How Much Weight Should Pregnant Women Gain?

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How Much Weight Should Pregnant Women Gain?

The National Academy of Sciences' Institute of Medicine released new guidelines today for how much weight women should gain during pregnancy. And the biggest change in the guidelines--the first revision since 1990--is that they for the first time include specific recommendations for obese women.

The addition is a nod to the rising concern about the nation's obesity epidemic. Nearly two-thirds of U.S. women of childbearing age are overweight and almost one-third are obese.

Here are the recommendations:

--Healthy American women at a normal weight for their height, which is defined as having a body mass index (BMI) of 18.5 to 24.9, should gain 25 to 35 pounds.

--Underweight women (a BMI less than 18.5) should gain 28 to 40 pounds.

--Overweight women (a BMI of 25 to 29.9), should gain just 15 to 25 pounds.

--Obese women (a BMI greater than 30) should limit their weight gain to 11 to 20 pounds.

BMI is based on a person's weight and height. For example, a 5-foot-6-inch tall woman weighing between 115 and 154 pounds has a normal BMI. To check your BMI, you can use this online calculator.

Pregnant women who gain too much weight face a variety of risks, including a greater likelihood of requiring a Caesarean section and more of a chance they will have a hard time shedding those extra pounds after giving birth. The babies are at risk for being born preterm, which can lead to impaired development, and also more likely to be born with extra fat, which boosts the chances of developing health problems later in life such as heart disease and diabetes.

My name is Zenneia McLendon and I am writing from the National Academies. We are happy to see that this report has garnered such attention.

I wanted to inform your readers that this report, "Weight Gain During Pregnancy: Reexamining the Guidelines", is available to download for free from the National Academies Press website (http://bit.ly/preg). We hope that by reading the report it will enhance the conversation.



Is there a minimum weight gain? My neighbor's daughter only gained 7 pounds during her pregnancy. She came to her baby shower in knee-high boots and tight jeans. To look at her you'd never know she was pregnant.



I have to say, being pregnant is all about the power of small-- you have to look not at the "bigger picture" (how much weight am I gaining? Am I getting too fat? etc.) and instead focus on the heart of things, what really matters-- like is the baby staying healthy depending on how much weight you're gaining or, well, not gaining?

This is the secret of happiness-- focusing not on the obvious, but on the core of things. Too many people overlook this.



Another rebuttal of the "fat acceptance" movement. From the article, it's clear that obese mothers definitely are putting their babies at a lifelong health disadvantage.

A coordinated education campaign seems to have succeeded in establishing a strong and near-universal social taboo against drinking while pregnant. Publicizing the impacts of maternal obesity might establish a similar taboo against being fat when you're trying to get pregnant.



It's important that people also are aware of the negative effects of both being too heavy or too thin on fertility. The current stick-thin ideal is actually not conducive to fertility, and studies have shown that gaining a little weight helps many very thin infertile women get pregnant.

Does the study comment on whether it is okay for obese or overweight women to lose weight during pregnancy on a nutritionally sound diet and exercise plan? I have seen studies saying the previous taboo against obese women working toward weight loss during pregnancy was misguided.

I do think that it's important for women to be aware of the risks of obesity, but it's really, really important for doctors to address weight without shaming and provide good information on exercise and nutrition. I was obese when I was pregnant and had a very negative experience with a freshly minted OB who dropped all her fat issues on me in our first visit in a highly unprofessional manner. I left the practice at 26 weeks because of that and other unsupportive behavior by the docs there.



Instead of weighing pregnant women, caregivers should be monitoring their diet and blood pressure, as well as urine. My first child was a mainstream, hospital birth, a C-section because she was breech (an idiotic reason, I now know, but most doctors have never seen one, whereas their predecessors caught breech babies regularly), and I gained 34 pounds (I started out slim). My second was a VBAC home birth and my CPM did not weigh me at all, but gave me the best care I've ever received, for anything. She monitored my diet, BP, measured the growth of the uterus, checked urine, palpated for position, monitored the different heartbeats and gave me tons of time and advice. I ate well, exercised, and was so very calm because I knew I was going to have a fantastic birth experience, and I did. Weighing expectant mothers is over-rated if the whole picture is ignored, and unfortunately, it is with the medical establishment. I could write thousands more words about my and my friends' negative experiences with the medical establishment regarding the natural, non-medical act of giving birth, but I'll end here.

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