Pregnancy can be an amazing time in a woman’s life.
She’s nurturing a new life, full of promise and with a near unlimited future to embrace.
Her body is changing and she has so many questions.
One of those questions is often “What the hell happened to my body and how do I get it back?!?”
Weight gain in pregnancy is not only natural, it’s a requirement if the baby is going to be healthy.
But that doesn’t mean that the wholesale changes in a woman’s body during pregnancy aren’t shocking and often scary.
But what do you really need to know about weight gain during pregnancy?
I’ve done some research, and I think I’ve found things you really need to know.
But first, a disclaimer. I’ve never been pregnant. I’m a dude, so, not going to happen. If that automatically disqualifies me in your book, then feel free to move on. No hard feelings.
However, as a fitness professional for the last 2 decades, I’ve worked with a number of pregnant clients, as well as those losing the pregnancy weight. So I do have some in-the-trenches experience around this subject.
So here we go!
1. How much weight is “normal” to gain during pregnancy? – Like so many other questions around health & fitness, the answer is “it depends.” Here’s what the CDC says:
For moms having one child, if your pre-pregnancy BMI was below 18.5 (considered underweight,) you should gain between 28 and 40 pounds. If your pre-pregnancy BMI was “normal,” or between 18.5 and 24.9, you should gain 25-35 pounds. If your pre-pregnancy BMI was “overweight” (25-29.0,) your weight gain should be 15-25 pounds. For “obese” BMI’s, the gain should be 11-15 pounds.
Of course, this changes for women having twins where the underweight BMI recommendation is 50-62 pounds. Normal BMI is recommended to gain 37-54 pounds. Those with overweight BMI come in at 31-50 pounds, while the obese BMI recommendation is 25-42 pounds.
2. Why do I have to gain so much weight? – The appropriate and healthy development of a miniature human is at stake! But I get it, nobody wants to pack on a bunch of pounds without a damned good reason.
According to researchers, women who gained too little weight during pregnancy were more likely to have babies with problems. Sneha Sridhar, Public Health researcher at Kaiser Permanente in Oakland, California said, “Gaining either too little or too much weight in pregnancy may permanently affect mechanisms that manage energy balance and metabolism in the offspring, such as appetite control and energy expenditure. This could potentially have long-term effects on the child’s subsequent growth and weight.”
Gaining too much weight during pregnancy can increase risk to the baby, too. “When a woman gains too much weight during pregnancy, it increases the risk of her baby being born too large, which can contribute to subsequent obesity in the child as well as delivery complications such as vaginal tears, excess bleeding and an increased need for a Caesarean section,” explains study co-author Andrea Sharma, Ph.D., an epidemiologist at the Center for Disease Control’s Maternal and Infant Health Branch.
So while we tend to think of pregnancy as a time of hard-to-control appetites and cravings, and the random weight gain that attends that problem, women should really aim for specific weight ranges. Those should be based on their current physical condition, previous pregnancies, if any and how many children are being carried.
3. What is Gestational Diabetes and should I be worried about it? – Often a temporary form of diabetes, gestational diabetes gets its name from the fact that it develops, or at least is first diagnosed, during a woman’s pregnancy. It often shows up around the second trimester, then dissipates after childbirth.
According to Dr. Christopher Glantz, Professor of Obstetrics & Gynecology at the University of Rochester Medical Center, “Even if a woman had required quite a bit of therapy and treatment to keep her blood sugars under control when she was pregnant, usually the day after delivery, her sugars go back down to normal.”
Most women are asymptomatic, meaning they exhibit few or no symptoms. Those who do usually present with symptoms normally associated with blood sugar issues – excessive thirst, increased urination and fatigue.
During pregnancy, changes occur that increase sugar availability to the fetus. Among these is that the placenta produces hormones which interfere with insulin’s action. Insulin is the hormone that shuttles sugar (glucose) from the bloodstream to the cells. Mom winds up with higher levels of blood sugar because it isn’t ending up in the cells.
Since the fetus takes in more sugar, normally there is a net zero effect on mom’s blood sugar, more often her levels decline. Sometimes, though, the placenta gets a little crazy and sends out way too much of the insulin-blocking hormones, jacking up mom’s blood sugar. If the levels get abnormally high, that’s when she is considered to have gestational diabetes.
If a woman is pre-diabetic prior to becoming pregnant, pregnancy may make it worse, leading to gestational diabetes. Some women enter their pregnancy with undiagnosed diabetes and then get diagnosed. The other factor disrupting the glucose-insulin balance is the changes that occur in the levels of estrogen and progesterone during pregnancy.
Gestational diabetes increases the risk of abnormal birth weight, post-birth low blood sugar, respiratory distress syndrome and jaundice for the baby. For mom, even if the gestational diabetes symptoms disappear after birth, she’s at a 60% greater risk of developing Type 2 diabetes in the future.
4. Is it safe for me to try to control my weight gain during my pregnancy and if so, how should I do it? – The answer to the first part is yes, and a recent study reinforces that.
Northwestern University Feinberg School of Medicine recently concluded a study funded by the National Institutes of Health (NIH) that found that women can safely control their weight gain through lifestyle adjustments. The study recommended coordinating those changes with your obstetrician and other physicians, but they saw positive results from the application of common-sense changes to activity, caloric intake levels and even from macronutrient adjustments.
Here are some suggestions that make sense:
- Set goals with your health care provider at the outset – This should be a no-brainer. Get your medical pro’s on board early.
- Track your weight at the start and throughout – You can’t change what you don’t measure. Tracking allows you to compare your progress to the recommendations of your care providers.
- Eat well – Whether you’re a keto eater, a vegan or somewhere in between, be sure to get the necessary macro- and micro-nutrients you need to keep you and your baby healthy. (Need a really good prenatal vitamin? Try Garden of Life Organic!)
- Limit sugars and processed foods – This makes sense if you’re trying to avoid negative weight gain and diabetes! So many processed foods are loaded with sugars that have unfamiliar names. Have you heard of cane crystals, Sorghum syrup, mannitol, treacle or diastatic malt? Maybe not, but those are just a few of the dozens of sneaky sugar names found as ingredients in processed foods.
- Know what you actually need – Did you know that in the first trimester, a woman carrying one baby doesn’t actually need any extra calories? In the 2nd trimester, the average additional daily need is 340 calories. It’s 450 calories a day in the third trimester. So, if you just found out you’re pregnant, put down that doughnut! Ok, have one to celebrate, then put them away.
- Get some exercise – If you’re currently exercising moderately to intensely, continue for as long as you are comfortable, at least into the 2nd trimester, if your doctor agrees. If you want to continue with a weight training program, there’s generally no problem. I strongly suggest getting some professional help. A fitness coach familiar with the neuromuscular, orthopedic and hormonal changes taking place in your pregnant body can be a real asset to staying healthy and fit during your pregnancy.
For those not working out now, try to work up to about 150 minutes (2 1/2 hour) of aerobic activity each week. Walking or swimming (as long as your doc allows) are great choices. You can start a weight training program, but again, I suggest getting help.
So there are 4 often challenging questions about pregnancy weight gain answered. As always, I invite your questions and comments below. I’m here to help!
Keep the faith and keep after it!