1. Maximize iron absorption by combining plant sources of iron with foods high in vitamin C.
2. Be sure to tell your healthcare provider you’re a vegan, and have your hemoglobin checked at least every other month. Because you can still feel anemic with a normal hemoglobin level, your doctor may want to do an iron profile, which is a more accurate measure of iron-sufficiency in your blood than is measuring your hemoglobin. (Research whether the increased fluid volume artificially dilutes the hemoglobin, giving a falsely low value.)
3. If your practitioner recommends that you take iron supplements, protect yourself from discomfort by taking smaller doses with meals, for example, 100 milligrams of ferrous sulfate tablets three times a day. To increase the amount of iron absorbed from these pills, down a 100-milligram vitamin C tablet at the same time.
4. Lean on sunlight as a valuable source of vitamin D. Since vitamin D is not stored in the body, you may need to take a supplement daily. Excess vitamin D is not readily excreted, so be sure you take only the required amount, which is 400 IU daily.
5. You will need vitamin B12 supplements, since animal foods are the primary sources of this vitamin. Consult your healthcare provider. Some Vitamin B12 is found in yeast, wheat germ, whole grains, eggs, and milk.
6. If you are a lacto-ova vegetarian (eat eggs and dairy, but no meat or fish), you can get adequate vitamin D and additional protein from these sources, yet iron and B12 may still be insufficient.
7. If you are unwilling to take commercial supplements but are willing to compromise, eating four ounces of fish (fish liver oils, salmon, sardines, tuna) daily will provide enough of the otherwise missing nutrients for you to safely continue being “almost” a vegetarian while pregnant.
8. If you’re a strict vegetarian (a vegan — no eggs, dairy, meat, or fish), you will need to monitor your diet most carefully. Consult a nutritionist to work out alternative sources of marginal nutrients.