The Dr. Brewer Pregnancy Diet
Nutritional Stress III
The Diet
Weekly Record
Special Needs
No-Risk Diet
Weight Gain
Bed Rest
Herbal Diuretics
Twin Pregnancy
The Twin Diet
Premature Labor
Blood Pressure
Mistaken Diagnoses
Underweight Babies
Gestational Diabetes
In Memory
Other Issues
Morning Sickness
Colds and Flu
Registry II
Registry III

"Why Women Must Meet the Nutritional Stress of Pregnancy"
Part III

The following is a continuation of a chapter reprinted by permission from 21st Century Obstetrics Now! (David Stewart, PhD, and Lee Stewart, CCE, Editors), National Association of Parents & Professionals for Safe Alternatives in Childbirth, 1977. (p. 387)

See here for "Why Women Must Meet The Nutritional Stress of Pregnancy" Part I

See here for "Why Women Must Meet The Nutritional Stress of Pregnancy" Part II

Medical Mismanagement--
The Prevailing Obstetrical Care

The rational observer would assume that, in the light of the wealth of scientific data and implications of basic principles of internal medicine and neurology, maternal nutrition would receive top public health priority. A neuro chemist and physician who extensively researched the relationship between prenatal nutrition and fetal development observed an inherent paradox in our feigned concern for infant and childhood health. He declared:

In this country, major biomedical efforts have pinpointed a number of fatal diseases for eradication, including poliomyelitis, cancer, and cardiovascular disorders. There has been a particular emphasis on diseases that affect children, and the news media often report cases that elicit immediate and generous response from individuals and organizations. But the oldest and most persistent scourge of mankind, which most often affects children and destroys their life opportunities--the triad of hunger, poverty, and ignorance--is largely forgotten by the community...One would assume that medicine devoted to the care of women and children would be the most advanced part of medical research and practice. Yet nothing could be further from the truth...Why is there so much indifference to this subject of hunger, malnutrition, and starvation, when children and pregnant women, who generate instinctive sympathy and concern from almos everyone, are the most severely affected victims?[76]

While veterinarians, farmers, and ranchers have clearly defined standards for the management of pregnant animals, no such standards exist for humans.

Notwithstanding the reluctance of obstetricians, who seldom receive much training in nutrition [as of 1977], to incorporate sound prenatal nutrition as a fundamental aspect of prenatal care, it staggers the imagination to attempt to justify their insistence on drugs and restrictive diets, especially since such regimens have been linked to reproductive pathology. One survey [as of 1977] showed that only 5% of obstetricians believe that appetite suppressants are unsafe among obese gravid women .[124] Among the obstetricians surveyed, 57% stated that they prescribe the drugs for "overweight" patients. In another survey only 57% of the obstetricians surveyed rejected the concept that the fetus behaves parasitically in extracting its nutrients regardless of the mother's nutritional intake.[125] It was not surprising that only 5% of them seemed to be aware of the protectie effects of applied, scientific nutrition.

One nutritionist stated:

Obstetricians seem to think that a low calorie diet to keep the mother's weight down is of prime importance. Many doctors [as of 1977] even threaten to hospitalize women in the last trimester if they gain more weight than prescribed. Some patients I have seen have said their doctors have prescribed a ridiculous (weight gain) of 12-14 pounds! The doctors still prescribe a low salt diet and blindly use diuretics to hopelessly attempt to prevent swelling...The restrictive diets these women are given daily are the most damaging regimen possible, to both mother and especially the developing fetus. Critical fetal brain development during this period can never be attained, besides the other possible damaging effects to maternal health and fetal development. It is frightening to see all these drugs the obstetricians still daily prescribe. You think they would have learned from Thalidomide that drugs and development don't mix, but it seems they want to recreate that horror in the 70's.

