How Much Water Should I Drink During Pregnancy?

Water makes up over half of our body weight and it’s recommended that adults drink at least eight 8 oz. glasses of water per day.  Pregnant women need to drink more because water is essential for the development and functioning of the placenta, making amniotic fluid, and for the circulation of nutrients from mother to baby. The placenta contains about .5L of water and pregnant women make between .5-1.2L of amniotic fluid. Pregnant women’s blood volume also increases by 50-60% during pregnancy and water is the major component of blood. 

It’s also important to drink enough water while pregnant for the following reasons:

• Helps with digestion
• Increased metabolic demands during pregnancy require more water
• Improves circulation
• Helps waste (toxins) leave the body in both urine and stool
• Increases absorption of water-soluble vitamins, including B vitamins and vitamin C
• Lowers risk of urinary tract infections (bladder infections) 
• Helps to prepare the breasts for making milk
• Prevents constipation and hemorrhoids
• Prevents overheating by making sweat
• Improves energy levels
• Prevents the development of kidney stones

American College of Obstetricians and Gynecologists (ACOG): recommends 8-12 glasses (64 to 96 oz.) of water every day 

Institute of Medicine (IOM): recommends ten 8 oz glasses of water per day

U.S. National Academies of Science, Engineering, and Medicine: recommends that average females (even non-pregnant) should drink 11.5 cups per day

Based on these recommendations, pregnant women should be sure to drink at least 10 eight-ounce glasses of water per day (2.5L). Some experts recommend drinking water throughout the day, while others recommend drinking fluids earlier in the day to prevent sleep interruptions from having to get up at night to go to the bathroom.

Pregnant women need to increase their amount of water and fluid intake if they live in hot climates, spend a lot of time outdoors in hot weather, exercise, have an illness with fever, or have a gastrointestinal illness with vomiting and/or diarrhea. Mothers with morning sickness are also at a higher risk of developing dehydration, so need to be sure to drink enough. As a rule, the amount of water intake is enough if you do not feel thirsty and your urine is clear to pale-yellow colored. 

• Carry a water bottle around with you all day
• Make sure to drink whenever you are thirsty
• Monitor the color of your urine – if it’s not pale yellow it’s a sign you have to drink more!
• Add fruits to your water to add flavor, like lemons or berries
• Drink extra water if you are exercising and/or have been in hot weather

• Dry mouth, lips, skin, and/or mucus membranes
• Fatigue and exhaustion
• Extreme thirst
• Dizziness and feeling like you are going to “pass out”
• Dark urine
• Headaches
• Edema (swollen feet and ankles)
• “Brain fog” and mental confusion
• Constipation and hemorrhoids

Dehydration can predispose women to Braxton-Hicks contractions during the third trimester. 

Per the American Pregnancy Association, dehydration during pregnancy is associated with pregnancy complications, including neural tube defects (i.e. spina bifida), low amniotic fluid, and preterm labor. Researchers in China are currently investigating the link between mothers’ hydration status during pregnancy and pregnancy complications in more in-depth. Signs of severe dehydration include a racing heart, low blood pressure, and decreased fetal movement. Severe dehydration can lead to shock and death. 

The treatment for mild dehydration is to increase oral fluid intake. Moderate to severe dehydration requires the administration of IV fluids with electrolytes, including sodium and magnesium.

Beverages: skim milk, fruit juice, sparkling water, tea (non-caffeinated), smoothies, and soup. If you choose to drink juice make sure if does not contain too much sugar or artificial sweetener. 

Foods: fruits and vegetables, especially watermelon, cantaloupe, oranges, berries, lettuce, cucumbers, squash, and celery.

1. Coffee and other caffeinated beverages, like energy drinks. This is because caffeine has a diuretic effect, causing you to urinate more (which can lead to dehydration). ACOG recommends no more than 200 mg of caffeine per day while pregnant, which is the equivalent of one 12 oz. cup of regular coffee. 
2. Alcoholic beverages
3. Soda (pop) and other sweetened carbonated drinks

It’s dangerous to drink too much water while pregnant because overhydration can lead to hyponatremia (a low sodium level) and deficiencies of other important electrolytes, like potassium and magnesium. Electrolyte imbalances can cause neurologic problems, including seizures, and even death. It’s especially dangerous to consume excessive water during labor as newborns are at risk of developing dangerous electrolyte abnormalities from their mothers’ overhydration. Warning signs of overhydration include headaches, vomiting, and muscle weakness.

You will need to make sure that your city’s tap water is safe before you drink it, as some tap water is contaminated with heavy metals including lead, mercury, and arsenic. If in doubt, make sure to drink only filtered or purified water, or purchase bottled water to drink. 

In conclusion, drinking enough fluids to stay hydrated is one of the best (and easiest) things you can do to ensure a healthy pregnancy. Listen to your body's cues – if you feel thirsty or notice the color of your urine is darker than normal, take a few minutes to fill up a glass of ice-cold water and enjoy!