Drinking Water During Pregnancy: How Much is Enough?

Why Is Drinking Enough In Pregnancy Important?

Hydration is important for many reasons. Water contributes to the proper functioning of cells, tissues, and organs in the body. Water carries nutrients into cells, transports waste materials out of the body, lubricates joints, aids in digestion, helps to regulate body temperature, and much more. 

Experts have determined that adequate fluid intake is around 11.5 cups or 2.7 liters of fluid per day for women and about 15.5 cups or 3.7 liters of fluid per day for men.

Many physiological changes occur in the mother’s body during pregnancy. Drinking fluids throughout these changes is important for both mother and baby. Continue reading to learn more about the importance of proper hydration during pregnancy.

What Are 5 Things Water Does for a Pregnant Woman?

1. Blood Volume

Blood volume increases during pregnancy to support the growing fetus, and water is required to support the increased need. Blood volume increases slightly during the first trimester and then progressively increases during the second and third trimesters. Increased maternal blood volume is also needed to supply oxygen and nutrients to the fetal circulation (growing baby). 

2. Amniotic Fluid

During pregnancy, water is necessary to form amniotic fluid, a clear to slightly yellow water-like substance that surrounds the fetus during pregnancy. The amniotic fluid acts as a shock absorber, offering protection to the unborn baby. Amniotic fluid also contains important substances, including hormones, antibodies, and nutrients essential for proper fetal development.  

3. Edema (Swelling)

Swollen ankles, feet, and fingers are common during pregnancy because the body retains water. Water retention occurs due to the increased release of hormones by the adrenal glands during pregnancy. These hormones, aldosterone and cortisol, signal to the body to hold onto fluid. Additionally, the growing uterus and fetus displace the maternal circulation (from the legs returning to the heart), causing dependent edema (or edema in the parts lower parts of the body). While sounds counterintuitive to drink more water to reduce swelling, drinking fluids actually helps to flush out extra water and reduce swelling.

4. Digestive System

Pressure in the pelvic area from both the growing baby and increased blood volume can alter how food moves through the mother’s digestive tract. Hormonal changes, including increased levels of progesterone and slow digestion during pregnancy, can lead to constipation. Persistent constipation can result in hemorrhoids or swollen veins in the rectum and anus that cause rectal bleeding, pain, and itching. Maintaining good hydration throughout pregnancy helps keep the bowels moving regularly and softens stool, thereby decreasing the risk of both constipation and hemorrhoids.

5. Urinary Tract

In pregnant women, the enlarged uterus can put pressure on the bladder and/or urethra (the tube that drains the urine from the bladder), causing urinary retention. Bacteria may grow in the stagnant urine, leading to urinary tract infections. The immune system function is suppressed during pregnancy, further increasing the risk of UTI. Drinking enough fluids keeps the bladder expanded, promoting frequent urination but also unrestricted flow of urine. 

How Much Water Should A Pregnant Woman Drink?

Recommended Daily Water Intake During Pregnancy

The American College of Obstetricians and Gynecologists (ACOG) recommends drinking 8 to 12 cups (64 to 96 ounces or 1.9 to 2.8 liters) of water daily during pregnancy.

Factors Affecting Individual Water Needs

How much water you should drink during pregnancy depends on many factors; therefore, an individual risk assessment for dehydration is appropriate. Some of the factors that can affect individual water needs include:

• Physical Activity: Pregnant women should drink extra water if they do activities that cause sweating, such as exercise. 

• Weather and Altitude: During hot or humid weather, drinking plenty of water is necessary to replenish fluids lost through sweating. People living at high altitudes are also at a higher risk of dehydration.

• Health Status: Many pregnant women lose fluids with morning sickness. Women with hyperemesis gravidarum, a severe form of morning sickness, can lose a large amount of fluid due to vomiting several times a day. Similarly, illnesses that cause fever, diarrhea, or vomiting can cause dehydration. In these situations, drinking enough water is necessary to replenish fluid losses.

Signs and Symptoms of Dehydration in Pregnancy

Signs and symptoms of dehydration or inadequate fluid intake in pregnancy include:

• Increased thirst.

• Decreased urinary frequency (peeing less often).

• Dark yellow urine.

• Dry mouth.

• Dry skin.

• Tiredness.

• Dizziness.

• Fast heartbeat.

• Fast breathing.

• Low blood pressure.

• Confusion.

Risks Associated With Dehydration During Pregnancy

Inadequate hydration can lead to pregnancy complications that affect both mother and baby. Potential risks of dehydration in pregnancy include:

• Low amniotic fluid (oligohydramnios). Oligohydramnios in the second trimester can lead to underdeveloped lungs in the growing baby and pregnancy loss. It can also restrict fetal growth and compress the umbilical cord in the third trimester.  

• Dehydration may increase the risk of congenital abnormalities. Studies suggest that drinking plenty of water offers protection against birth defects, including neural tube defects. 