The practice of weight control, salt restriction, low calorie diets, and drug use during pregnancy is still the biggest problem with the obstetrical care in the (San Francisco) Bay Area, and probably the entire U.S. These obsolete ideas are still being practiced daily, despite constant warnings from the nutritional researchers...The only answer is to inform all pregnant women of the risks they will encounter if they follow their obstetrician's philosophy, and to recommend they either find an obstetrician who has adopted the most recent methods (they are few and far between) or advise them to talk to a nutrition consultant or a university nutrition researcher in their area.[126]

"There are a number of phenomena which we have accepted as 'normal in pregnancy' which I have realized were nutrition-related and which I do not see in my practice any more ... Mothers who are properly nourished do not get stretch marks, and they do not seem to have acceleration of dental caries or softening of the gums. I do not see loss of hair, splitting of nails, softening of bones, anemia, postpartum hemorrhage, or failures of nursing. In addition, after the 4th month, most mothers feel normal as far as energy output."
(One physician's observations after adopting an effective nutrition program for his pregnant patients.)

A concerned supporter of good prenatal nutrition explained:

The American medical profession appears to have a dragnet out during prenatal care. Or are the medical profession and drug industry blind regarding the nutritional needs of the expectant mother, or too ignorant or stiff-necked to care?

The doctor, as one mother put it, doesn't have to live with the child whom he has caused to suffer brain damage and deformaties. So a mother has to use her own judgement. She must discard the doctor's advice for restrict her weight, use drugs, and omit salt which the baby needs during her prenatal care. Indeed, she should question that doctor's whole professional outlook. Since the doctor's aducational preparation for his profession does not include nutrition, the expectant mother must learn for herself about the nutritionally balanced diet. If she omits the empty calories from her diet, she will not put on unneeded fat. She must remember that weight and water gain is important for a healthy baby.[120]

Since the doctor's educational preparation for his/her profession does not include nutrition, the expectant mother must learn for herself about a nutritionally balanced diet.

While veterinarians, farmers, and ranchers have clearly defined standards for the management of pregnant animals, no such standards exist for humans. A professor of animal husbandry stated: "With too little salt in the diet...animals become unthrifty and in time go to pieces. Cows deliver weak calves, or even lose their calves. Cows may even die from salt starvation...When thinking about salt in livestock management, keep in mind that it is: 'Profitable to remember, costly to forget'"[127]

In contrast, a widely distributed booklet for pregnant women reads: "(Your doctor) may prescribe medicines to help control your blood pressure and/or fluid retention."[128] To toxemic women the booklet suggests: "Do not use salt to season your food, either at the table or in cooking."[128]

A booklet written for diabetics gives similarly pernicious advice. It reads: "Besides insulin, your doctor may want to prescribe other medications during your pregnancy--a diuretic, for example, if you are retaining fluid excessively...Follow his directions carefully."[129]

The insistence of weight control during pregnancy by physicians has led to an innumerable number of instances of preventable iatrogenic maternal and infant morbidity and mortality.

Another area of obstetrics which is completely misunderstood involves weight gain during pregnancy. As in the case with distorted views on salt metabolism, the use of weight control has led to an innumerable number of instances of preventable iatrogenic maternal and infant morbidity and mortality.

Weight gain has been shown to be the maternal factor which is most highly correlated with birth weight.[51] Although weight gain during pregnancy can reflect nutritional status, it is not an accurate indicator of dietary adequacy. One reason that a dietary history and/or blood constituents analysis are more accurate means of assessing nutritional status is that, as in the nonpregnant state, a high weight gain can result from a high-calorie diet which is low in essential nutrients. Also, paradoxically, undernourished (particularly protein-deficient women) can gain a rapid amount of weight in a relatively short period of time as a result of pathological edema. As has been established herein, the edema in such women is a direct consequence of lowered colloid osmotic pressure of the plasma protein caused by hypovolemia [36,102] and frequently leads to metabolic toxemia of late pregnancy.[36]

Since healthy, full-term children are born to women who have a normal pregnancy at a wide range of weight gain (or weight loss), subjecting a group of women to any particular weight control regimen is unscientific and potentially hazardous.[130] Hytten discovered that the distribution of weight gain during the last 20 weeks of healthy pregnancies approaches the normal statistical distribution with a mean weekly gain of one pound.[100] Because of individual differences, it is best for pregnant women to eat a diet of nourishing foods to appetite without regard for their weight gain.[36]

In a study of approximately 8,000 single live births of 37 to 44 weeks' gestation, Lowe demonstrated the direct and highly significant relationship between weight gain and birth weight.[35] The correlation between birth weight and maternal weight gain was 0.94. He showed that the relationship was not continuous, since, at and above approximately 3500 grams (7 pounds 11 ounces), birth weight does not increase as weight gain increases.

