Detailed Outline for Capstone Paper

Rachel Rockecharlie
1.) Essential Question:
 How does nutrition effect pregnancy?

2.) Purpose of Paper:

 The purpose is to inform the audience of information regarding the best nutrition during pregnancy and
dispel myths regarding nutrition during pregnancy.

3.) Introduction:
 Importance of pre-emptive measures to guard against complications
 Nutrition during pregnancy on a global level
 Misconceptions regarding appropriate nutrition during pregnancy must be made clear

4.) Thesis:
 The impact of nutrition on pregnancy must not be underestimated, and it is essential to subdue
misconceptions on this issue in an effort to increase knowledge and understanding of the basics of
healthy living so as to ensure that pregnancies occur with minimal risk for all involved.

5.) Basic Nutrition

A. Food Groups and Nutrients
a. Five basic food groups
i. Fruits, vegetables, grains, protein, and dairy
1. A balance of these foods contributes to the overall health of a woman
2. By following recommendations regarding intake of these foods and sticking
close to the caloric recommendations, it is possible to remain very healthy during
pregnancy
a. It is recommended that a pregnant woman only increase her caloric intake
by 300 calories each day
b. Fats, carbohydrates, fiber, and other nutrients
i. Inaccuracy in belief that all fat is bad—it plays a vital role in the functioning of immune
system + clotting of blood
ii. Emphasis on “nutrient dense” foods—i.e., foods that are low in calories but rich in
vitamins
c. Explanation of Tie-Back to Thesis: By having an understanding of the impact that certain
nutrients have on pregnancy, it is possible for women to better recognize the actions they must
take and the choices they must make both before and during pregnancy.
B. Pre-Pregnancy Habits & Lifestyle
a. Pregnancy represents an opportunity to break bad habits
i. Many women have anxiety about hurting their babies, so they make changes they might
not otherwise make
1. Antenatal Weight Article
a. The “growth and development of the unborn child has been shown to act
as a stimulus for changing lifestyle habits”
b. Pregnancy should not be a snapshot in time in regards to nutrition
i. A woman can’t make a change just for pregnancy and then go back to old habits; a
healthful lifestyle must be for the long haul
1. Nutrition Requirements During Pregnancy Article
 a. We need to look at when a woman is pregnant not in isolation but rather
in the “larger context of the mother’s overall health”
c. Explanation of Tie-Back to Thesis:
i. Nutrition during pregnancy starts before conception; having healthful nutrition doesn’t
start and end when a pregnancy starts and ends. In understanding this notion, it becomes
easier to reduce certain risks associated with pregnancy.

6.) Vitamins and Supplements

A. Rampant Vitamin Deficiencies in Women
a. Globally, women are deficient in both iron and folate
i. Iron—American College of Obstetricians and Gynecologists Definition:
1. Iron is “used by your body to make a substance in red blood cells that carries
oxygen to your organs and tissues”
2. Most foods contain nonheme iron, which is difficult for the body to absorb 
people don’t realize their deficiency
3. Heme iron, by contrast, is found in certain types of meats and is easier to absorb
4. Deficiencies in iron can cause anemia and lead to pica and preeclampsia for the
mother, low birth weight for the baby, and many other complications
5. Pregnant women must be extremely aware of their intake of iron, as her intake
must be adequate for the baby to “store enough iron to last through the first few
months of life”
a. Quotes from International Food Information Council
b. Important because iron assists in brain development, temperature
regulation, and metabolic rate
ii. Folate—International Food Information Council Definition:
1. Folate = “term for the different forms of the nutrient found naturally in foods”,
whereas folic acid = the “synthetic form used in supplements and in fortified
grain products”
a. Folic acid ties into why it is so important for women to take vitamins—
they can make up for their deficiencies in that way!
2. Folic acid and folate play formative roles in the development of the central
nervous system—they help to prevent and decrease neural tube defects in fetuses
b. Explanation of Tie-Back to Thesis: A woman’s intake of these essential vitamins is important
because they greatly impact the outcome of a pregnancy. Therefore, it is in this way that they
relate to the overall nutrition of a woman during pregnancy, as only through adequate levels of
these vitamins is it possible to be sure of a good outcome.
B. Necessity of Prenatal Vitamins
a. Many women lack the expertise and awareness to know if they are getting enough vitamins in
their diet. By taking a prenatal vitamin, they can ensure that they are covering all of their
bases—these vitamins help to build up a store of nutrients.
i. Vitamin A = important for its role in growth, vision, cell differentiation, etc.
ii. Vitamin B12 = necessary for production of red blood cells
iii. Vitamin D = Fetus gets vitamin D directly from mother, so there needs to be enough
iv. Iodine = Important for IQ
1. “Mild iodine deficiency during pregnancy leads to lower IQ in children”
a. Dr. Mercola Quote
b. Explanation of Tie-Back to Thesis: Prenatal vitamins are preemptive and proactive measures
that expectant mothers should take in order to decrease the likelihood that their children will
have any abnormalities or defects relating to a mother’s deficiencies.
7.) Drugs, Alcohol, and Caffeine
A. Caffeine and Drugs
a. Research by the International Food Information Council notes that anything beyond 300
milligrams of caffeine is pushing the boundaries of what is acceptable
b. Research on illicit drug use during pregnancy by professor of nursing Amy Levi:
i. More than 20% of pregnant woman have used “illicit drugs, including opiates such as
heroin and illegally obtained prescription painkillers”
1. Opiates = “not teratogens in humans”, but they can still cause and increase
complications with pregnancy
a. Levi Article
2. Heroin moves through the placenta  fetus within one hour of use  toxic
build-up of this substance in amniotic fluid + changes to chemical makeup of
placenta
ii. Methods of Treatment:
1. Methadone = “first-line treatment of opioid addiction in pregnancy”
a. Levi
2. Buprenorphine is another option for managing opiate addiction
iii. Importance of weaning a woman off of drugs in the first trimester mustn’t be
overlooked—the later into the pregnancy it occurs, the higher the risk of premature labor
or fetal death
1. Necessity of maintenance therapy
c. Explanation of Tie-Back to Thesis: Drugs and caffeine demonstrate the most extreme impact
that nutrition can have on pregnancy. By highlighting to what extent such substances cause
danger, it is easier to recognize the reasons to avoid these substances. It also relates to current
problems in society and why it is so important to address these issues before they also affect the
next generation.
B. Alcohol
a. Alcohol consumption is tied to preterm birth, low birth weight, and especially Fetal Alcohol
Syndrome
i. Fetal Alcohol Syndrome
1. Mental retardation, skeletal and cardiac malformations, and more
a. Brown Article
b. Explanation of Tie-Back to Thesis: Like drugs, alcohol’s impact on pregnancy is obvious and
even fatal. Therefore, in recognizing the role that alcohol plays in contributing to deformities
and fetal death, women will have the knowledge to know to avoid all alcohol.