• Braxton Hicks contractions, also known as “false labor,” are irregular cramp-like pains that may occur as early as 6 weeks in pregnancy and can last throughout the entire pregnancy. Dehydration can trigger Braxton Hicks contractions.

• Preterm labor. 

• Lower birth weight (smaller baby at birth).

• Decreased breast milk production.

Drinking Too Much Water During Pregnancy

Water accounts for 50-70% of an average person’s body weight. Minerals or electrolytes, such as sodium and potassium, are dissolved in the water within the body.  Therefore our intake of water greatly affects our electrolyte balance.  

Water intake should balance fluid loss. This will aid in maintaining the overall function of the various systems. The body obtains water primarily through the digestive absorption of ingested water, food, and other fluids. Water loss primarily occurs through urine, through the skin during perspiration, and water vaporization through breathing. There is a very small amount of water loss through feces, tears, and saliva as well.  

Healthy adults should consume approximately 2 liters of fluids daily. Too much fluid is better than too little because the body handles excess water more easily than a lack of water. 

Potential Risks of Overhydration

Overhydration occurs when fluid intake is significantly more than bodily fluid loss. Too much water in the body can lead to low sodium (hyponatremia) levels due to the dilutional effects of over-hydration. Low sodium can be dangerous. 

In addition, studies have found that prenatal fluoride exposure can potentially lead to neurobehavioral problems in children (municipal water in the US is fluoridated to prevent tooth decay). Increased consumption of fluoridated water may contribute to the neurobehavioral problems being studied.  

Overhydration is not usually a problem in healthy people with normal kidney function. Healthy kidneys can process up to 23 liters of water per day. However, excessive fluid intake can be difficult to process in those with decreased kidney function, heart or liver function.

Tips To Help You Drink More Water During Pregnancy

• Don’t wait until you feel thirsty. Take sips of water throughout the day.

• It’s easy to increase your fluid intake in warmer weather. But remember to stay hydrated in cooler weather too.

• Drink even more water if you’re sweating in hot and humid weather, as well as before, during, and after exercise.

• Choose the temperature of your beverages based on the weather. An ice-cold glass of water is refreshing on a hot summer day, while a warm cup of tea is soothing on a cold winter day.

• Eat hydrating foods with a high water content, such as spinach, broccoli, celery, cucumber, asparagus, bell peppers, lettuce, tomatoes, zucchini, watermelon, strawberries, apples, oranges, peaches, and pineapple. 

• Drinking plain water is the best way to stay hydrated. If you are drinking other fluids, such as fruit juices, read the nutrition column to check the added sugar content. Too much added sugar can contribute to dehydration.  

• If you don’t like plain water, add flavor with a wedge of lemon or lime. Avoid sparkling water as it can cause gas and bloating.

• Carry a reusable water bottle with you everywhere.

• Use a fluid intake tracking app to help you stay hydrated.

• Avoid or limit caffeinated beverages, which can dehydrate you.

Monitoring Hydration Levels Effectively

• Urine Color: The simplest way to monitor hydration levels is to check the color of your urine when you urinate. A pale yellow color indicates adequate hydration, and a darker urine color indicates dehydration. 

• Thirst Cues: Paying attention to thirst sensations can also help you identify dehydration, although this symptom is not always a reliable indicator. 

• Skin Turgor Test: You can do a quick skin turgor test at home. Gently pinch the skin at the back of your hand and observe how quickly it returns to its normal position. A slower return indicates dehydration.

Frequently Asked Questions

How Much Water Should I Drink While Pregnant?

According to experts, the appropriate amount of water to drink while pregnant is 8 to 12 cups daily. However, water intake while pregnant depends on factors such as fluid loss due to morning sickness or sweating. 

What Happens If You Don't Drink Enough Water While Pregnant?

Not drinking enough water while pregnant can lead to pregnancy complications affecting mother and child. These include low amniotic fluid, increased risk of birth defects, preterm labor, and lower birth weight. It can also lead to decreased milk production when breastfeeding (postpartum or after childbirth) Severe dehydration can cause serious health issues that may require hospitalization.

Is 4 Liters of Water a Day Too Much While Pregnant?

Drinking 4 liters of water a day may be too much while pregnant. The American College of Obstetricians and Gynecologists (ACOG) recommends a daily intake of 1.9 to 2.8 liters of water during pregnancy. This equals 8 to 12 cups or 64 to 96 ounces of water daily. 

Is Drinking Water In The Morning Good For Pregnant Women?

Yes, drinking water in the morning is good for pregnant women. It provides hydration after 7-9 hours of no fluid intake during sleep. Integrating water, tea, and/or bland foods in the morning may help with symptoms of morning sickness.

Can a Baby Feel When I Drink Cold Water?

Drinking cold water does not affect the growing baby in any way. There is some anecdotal evidence that ice-cold water can “wake a baby up” and increase fetal movement compared to room-temperature water. However, experts say there isn’t enough scientific proof to support this theory.