Utilizing data from the Collaborative Perinatal study, Singer et al. analyzed the association between weight gain and infant development.[131] They confirmed the findings of other researchers that age, parity, and many other factors are not related to birth weight when weight gain is one of the independent variables. The data in Table 39 show that the incidence of low birth weight is related to weight gain at the .001 significance level.


Weight Gain (Pounds)
% Low Birth Weight
36 or more

They also discovered the relationship between maternal weight gain and infant size and neurological function at one year of age and that between weight gain and psychiatric, mental and motor function at one year of age and that between weight gain and phychiatric, mental, and motor function at eight months of age. Table 40 lists infant size and the three exams in descending order of their degree of association with weight gain. All infant abnormalities except those measured by the neurological exam are significantly related to birth weight on a statistical basis. Even when the relationship between birth weight and infant abnormalities was removed from the analysis, low maternal weight gain was found to be associated with infant abnormalities.




36 Pounds




Motor Exam



Mental Exam






Neurologic Test



Despite the overwhelming evidence of the potentially pernicious consequences of weight control, which is most devastating during late pregnancy (at which time fetal brain development is most rapid), obstetricians still unduly restrict weight on a routine basis. One survey showed that 95% of obstetricians restrict weight gain during pregnancy.[125] A present study showed similar results.[132] A large number of the women were reprimanded for approaching or exceeding their weight quota. One woman, who had gained 23 pounds by the ninth month of pregnancy, said: "He (the doctor) yells at me every visit. He says I eat too much. I just get so depressed. He told me my delivery is going to be harder because of my weight gain."[132]

The only answer is to inform all pregnant women of the risks they will encounter if they follow their obstetrician's philosophy. The doctor doesn't have to live with the child whom he has caused to suffer brain damage and deformities. A mother has to use her own judgement. She must discard the doctor's advice to restrict her weight, use drugs, and omit salt. Indeed, she should question that doctor's whole professional outlook.

More of the text of this chapter follows the letter excerpts.

Excerpts from Letters

The following excerpts of letters indicate that many physicians, instead of ensuring that women satisfy the nutritional stress of pregnancy, are placing them on regimens which endanger their health and the lives and health of their newborns:

I just spent the morning working with OB/GYN residents in High Risk Clinic!! One woman--seen for Rh problem--34 weeks' gestation, skinny, with a total three-pound weight gain, was sent for sonar by resident for small baby. I pointed out weight gain and asked if he would like to consider the low weight gain and do some nutrition counseling. He said, "No, she looks good that way." She'll really look good with a damaged baby on her hip. Three patients today had low weight gains, small babies, and not one word about eating. Needless to say, I ran after these women and talked to them.

I have a student underweight for her height who is going to a private doctor here in Miami. The doctor does not want her to gain any more than 18 pounds. One month she gained three pounds and he was very upset about it. He also told her not to salt her food. I have given her material to read and have been encouraging her to eat right.

I can't believe with all the information available that a doctor would still be prescribing this detrimental program.

I couldn't help but agree with what you said about low-calorie, no-salt diets with diuretics. My doctor is one of those that worries about weight. With my first pregnancy I had badly swollen ankles in my fourth month. He gave me water pills and took me off salt. After another month or so, when the swelling didn't get any better, he gave me a diet of 1,000 calories a day...None of the above three things helped. I was troubled with swollen ankles for the rest of the pregnancy.

I have been paying pretty close attention to the diet you recommended in the pamphlet "Pregnant? And Want a Healthy Child."...So far I have gained 20 pounds. Some of this has been as much as seven pounds a month. But I have not had the least bit of swelling in my ankles and fingers...The nurses and doctor are alarmed and telling me that the rapid weight gain could easily mean I will get toxemia. The doctor said any time now my ankles could swell or without any other symptoms I could start convulsing. He gave me another 1,000-calorie-a-day diet like the last one and told me to keep it to two pounds a month.

Just a few days before, he (my doctor) was called in by an associate at Stanford to assist with the worst (still living) case of metabolic toxemia of late pregnancy they'd ever seen. They treated her with diuretics because "they are the only accepted treatment in reducing the edema of toxemia--we don't know of anything else." Well, need I tell you that she showed no improvement and gave birth to a very low birth weight baby. But then, as if that isn't enough, she went into heart failure!...and to think that it could've been prevented!