8.) Diets, Eating Disorders, and Obesity—Nutrition During Pregnancy in Today’s World
A. Diets
a. Diets are not synonymous with nutrition, and many women fail to recognize the distinction
between the two
i. Vegan Diets
1. The International Food Information Council recommends an increased
consumption of soy protein, the only complete vegan protein source
ii. Gluten-Free Diets
1. Due to the additives in gluten-free foods, these women must be mindful of sugar
and carbohydrate intake
b. Explanation of Tie-Back to Thesis: Diets have a significant impact on nutrition, particularly
during pregnancy, when a woman’s nutrition directly impacts her baby.
 B. Eating Disorders
a. Anorexia
i. Leads to excessive weight loss
ii. Increases likelihood of baby developing heart disease, diabetes, etc.
iii. Brown Article
b. Pregorexia
i. Quote by Brown: Women “overly restrict energy intake and/or over-exercise during
pregnancy to minimize weight gain”
1. Such a disorder in turn endangers both the mother and baby
c. Explanation of Tie-Back to Thesis: Serious body dysmorphia is a disease that is not only
dangerous for the mother, but also for the developing fetus. People don’t realize the extent to
which such a disorder truly effects a body.
C. Obesity
a. Correlations between obesity and pre- and post-pregnancy complications
i. Pre-pregnancy obesity = associated with Polycystic Ovarian Syndrome + miscarriage
b. Pre-pregnancy weight = a good predicator of amount of gestational weight a woman will put on;
planning should be done accordingly
c. Explanation of Tie-Back to Thesis: Nutrition is not only about the food one eats, but also about
the lifestyle one leads. Obese women need to understand how their weight could endanger
themselves and/or their baby during and after a pregnancy.

9.) Role of Health Professionals

A. Weigh-ins
a. According to Allen-Walker et. al., despite previous claims, there is no evidence that routine
weighing during antenatal care caused anxiety”
b. 2015 study by Daley et al. found that “women felt motivated to think about their weight gain in
terms of eating and physical activity habits as a result of being weighed, and responded
positively to the importance of being weighed routinely”
i. Sympathy + Compassion
c. Explanation of Tie-Back to Thesis: Anxiety in the doctor’s office regarding weigh-ins is largely
not an issue, but this ties back to the importance of nutrition during pregnancy because it serves
as a check for women to make sure they are staying on track with weight gain throughout their
pregnancies.
B. Spreading of Information
a. Healthcare providers feel that there is a lack of knowledge + opportunity to discuss and educate
women about gestational weight gain
i. Better education and resources must be made more accessible for all
b. Explanation of Tie-Back to Thesis: A doctor’s sympathy and understanding of the need to
educate women on this topic is important because proper nutrition during pregnancy cannot be
spread without the help of experts.

10.) Conclusion:
A. Full circle importance of nutrition during pregnancy
B. Nutrition must be across a lifespan and cannot be looked at in isolated chunks of time
C. Positive/negative impacts for mother and baby