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Gaining Weight in Pregnancy

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Updated August 29, 2013

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Pregnant Woman on Scale

Pregnancy weight gain is a very individual and should be discussed with your practitioner.

Photo © iStockPhoto

Nowadays all we seem to be concerned with is how much anyone weighs. Is so and so fat? Or are they skinny? We really don't seem to care much about health. These attitudes linger into the realm of pregnancy weight gain, when weight really does matter, but maybe not in the ways you think.

Go back to when my husband was born and my mother-in-law will tell you the delightful story of how she went in to her doctor for the first visit weighing 99 pounds (after two previous children). He gives her several prescription medications. She had water pills, she had diet pills, she had it all. The message was loud and clear, don't gain weight.

Many practitioners don't do this any more, although a good majority still don't send the right messages about weight gain in pregnancy. Society is also largely to blame for our fear of fat, even during pregnancy.

Anyone here have night mares about chubby thighs, expanding waists and a body that is never quite the same? One woman told me recently that when she's done having children her husband is going to pay good money to have her body put back together "the way he found it."

Let's look at what needs to happen to stay healthy during pregnancy.

First of all, no matter what you weigh prior to pregnancy you must gain weight. Women who are clinically obese still need to gain at the minimum 11 pounds, and women who are underweight need to gain more than the average statement of 25-35 pounds, usually at least 10-15 pounds more depending on the severity of the weight problem. These figures are for the healthy woman carrying a single baby. Moms who are expecting multiples will need to gain more weight, although no standards have been devised for these special needs as a whole. (More on weight gain for a twin pregnancy.)

Why gain weight?

Weight gain does things for you and your baby. First of all remember you are growing a new human being. We know that women who deprive themselves of good nutrition during pregnancy tend to have smaller, sickly babies who require more hospital time and have a higher incidence of problems including neonatal death.

How should I gain weight?

Good thing you asked! Because I'd tell you anyway! Remember that eating for two doesn't mean eating twice as much. In general you do not need to add any more than 200-300 calories a day to your present diet. However, it's what you eat that really counts.

Making sure that your diet is nutrient dense, that is full of good things for you and your baby as opposed to junk food that is full of fat and sugar. This means at snack time reach for fresh fruit instead of a candy bar. Add some cheese to your crackers.

Most women will notice a slight weight gain in the beginning of pregnancy, usually about four pounds during the first trimester. Some of this is water weight, some of this is materials needed to help your baby grow. Your baby is still very tiny at the end of this trimester. Occasionally you will see women who gain a bit more weight up to about ten pounds during the first trimester from lowered activity levels and water weight gain. If you are overweight you need to gain about three pounds and if you are underweight you should gain about five pounds.

The majority of the weight will be fairly evenly spread over the last two trimesters, about a pound a week, with a little more at the end. Again, if you are underweight it should be increased by about 25% (or a quarter pound per week) and if you are overweight it should be decreased by the same amount. It is also quite common to notice a cessation of weight gain, perhaps even a slight weight loss at the very end of pregnancy.

If you notice that you've put on several pounds one week, look back at your diet. Did you changes your dietary habits? Your practitioner will also use your weight gain as an indicator of baby's growth and in looking for potential problems.

Remember slow and steady wins the race!

Source:

Weight Gain During Pregnancy: Reexamining the Guidelines. Kathleen M. Rasmussen and Ann L. Yaktine, Editors; Committee to Reexamine IOM Pregnancy Weight Guidelines; Institute of Medicine; National Research Council; 2009.

How Much Weight Should You Gain in Pregnancy

BMI Recommended Weight Gain
30+ 11-20 lbs
25 - 29.9 15-25 lbs
18.6-24.9 25-35 lbs
18.5 and lower 28-40 lbs

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