Pregnancy Matters: Weight Gain
By Theresa Gipps MD
A woman’s health during pregnancy is important for her and her baby’s health long after her pregnancy ends. Last time we reviewed guidelines for exercising safely during and after pregnancy. Exercise and diet are key factors in a woman’s weight gain during her pregnancy.
About half of American women gain more weight than recommended during pregnancy. Women who are overweight or obese before pregnancy are even more likely to gain excess weight in pregnancy. Twenty percent of women will not gain enough weight during pregnancy. This means only about 30% of women gain the recommended amount during pregnancy.
Women who gain more than the recommended amount of weight are not only more likely to have trouble losing their pregnancy weight, they are at increased risk of gestational diabetes, pregnancy related hypertension, cesarean delivery and delivery of a large baby.
Women who don’t gain enough weight during pregnancy are at risk of delivering a preterm baby, or a baby that is small for its age.
How much weight should I gain during pregnancy?
It is important to know where you are starting from: calculate your pre-pregnancy BMI (The CDC has an online adult BMI calculator). Women with a normal BMI of 18.5 - 24.9 before pregnancy should aim to gain 1-5 lbs. in the first trimester (first 14 weeks) and about 1 pound per week for the duration of the pregnancy. This adds up to a total of 25-35 pounds’ total during the pregnancy. Underweight women should gain between 28-40 pounds while pregnant, and obese women should gain 11-20 pounds.
Note your weight before pregnancy, and keep an eye on it as your pregnancy progresses.
It is important to remember: all pregnancies are different. Women with twin pregnancies will need to gain more weight. Women on bedrest or with activity restrictions may have more of a challenge staying in the recommended range. Women with significant nausea will often have trouble gaining or maintaining weight in the beginning of pregnancy, but are usually able to catch up when nausea improves.
How do I stay on track?
Most people know the basics for maintaining a healthy weight. Remember that exercise is typically safe and healthy during pregnancy!
Food choices are the second part of the equation: listen to your body - eat when you are hungry! But try to make most of your food choices healthy ones. Carbohydrates are your body’s main source of energy. Choose whole grains, brown or wild rice, and other grains like barley and quinoa. Fats are important for building your baby’s brain. Protein is necessary for building muscle, and minerals like calcium and iron are needed to make bones and blood. Babies born to women with a high fruit intake have improved cognitive development at 1 year of life. Whole fruits are healthier than juices.
If you are struggling with food choices ask for help. Nutritionists can help with meal planning, and physical trainers can help you plan a safe exercise program. Women with specific dietary needs or restrictions - like allergies, diabetes, or gastric bypass - may especially benefit from consulting with a nutritionist.
Getting back to your pre-pregnancy weight
The best way to lose your pregnancy weight is by eating healthy and getting active. Most new moms get back to their pre-pregnancy weight by about 6 months after delivery, but every woman is different. Many factors will affect your weight loss - including the amount of weight gained during pregnancy, pregnancy complications, and breastfeeding. Women who breastfeed are more likely to lose their pregnancy weight faster than women who do not.
Your progress will vary from week to week. Be patient - weight loss takes time. Remember, the healthy habits you develop now will improve your health and your family’s health for years to come.