I am a public health nurse involved in a prenatal clinic in New York City, and in spite of the convincing evidence of harm, the clinic physicians still order low-salt and weight-reduction diets. THEY GET HYSTERICAL OVER A FOUR-POUND WEIGHT GAIN IN A MONTH...P.S. I'm pregnant myself and doing my best to eat right!

I can't tell you how many pregnant women I've already met who've been put on diets to restrict weight gain, or who have been told to lose ten pounds before delivery. I myself had a low birth weight baby, due in part, I'm sure, to a diet which caused me to lose weight each month ... Enclosed is a check for $5.00 to contribute to your cause.

I had a first child who was a low birth weight, "toxic baby" due to the severe toxemia I developed in my last trimester of pregnancy. My OB doctor restricted me to liquids (clear) only for six weeks and diuretics daily. I have never received a straight answer to my questions about toxemia and its cause ... I think your works and efforts are marvelous. Please continue to help.

I am very concerned about the appalling rate of birth defects and other birth abnormalities ... Also what concerns me even more is the doctors' views on nutrition (there isn't any) and drugs. Here in Philadelphia they are filling pregnant women with diuretics, appetite depressants, harmful drugs for nausea, and tranquilizers, but not anything on nutrition for their problems.

I am especially pleased to learn of your organization because I obtained diet and health records of 100 welfare women and their infants while I was on the staff of the Miami Valley Project, University of Cincinnati ... Of these mothers, five actually lost weight during pregnancy ... Thirty-one gained less than 20 pounds ... The dieticians in the clinic saw 68 women; of these they persuaded 19 to gain less than 20 pounds ... Sodium restriction was imposed on 49. Diuril was prescribed for 49.

I'm still convinced that I was right to follow my judgment against my doctor's en masse methods. I see the results in friends' babies as they are born, who followed the low-calorie, low-salt diet our doctor prescribed. My little girl showed what I would consider normal and healthy development, whereas the only word that comes to mind to describe my friend's children is 'stunted'.

Enclosed is my check for $10.00 as a donation to SPUN. Please include me on your mailing list. Thank you also for sending me the materials I asked about. We need all the 'ammo' we can get to start aiming our [information] at the doctors here in Columbus who are still restricting calories, salt, and essential nutrition and calmly shrugging off their patients' concerns about what these restrictions are doing to their babies. Just last night in class one "skinny" gal four and a half months pregnant stated her doctor reduced her diet to 1,000 calories because she gained seven pounds in seven weeks (the only weight she has gained thus far in her pregnancy). I asked her what she was going to do. (We had just had the nutrition session the night before.) "I'm going to ignore him," she said proudly. "After all, he's not the one who has to live with a deformed or mentally deficient child." I couldn't have said it better.

From strictly an economic standpoint, preventive obstetrical care is one of the nation's soundest investments. For each case of severe mental retardation that is prevented, the economic gain to society is more than $900,000 [1977].

Despite the accepted practices of weight control and salt restriction, there are, fortunately, physicians who do practice preventive obstetrical care. One physician enumerated the benefits from his emphasis on protective prenatal nutrition:

Letter from a Physician With a Nutrition Program

When I initially counsel patients with their first pregnancy visit, nutrition is strongly stressed. I do not mention limiting weight in any way but instead tell to gain at least 25 to 30 pounds during this pregnancy and that this weight gain will be a protein weight gain. I give them a list of protein-containing foods and reassure them that much of this weight is to gained in the first few months of pregnancy. I do not at any time, with any visit, tell the patients that they are gaining too much but instead stress only good nutrition ... The patients did need constant support from me since attitudes of others around them tended to express that they were gaining too much weight or that somehow weight gain was harmful in pregnancy. I do not use diuretics in pregnancy, nor any other medications other than a good prenatal vitamin.

