart to work harder and circulation to change. Blood pressure may fluctuate, while insulin sensitivity can go completely haywire, leading even to gestational diabetes. The musculoskeletal system experiences strain as posture shifts and ligaments loosen in preparation for childbirth. Despite these challenges, pregnancy is a remarkable demonstration of the body’s resilience and intelligence. It constantly recalibrates itself to nurture and protect new life. While many women continue daily routines through pregnancy, it is important to recognise the immense internal work taking place and offer understanding, care, and support throughout this life-changing journey. It is a general belief however that women during pregnancy suffer from iron deficiency. But the fact is, there are many more things that need to be taken care of during this delicate period. In India, iron and folic acid have long been the centre of maternal supplementation. Yet the country continues to face a significant burden of maternal malnutrition, with 52% of pregnant women estimated to be anemic according to National Family Health Survey (NFHS-5). While IFA is certainly crucial, pregnancy nutrition often requires a broader and more sustained approach. Several other micronutrients also play an important role during pregnancy and well into the first 1000 days of the baby’s life. With that in mind, here are the key nutrient groups commonly considered in maternal supplementation and how they support pregnancy.
1. Iron and folic acidIron supports haemoglobin, which carries oxygen through the blood. During pregnancy, blood volume increases significantly, leading to increased iron requirements. Low iron levels can lead to fatigue in the mother and reduced oxygen supply to the baby. Folic acid supports early cell division and development, particularly in the formation of the baby’s brain and spinal cord. These two nutrients remain the foundation of antenatal care. “Addressing iron deficiency is critical, especially in a country where anaemia remains widespread,” says Dr. Vinay Purohit, MBBS, MD (Pharmacology), LLB “But pregnancy does not increase the body’s need for iron alone. The body is creating more blood, supporting organ development and maintaining maternal strength, all at once. If fatigue or weakness persist despite iron supplementation, it may signal the need to look at overall nutrition rather than focus on a single nutrient.”2. Vitamin B12 and vitamin B6Vitamin B12 supports red blood cell formation and energy metabolism. It also plays an important role in the development of the baby’s nervous system. There is a high prevalence of vitamin B12 deficiency in Indian women during pregnancy. Studies estimate it affects between 40% and 70% of expectant mothers, particularly with predominantly vegetarian diets where natural sources are limited. Vitamin B6 supports nerve function and contributes to appetite regulation and managing nausea in early stages pregnancy. Dr. Alaka Godbole, M.D. (Gynaecology& Obstetrics), FICOG, P.G.D.M.L.S., says, “Maternal nutrition requires a comprehensive and sustained approach, as nutritional needs evolve across different stages of pregnancy and lactation. Moving beyond a limited focus on iron and folic acid to a broader spectrum of essential micronutrients including calcium, which is critical for maternal bone health and fetal development is the key to improving outcomes. Ensuring the right balance of nutrients can support healthier pregnancies and better long-term outcomes for both mother and child.” 3. Calcium, vitamin D and magnesiumAs per several studies calcium supports skeletal development in the baby and helps maintain bone strength in the mother. Dietary assessment in India suggests that calcium intake during pregnancy often falls below recommended levels. Vitamin D helps the body absorb calcium effectively while supporting muscle & immune function. Low vitamin D levels are widely observed in Indian populations despite abundant sunlight. This may be linked to factors such as limited outdoor exposure, higher skin pigmentation which reduces vitamin D synthesis, and cultural practices that limit direct sun exposure. Magnesium supports muscle and nerve function and contributes to overall musculoskeletal balance, especially as pregnancy advances and cramps or muscular discomfort become more common. It is advised to consume iron and calcium at separate times of the day, allowing at least a two-hour gap, because calcium can reduce iron absorption if taken together. Small practical adjustments can significantly improve both tolerance and effectiveness.4. Zinc and copperZinc supports immune function and cellular growth. Research has linked low zinc levels with adverse pregnancy outcomes such as preterm birth, low birth weight and impaired fetal growth in certain populations. Nuts, seeds, legumes and whole grains are a rich dietary source of zinc. Copper supports iron metabolism and tissue repair and contributes to fetal growth and development. Adequate copper levels help ensure that iron is properly utilised in the body, reinforcing its role in preventing anaemia during pregnancy. Copper is naturally present in foods such as whole grains, nuts, seeds and shellfish.5. Docosahexaenoic acid (DHA)Docosahexaenoic acid, commonly known as DHA, is an omega three fatty acid important for brain and eye development in the baby. In diets where fish intake is limited, DHA consumption may be lower and dietary patterns are often assessed before supplementation is considered. A balanced diet remains central to maternal health. However, pregnancy also places an increased nutritional requirement on the body. Doctor guided supplementation helps bridge gaps that diet alone may not fully address. Maternal nutrition works best when it is steady and informed. A holistic outlook towards micronutrients and addressing deficiencies in time supports better health for mother and child, during the first 1000 days and beyond.
