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DESCRIPTION
Weight gain during pregnancy is made up of several elements. About half comes from the baby, placenta and the amniotic fluid; about one third comes from increased weight of the uterus, extra breast weight and increased blood and tissue, and the balance of the weight is stored fat (which is necessary for energy reserves during labor).
The weight gained in pregnancy varies from one individual to another and from one pregnancy to another in the same woman. The guidelines discussed here are averages and are only meant to be guidelines. The main concern is to eat a high-quality, balanced diet with adequate calories that will ensure good health for you and the baby. If you eat well and nutritiously, the weight gain should take care of itself.
MoonDragon's Nutritional Guidelines for Pregnancy
At your first prenatal visit, your height and weight will be measured and the two compared to help determine if you are starting pregnancy at about the right weight for your height and gives a good starting point to work with for the remainder of the pregnancy. At each or most of the subsequent prenatal visits, you may be weighed again and any concerns you or your midwife may have about weight gain or lack of weight gain will be discussed. Midwives are usually more relaxed about weight gain issues than other health care providers as long as the pregnancy is healthy, the mother and the baby are doing well and her nutrition is optimal with plenty of good nourishment, calories, protein, vitamins and minerals, and salt to taste. Junk and processed foods (often containing empty calories, hidden high fat and salt, and poor nutrition) should be avoided or limited.
AVERAGE WEIGHT GAIN GUIDES
A general recommendation for weight gain in pregnancy is in the range of 25 to 35 pounds (it is not unusual for women to gain more than 35 pounds, as long as her diet is nutritious and she is getting what she needs). Underweight women may need to gain more. For overweight women, pregnancy is NOT the time to try to lose weight. However, a special pregnancy diet may be recommended to keep weight gain within certain limits. If a woman is expecting twins (multiple fetuses), her nutritional requirements are going to have to be increased to support more than one growing fetus. This means more calories, more protein and other nutrients.
Weight gain should be steady throughout the pregnancy. Occasionally in the first trimester some weight loss occurs if the woman is having morning sickness or nausea. This is natural, but it needs to be watched carefully and the midwife will usually recommend some helpful hints for relieving morning sickness symptoms.
A gain of 3 to 4 pounds the first trimester is usual.
A 1 pound gain about every week during the second trimester for a total of 12 to 14 pounds.
During the third trimester, a pound a week gain continues for the seventh and eighth month, and then just 1 to 2 pounds are gained during the ninth month for a total of 9 to 10 pounds. It is important during the last month of pregnancy to eat well, rest well and take care of yourself. This is the month that the baby is maturing and putting on his/her birth weight which includes the body fat it needs for energy storage for the birth and the first few days of life until the breastmilk comes in.
With each monthly prenatal visit, the expected weight gain is usually 3 to 4 pounds over the previous visit. If the weight gain is significantly under or over that amount, further evaluation may be necessary to assess nutrition and diet, or the presence of edema (swelling in the hands, feet, and legs).
If a woman is pregnant with more than one fetus, the weight gain will be higher, but not double or triple. The midwife or health care provider will discuss a recommended amount.
WEIGHT GAIN CONCERNS
Controlling weight gain is more difficult in late pregnancy, so it is important that the mother does not gain most of the total weight during the first months. If an excess amount of weight is gained during the first or second trimester, DO NOT DIET! Your nutritional intake needs to stay balanced to supply the daily needs for the fetus. Reassess your diet and make sure you are eating properly.
A lack of weight gain in pregnancy may be due to poor nutrition or an illness in the mother-to-be. It can contribute to intrauterine growth retardation (IUGR), a term used to describe infants whose weights are much lower than expected for gestational age.
When an obese woman becomes pregnant, there is somewhat higher risk of gestational diabetes and hypertension than in the average weight mother (although many plus-sized women do not have these problems during pregnancy and have very healthy pregnancies with healthy babies). It may be more difficult to determine the size of the fetus or pick up fetal heart tones during prenatal visits because of the fat layers (it may take a bit more work on the part of the midwife or health care provider, but it is possible to do a decent assessment with practice and patience), and delivery is sometimes more complicated because the fetus may be larger than average (gestational diabetic problems may cause this... but many plus-size women give birth the average size babies as well as their slimmer sisters!). In a hospital setting, cesarean deliveries are much more common with obese women, although cesarean deliveries are also complicated more by the amount of fat in the abdomen area. Regardless, obese women should NOT diet during pregnancy! The midwife will work with these large mothers to help control weight gain with a good nutritious diet plan and attempt to keep it within recommended guidelines. Good nutrition with adequate moderate exercise is much more important than weight gain!
On the average, the larger the weight gain in pregnancy, the larger the baby. However, this is not always the case and a healthy woman can gain 45 or more pounds and still have a healthy 6 to 7 pound baby and a uncomplicated labor and birth.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or a family member is pregnant and wants additional information on weight gain.
You are pregnant and your weight gain increases significantly or does not increase at all during a 2 week period.
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