During the time I have been in practice here, I have managed approximately 500 obstetrical patients, I have had two patients with preeclampsia, both of whom had severe chronic diseases. One of these had systemic lupus erythematosis, the second a hereditary cholesterol problem. Both of these now have healthy babies. I have had six spontaneous premature infants. One of these was from a mother who had acute appendicitis in her sixth month of pregnancy. Three of the patients did not start prenatal care until their sixth month of pregnancy and were severely malnourished when I started with them; two of the patients had placenta previa, and one patient was a total vegetarian whom I judged was on inadequate sources of vegetable protein.

The remainder of my patients have had normal, healthy children. One patient had a sudden infant death occur at four months of age. The mother of this baby was an epileptic requiring large doses of Dilantin to control her seizures, and this had been taken all through her pregnancy. Nearly all of my patients breast-feed their babies, and good nutrition is stressed throughout the breast-feeding time. Most of them breast-feed for six months or more. The mothers begin their first breast-feeding on the delivery table and continue to breast-feed every two to four hours throughout the hospital stay. The hospital stay in my patient group averages 24 hours. Cesarean sections taken as a group are kept for approximately 48 hours ... All cesarean section mothers nurse their babies.

In answer to the question "Do doctors in our area limit weight gain?" I would say most still do ... As an aside, there are a number of other phenomena which we accepted as "normal in pregnancy" which I have realized were nutrition-related and which I do not see in my practice any more ... Mothers who are properly nourished do not get stretch marks, and they do not seem to have acceleration of dental caries or softening of the gums. I do not see loss of hair, splitting of nails, softening of bones, anemia, postpartum hemorrhage, or failures at nursing. In addition, after the fourth month of the pregnancy, most mothers feel normal as far as energy output. We see very quick recoveries after pregnancy, and we do not see failures at breast-feeding because of nutritional problems in the mother.[126]

The testimonies to the adherence of good nutrition are numerous. The following all indicate the benefits of sound prenatal nutrition:

Testimonials to Nutrition

My seven-month-old baby is a good example of optimal prenatal care. With an excellent high-protein diet and vitamin/mineral supplements, I gained 40 pounds with no signs of toxemia or eclampsia, and needed no drugs of any kind. My son's birth weight was 9 pounds 6 ounces, and he has been in perfect health since he was born...

My son ... now 22 months old, has the most lustrous hair, perfect, even teeth, sparkling eyes, satiny skin, and solid body. People marvel at him and believe it's all predestined, all genetically controlled, and that if you have God on your side, then you'll have a healthy baby. They just don't understand that they can take control and insure the health of their own child.

Having followed basically the dietary program you advocate during a pregnancy three years ago and having had a delightful pregnancy and beautiful 8 pound 14 ounce baby with an Apgar of 10, I firmly believe that you are absolutely right!...

I have four children and have been submitted to these drugs, thinking they are helping me, but I have found with my last two, all that was needed was to adhere to an adequate diet...

Why are so few obstetricians attuned to the role of maternal nutrition in protecting the health of the expectant mother and her unborn? A professor of OB/GYN reflected:

In this current flurry of interest in nutrition in pregnancy, the physician responsible for the care of pregnant women often finds himself in a difficult position. His knowledge of nutrition in general is deficient, for formal instruction in nutritional principles is notably absent from medical school curriculae and residency programs ... Thus, when faced with providing nutritional advice to his patients, he all too frequently finds himself confused.[133]

Because obstetricians are not educated in the field of practical nutrition, they are susceptible to unscientific advertising claims of the drug industry. As late as 1974, diuretics and appetite suppressants were advertised in major obstetrics journals.[134] In addition, the medical profession, especially the American College of Obstetricians and Gynecologists (ACOG), have directly or indirectly sanctioned the use of medical regimens which lead to reproductive pathology. The powerful American College did not form a Committee on Nutrition until 1972. Their first position paper on maternal nutrition, which is replete with myths and unscientific speculation, was not published until December 1972.[134] A recent enumeration [as of 1977] of the ACOG's ten-year goals did not include mention of the implementation of nutrition education for the pregnant woman or standards for the nutrition education of physicians.{135]

Because of the lack of awareness among health care professionals and the reluctance of most organizations to advocate that pregnant women follow sound nutritional guidance and refrain from taking drugs (unless absolutely necessary) when such advice is contrary to that given by a physician, hundreds of thousands of pregnant women unwittingly place themselves and their unborn at risk. It is not surprising that a major university study showed that approximately one million infants are at risk of needlessly being brain damaged every year in the U.S.[136] Since the study was basically confined to low-income populations, it did not consider the large numbers of affluent women who subject themselves and their newborns to needless pathology as a result of adhering to low-salt and/or low-calorie regimens, controlling their weight gain, and/or taking physician-prescribed drugs.

