Even During Pregnancy You Need to Watch Your Weight

woman receiving ultrasound Excessive weight gain during pregnancy poses unnecessary risks

If you are pregnant, you may be getting mixed signals in regards to how much weight you should gain.  Making matters worse, food cravings can be intense when you are pregnant. And since your waistline is growing anyway, you may feel inclined to give in to them. Don’t. Excessive weight gain can be problematic for both you and your growing baby. Research shows that most women having one baby only need to minimally increase their calorie intake for the first trimester of pregnancy by approximately 100 calories/day.  For the last 2 trimesters you would roughly add another 100 calories for each trimester.  These general guidelines would change with activity level and starting weight.  A calculator for caloric intake per trimester is available here. Make sure your obstetrician or midwife recommends your target weight gain, diet and exercise plan at your first prenatal visit, based on your pre-pregnancy body mass index. Women who are already underweight will need to gain more pounds than those in a normal weight range in order to avoid the risk of delivering an underweight baby. Overweight and obese women will need to gain significantly less.  In fact, some recent studies show that women who are obese may have improved outcomes by losing a half pound every 2 weeks.

Gaining weight can harm both you and your baby 

For most women, the biggest fear of gaining too much weight during pregnancy is losing their figures. Excessive weight gain is indeed associated with post-delivery weight problems. In fact, those who gain more than the recommended amount may retain twice as much of their non-baby weight as women who stayed within the guidelines. If you’re unable to lose that weight within six months, you’re at greater risk of obesity down the line. But how you end up looking is only one of the complications that should concern you. By consuming too many calories, you subject your own health and your baby’s to the following risks:
  • Gestational diabetes: This type of diabetes, which develops during pregnancy, not only puts you at risk, but the baby too, if not monitored and treated. Babies can become overweight and the risk of cesarean section or complications during the actual delivery may increase (see below). If your baby is born overweight, it is also more likely to become obese, develop hypertension as an adult and be at risk for type 2 diabetes.
  • Preeclampsia:  Obesity during pregnancy can cause increased blood pressure.  This complication can result in earlier delivery and the complications that come from prematurity.
  • Complications during delivery: If your baby is overweight there is a greater risk that it may sustain injury during birth. In some instances the baby may develop a complication called shoulder dystocia during a vaginal birth. The bone structure of the mother’s pelvis may not accommodate the overweight baby’s shoulders, leading in some cases to permanent injury. C-section delivery is also more common with a larger baby, which is associated with several complications.

Eat the right diet for your weight and activity level

The amount of weight you should gain during pregnancy depends on how much you weighed when you became pregnant, your activity level and the kind of exercise program you plan to maintain. No matter how much you eat, you should make sure that you consume a balanced diet rich in minerals and nutrients. If you have trouble maintaining an appropriate weight gain, let a professional dietician help you adjust your eating habits. The American Congress of Obstetricians and Gynecologists recommends the following weight gain ranges:
Prepregnancy Weight Category Body Mass Index*

Recommended Range of Total Weight (lb)

Underweight Less than 18.5 28–40
Normal Weight 18.5–24.9 25–35
Overweight 25–29.9 15–25
Obese (includes all classes) 30 and greater 11–20**
*Body mass index is calculated as weight in kilograms divided by height in meters squared or as weight in pounds multiplied by 703 divided by height in inches.  Easily calculators may be found online by looking up BMI calculator ** Mild loss of weight as stated above may improve outcomes in obese mothers.