Can You Do Keto While Pregnant?

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Written by Brenda Peralta, Registered Dietitian and medically reviewed by Abby Courtenay

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Keto is one of the most talked-about diets nowadays. We all know the benefits that it provides for weight loss. However, some special cases where following a ketogenic approach might not be the best option. One of those cases is pregnancy. Can you be on keto while pregnant?

While doing keto is good for some people, it is not the case for pregnant women. A healthy diet is fundamental for the health of the mother and the baby.

Let’s take a closer look at it!


Keto and pregnancy

The ketogenic diet and pregnancy are the most common topics people often wonder about. However, there is little to no research regarding the relationship between the two for ethical reasons.

There are more studies available on pregnancy and a low-carb diet. In a study done to determine the relationship between a low-carb diet and birth defects, it was found that children of mothers with a low-carb diet were 30% more likely to develop a birth defect (like anencephaly or spina bifida1). The reason for this is that when following a low carb diet, you may be avoiding natural sources and fortified sources of folic acid.

So, can you lose weight on keto while pregnant? 

During pregnancy, you should gain weight, not lose it. However, how much you should aim to gain varies depending on your weight before starting the pregnancy. 

Here are the recommendations of weight gain during pregnancy according to the mother’s weight prior to pregnancy2. The classifications are based on body mass index (BMI).

  • Underweight: 28-40 lbs. (12.7-18 kg)
  • Normal weight: 25-35 lbs. (11.4-15.9 kg)
  • Overweight: 15-25 lbs. (6.8-11.4 kg)
  • Obese: 11-20 lbs. (5-9.1 kg)

As you can see, overweight women are not expected to gain as much weight as others, but you are still meant to gain at least 15 pounds. At the end of the day, the weight you are gaining is not only fat. Some of it is the baby, increased blood volume, increase in breast tissue and even the weight of your placenta.

A more balanced approach to diet is advised during pregnancy. While the ketogenic diet follows a macro distribution of 5-10% carbs, 20% protein, and 70-80% fats, the recommended macros during pregnancy are 45-64% carbs, 15-20% protein, and 20-35% fats3. That’s a big difference.


Can you drink ketones while pregnant?

There are some natural moments where ketones are produced in the body. For example, ketones are made to provide your body with the energy it needs when you are in a fasted state, for example when you first wake up in the morning, before breakfast. This state of ketosis is normal, even for pregnant women.

However, when it comes to ketones induced by an intentional lack of carbs in the diet, there is very little experimental research in pregnant women and so it’s difficult to draw concrete conclusions. However when it comes to vulnerable states, like pregnancy, it is always better to err on the side of caution.


The ketogenic diet and gestational diabetes

Gestational diabetes is a type of diabetes that only shows up during pregnancy4. Although it usually disappears after childbirth, some women end up having type 2 diabetes afterwards.

Some health professionals might recommend following a low-carb approach to handle this condition. However, a steady glucose supply is essential for the development of the fetus. Thus, cutting its main energy source could have certain health concerns for the baby5.

To avoid possible side effects, it is not recommended to drop below 40% of the total carbs for a pregnant woman.

More studies need to be carried out to determine if following a ketogenic approach is good and safe for women with gestational diabetes6.


Eating low-carb while pregnant

Eating a low-carb diet might be ok for some women, but only with a doctor’s approval, and you wouldn’t be dropping the carb intake as low as 10% like on a ketogenic one.

It’s fine to eat some low-carb foods since most of them are non-starchy vegetables that can provide you with essential nutrients that you need for pregnancy

During pregnancy, you need an increased intake of certain nutrients like calcium, iron, folate, vitamin D, and vitamins from the B complex7. Adding low-carbohydrate options (for example, cauliflower rice) can help you add more veggies to your diet.

However, keep in mind that this doesn’t mean that all of your meals should be low in carbohydrates. As long as you keep the carb intake in the range recommended by your doctor, you can consume low-carb foods once in a while.


Risks of doing keto while pregnant

There are certain risks that could be associated with a ketogenic diet during pregnancy.

  • Nutrient deficiency. Removing a food group could potentially decrease the nutrients that you receive from your diet. A low intake of folate could lead to birth defects like spina bifida.
  • Constipation. Due to the reduced intake of carbs, there might be a decrease in fiber, leading to constipation.
  • Risk of baby development. A high-ketone environment during pregnancy can affect the neural development of the fetus and may subsequently lead to a lower IQ score later in life.


Can keto cause miscarriages?

No research has determined if there is a link between the two. 

However, multiple studies have linked the consumption of fruit with increased fertility and lower risk of miscarriage, and fruit is strictly limited on keto due to sugar levels.

Increased fertility and improved hormone levels have been studied when it comes to the ketogenic diet. Still, more research needs to be done on all of these topics.


Should you do keto while pregnant?

No, you should not. While a ketogenic diet can help with weight loss which may balance hormones and promote fertility while trying to conceive, it is not recommended for pregnant women to do keto.

A low-carb diet is also not the best option for a developing fetus since it needs to have a constant glucose supply.

Additionally, removing key groups like carbs could mean that your fiber intake can severely drop down. This could increase the risk of heart disease, constipation, and diabetes. You should strive to get 25-38 grams of fiber per day to help prevent these conditions8.

During pregnancy, make sure to have all the food groups (protein, healthy fats, and complex carbs). Also, aim to eat the rainbow. Each color of fruit and veggie has a different nutrient. Thus, it is essential to have as much variety as possible to ensure a diversity of nutrients.


Is keto safe for pregnancy?

There is still little to no evidence for a keto diet and pregnancy. Given the limited research, most doctors advise against doing keto during pregnancy. A balanced diet with all the food groups (whole grains, fruits, vegetables, healthy fats, and protein) is advised to ensure that you get all the nutrients your body and the baby need.

Always check with your doctor beforehand if you are considering making a drastic change in your eating habits. Getting the right nutrition is essential for a healthy pregnancy and can have lasting effects on your child’s life now and in years to come.



  1. Desrosiers TA, Siega-Riz AM, Mosley BS, Meyer RE; National Birth Defects Prevention Study. “Low carbohydrate diets may increase risk of neural tube defects”. Birth Defects Res. 2018 Jul 3;110(11):901-909. doi: 10.1002/bdr2.1198. Epub 2018 Jan 25. PMID: 29368448.
  2. Weight gain during pregnancy”.
  3. Kominiarek MA, Rajan P. “Nutrition Recommendations in Pregnancy and Lactation”. Med Clin North Am. 2016;100(6):1199-1215. doi:10.1016/j.mcna.2016.06.004
  4. The NHS website: “Gestational diabetes”.
  5. Farabi SS, Hernandez TL. “Low-Carbohydrate Diets for Gestational Diabetes”. Nutrients. 2019;11(8):1737. Published 2019 Jul 27. doi:10.3390/nu11081737
  6. Mahajan A, Donovan LE, Vallee R, Yamamoto JM. “Evidenced-Based Nutrition for Gestational Diabetes Mellitus”. Curr Diab Rep. 2019 Aug 31;19(10):94. doi: 10.1007/s11892-019-1208-4. PMID: 31473839.
  7. American College of Obstetricians and Gynecologists (ACOG): “Nutrition during pregnancy”.
  8. Mayo Clinic: “Nutrition and healthy eating”. Check out their chart of high-fiber food.