An overt expression of the prevailing neglect to recognize the nutritional needs of expectant mothers and their unborn is human experimentation. Because the medical profession and others have not advanced to the stage of instituting rigorous standards for the management of pregnancy (as have veterinarians and ranchers), numerous women have been subjected to cruel experimentation.

In a well-publicized study at Columbia University, pregnant women in an area in which the low birth weight rate is 17% were placed in 2 groups for purposes of comparing the viability of their newborns.[137] In neither group (one group of women received a 40 gram protein supplement daily; those in the control group received a supplement containing only 6 grams of protein) were the women given nutrition counseling or warned of the risks of undernourishment. In another study, the women in the control group, who were known to be consuming an average of less than 40 grams of protein per day, were not informed of the dangers of their dietary inadequacies.[138] Naturally, the researchers in both studies observed a higher incidence of reproductive casualty among the controls.

In another "scientific" study, 8 pregnant women were placed on a diet which provided less than 25 grams of protein for a period of five successive days.[139] It should not have surprised the researchers that their ratio of urinary urea nitrogen to total nitrogen decreased significantly (p.01), indicating that the women were protein deficient. The urinary urea nitrogen/total nitrogen ratio in one woman who was placed on a diet which provided only 1500 calories and 20 grams of protein for 15 consecutive days decreased more than 43%.

The practice of preventive medicine is probably more essential in the field of obstetrics than in any of the other medical specialties. A child born to a mother who is not exposed to proper obstetrical guidance is at risk of developing mental, physical, and/or behavioral abnormalities. Emphasizing the social and economic benefits of a practical approach to prenatal nutrition, the international publisher of perhaps the most widely circulated medically oriented publication, wrote:

"What is most baffling is that these precedents, so important to people in terminal stages of irreversible disease, seem to have little or no bearing in regard to preventible disorders of infinitely greater incidence and of infinitely greater economic consequences. Once again, our characteristics as an activist society distort what should be the proper relationship between preventive and curative medicine. We are prepared, and we are a rich enough country, to afford $500,000,000 to $2 billion to prolong life for a few years in those with irreversibly damaged hearts and kidneys.

"Why, then, the incredible neglect annually of many thousands of pregnant women whose malnutrition causes irreversible fetal brain damage and physical anomalies in children who will for a lifetime be a burden to themselves, to their families, and to society? These are preventable conditions due to ignorance and/or lack of the most simple nutritional essentials. We seem fascinated by our mechanical facilities and technologies. It would seem that if a brain transplant were possible, our social and psychic orientation is such that we would be prepared to support a Medicare charge of $20,000 to $25,000 per "transistorized brain" transplant. Why then do we fail to make available a few hundred dollars per pregnancy to assure normal neurologic and general physical development in the unborn? Supplementation to the point of total nutritional adequacy for ALL American mothers could probably be achieved for less than the presently anticipated cost for renal dialysis of 13,000 patients [as of 1977]. This is not to suggest that the United States need forego either Medicare coverage for renal dialysis or for totally implantable artificial hearts but, rather, that it makes good medical sense--indeed, common sense--and good economics to invest in preventive medicine for the pregnant woman and unborn child--a venture which economically is self-liquidating and less costly than attempts to correct, as we do now, preventable damage and its heavy economic liability.

"It seems that we still have to learn the simplest lesson of good, preventive medicine. Why?"[140]

From strictly an economic standpoint, preventive obstetrical care is one of our nation's soundest investments. For each case of severe mental retardation, which frequently results from inadequate maternal nutrition, that is prevented, the economic gain to society is more than $900,000 [by 1977 prices].[141] Recognizing the extremely high rate of preventable retardation which occurs in the U.S., a university president declared:

"We must ... prevent the occurrence of gratuitous retardation, that is, of retardation that results, not from genetic malformation or other unavoidable causes, but rather from social neglect. In order to do this, we must understand the importance of nutrition, especially the nutrition of the fetus ... It is a gratuitous retardation, imposed on those children whose prenatal and early nutrition has been defective. Only a society that has lost its respect for human life and its concern for the fulfillment of each individual can be indifferent to this retardation. If we are to avoid such retardation, we must insure that no mother, either through poverty or ignorance, malnourishes her children in utero.

"The highest priority in American education today should be the establishment of a national program of nutrition and early childhood education ... It is the obligation of educators at all levels--in schools, colleges, institutions, social agencies, and medical institutions--to provide this education. It is the obligation of society to see that no carrying mother or young child is undernourished because of financial need."[142]

Illustrating a case history of preventable mental retardation, a concerned obstetrician appealed to his colleagues for the immediate implementation of primary prevention through good nutrition as a routine, integral facet of obstetrical care. He wrote:

Patient M. was a small Mexican woman who followed her doctor's orders to the letter. A private OB/GYN specialist in California restricted her to one egg and one glass of milk a week, on the grounds that there is too much salt in milk and eggs. She was constantly advised at each prenatal visit: "Keep your weight down!" She wanted a healthy baby, so she faithfully followed her doctor's orders. Result: she gained only 14 pounds in all (from 112 to 126) and went into labor right at term. This was three months after she had been given a low-salt diet and diuretic pill to take every day; she didn't miss a day.

Her son, J.F., weighed 4 pounds, 15 ounces at birth. His blood sugar dropped to 20 mg. per cent and he had hypoglycemic convulsions repeatedly. The mother, after a normal blood loss at delivery, went into what her doctor termed "idiopathic [unknown cause] shock"--which we know was caused by her hypovolemia.

The boy is obviously and grossly mentally retarded and has to attend a special school for brain-damaged children. At age 15 months he was age three to four months in development and function on the Denver Grid-head drop, crossed eyes, small head. At age 18 months he still could not pull to stand or walk.

The patient had her second son after prenatal care in my clinic. During this second pregnancy she gained 50 pounds, had two eggs and a quart of milk every day, meat, vegetables, fruits, cereals, and no salt diuretics, not dietary salt restriction. She was told on each visit: "Keep eating a good diet--salt your food to taste!" This second child, A., weighed 9 pounds at birth and is a perfect specimen.

Fellow American physicians, how long are we going to disregard the scientific evidence of the causal relationship of protein-calorie malnutrition, restriction of salt, and the dangerous use of salt diuretics to complications of pregnancy, fetal mortality, and damage to the newborn human infant?[143]


To counteract the lack of availability of nutrition education services for pregnant women and the prevailing nonchalance among health care professionals concerning the application of primary prevention through applied, scientific nutrition, the Society for the Protection of the Unborn through Nutrition (SPUN) was established. For five years SPUN has represented expectant mothers in their quest for services designed to make pregnancy a healthy, fulfilling, and everlasting experience. Additionally, SPUN works directly with health care agencies and providers of medical care toward establishing standards for scientific nutritional management in American obstetrics.

Note from Joy: Unfortunately, SPUN no longer exists, but I include the information about SPUN for its historical significance.

Membership in SPUN (17 N. Wabash, Suite 603, Chicago, IL 60602) is now available to the general public. The annual membership fee of $10.00 (which is tax-deductible) entitles members to a subscription to SPUN's newsletter and other publications pertaining to maternal and infant health care and to numerous services, such as access to audio-visual aids, referrals, and reduced or waived registration fee for special events.

A new SPUN program on the regional level is to sponsor seminars for the education and certification of community prenatal nutrition counselors. These individuals will provide SPUN services to women and medical personnel through liason with local childbirth educators and women's health facilities.

Join with other concerned individuals who are involved with the health of expectant mothers and the growth and development of their babies.

"What Every Pregnant Woman Should Know"
(The Truth About Diets and Drugs in Pregnancy)

A new book dealing with the mismanagement of the nutritional aspects of pregnancy by American obstetricians will be published by Random House in September 1977. Written by Gail Sforza Brewer, with Tom Brewer, M.D., as medical consultant, it explains to mothers how they can protect themselves and their unborn from the hazards of nutritional nonchalance during pregnancy. Menus and recipes for pregnancy are included.

If not available from your local bookstore, order from Publisher:
Random House, 201 E. 50th St., New York, NY 10022
$8.95 (plus 75 cents for postage $ handling)

"If brain transplants were possible, our social and psychic orientation is such that we would be prepared to support a Medicare charge of $20,000 to $25,000 per "transistorized brain" transplant. Why, then, do we fail to make available a few hundred dollars per pregnancy to assure normal neurological and general physical development in the unborn? Supplementation to the point of total nutritional adequacy for ALL American mothers could probably be achieved for less than the presently anticipated cost for renal dialysis of only 13,000 patients."

21st Century Obstetrics Now! Vol. 2 available here


1.Stewart, D., and Stewart, L., (eds.), Safe Alternatives in Childbirth, 2nd ed., Chapel Hill, NC: NAPSAC, 1977.

2.McCleary, E., New Miracles of Childbirth, New York: David McKay Co., 1974.

3.SPUN Reports, Oct 1, 1973.

4.Lilienfeld, A., and Parkhurst, E., A study of the association of factors of pregnancy and parturition with the development of cerebral palsy, Am. J. Hygiene 53:262-282, 1951. (quoting Freud, S., Die infantile cerebrallahmung, Vienna: Alfred Holder, 1897.

5.The women and their pregnancies, quoting Subcommittee on Appropriations of House of Representatives, Depts. of Labor and HEW Appropriations for 1962, U.S. Dept. HEW, p. 756, 1972.

6.ICEA News, vol 15, no 1, Jan 1976.

7.Berger, G., et al., Regionalized perinatal care: an estimate of its potential effect on racial differences in perinatal mortality in North Carolhm, NC Med. J. 36:476-479, 1975.

8. Bishop, E., NC Med. J. 36:89-91, 1975.

9.Demographic Yearbook.

10.Abramowicz, M., and Kass, E., Pathogenesis and prognosis of prematurity, N.Eng. J. Med. 275:878-885, 1966.

11.U.S. Vital Statistics - Natality, Nat'l Cte. for Health Statistics, Vols for each of the years, 1950 through 1972.

12. Wynn, M., and Wynn, A., The protection of maternity and infancy, New York: E.H. Baker & Co., 1974.

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110. Grieve, J., Prevention of gestational failure by high protein diet, J. Repro. Med. 13:170-174, 1974.

111. Albumin concentrate can be used for mid preeclampsia, Ob. Gyn News, Oct. 1, 1974.

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123. Taylor E., Organic causes of minimal brain dysfunction, Cont. Med. Digest, pp. 822-823, 1972.

124. Lasagne, L., Attitudes toward appetite suppressants, JAMA, July 2, 1973.

125. SPUN Reports, May 15, 1975.

126. Various personal correspondences.

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129. Diabetes in Pregnancy, Ross laboratories.

130. Pomerance, J., Weight gain in pregnancy: How much is enough?, Clin.Ped. 11:554-556, 1972.

131. Singer, J., et al., Relationship of weight gain during pregnancy to birth weight and infant growth and development in the first year of life, Ob. Gyn. 31:417-423, 1968.

132. SPUN Reports, Oct. 1, 1976.

133. Kaminetsky, H., Ob. Gyn., Dec. 1972.

134. Pitkin, R., et al., Ob. Gyn. 40:773-785, 1972.

135. Russell, K., Ob. Gyn., Nov. 1973.

136. Schmack, H., Brain harm in U.S., laid to food lack, N.Y. Times, Nov 2, 1975.

137. SPUN Reports, Jan. 15, 1973.

138. Roeder, L., Discussion: Supplementation of diets of pregnant women in Taiwan, Am. J. Clin. Nutr. 26:1143, 1973.

139. Aubry, R. , et al., Maternal nutrition, I. The urinary urea nitrogen/ total nitrogen ratio as an index of protein nutrition, Am. J. Ob. Gyn. 114:198-203, 1972.

140. Sackler, A., Wbo shall live and who shall die?, Medical Tribune, Dec. 19, 1973.

141. Conley, R., The economics of mental retardation, Baltimore: Johns Hopkins Univ. Press, 1973.

142. Silber, J., Nutrition's role in learning, NY Times, Nov. 16, 1975.

143. Brewer, T., Doctors' Debate, letter to editor, Med. Tribune, Feb-Mar, 1973.

To Be Continued....

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