Monday, 17 November 2008
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The Skinny on Obesity and Pregnancy
by Nurse Jenna 
It is one of the classic portrayals of pregnancy—the weird food craving of pickles and ice cream. Unfortunately many pregnant women do not just indulge in occasional odd flavor combinations, they gain weight far beyond what is recommended, or are already carrying an unhealthy number of pounds prior to their pregnancy.
Obesity has become an epidemic that has led to a plethora of health problems that carry over to complications during pregnancy. This in turn often leads to many delivery interventions and complications for both mothers and babies that would otherwise be unnecessary in a normal, healthy pregnancy.
A woman who has an appropriate BMI (body mass index—determined by dividing weight in kilograms by height in meters with 19.6-26 being normal) prior to her pregnancy would be expected to gain 25-30 pounds during the course of the pregnancy. Often women use pregnancy as an excuse to eat whatever they want and rationalize it because they are “eating for two.”
The reality is that during pregnancy, a woman only needs an additional 500 calories per day for a healthy weight gain if she is of normal weight. If a woman is already overweight going into the pregnancy, which half of the woman of childbearing age are, she should only gain 15-25 pounds. Those who are considered “obese”, with a BMI greater than 30, should gain no more than 15 pounds.
A woman’s weight gain not only affects her, but continues to affect her baby throughout its life. It has been shown that women that gain more than 40 pounds are twice as likely to have children who struggle with weight problems their entire life. Women who gain more than the amount suggested by their providers are more likely to give birth to babies greater than 9 pounds, which then have a greater risk of longer deliveries and a higher rate of Cesarean sections. They are also at greater risk for pre-eclampsia, gestational diabetes, preterm delivery and babies with congenital birth defects.
So why is it that over 70-90% of women are gaining “excessive” amounts of weight with pregnancy (more than that recommended)? This is one component of a pregnancy and the resulting lowered risk of deliver complications that women can control. With the push for “decreased medical intervention” in what should be a normal birthing process why aren’t women taking charge of something they can by maintaining proper eating and exercising habits before and during the pregnancy?
How much weight did you gain during pregnancy? Had your provider discussed appropriate weight gain with you during your prenatal visitis?
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Comments (56)
Well, I'd probably lose weight afterwards because I'd go back to a normal routine and expectation of having to be slender.
I gained 30, 15 and 4 pounds with my 3 pregnancies. Having a big ole belly and being SO uncomfortable (at night) was enough motivation for me to not let my weight get out of control.
From the comments, I gather that this is a pretty touchy post. I learned in my nutrition classes that pregnant women are really only supposed to eat about 500 extra calories. So, I am a bit confused about people saying they "agree with you, for the most part". It doesn't really seem like an opinion to me, but a fact.
Anyway, to answer your question about why women don't take control of it, I have a couple of theories. 1) They are either lazy or don't know how to really count calories or watch their intake- maybe they have never had to, and 2) They have been so hit over the head with the pregnant-woman-eats-like-crazy image and don't want to be told that that is incorrect and unhealthy.
I have not had children yet, but I am at a healthy weight now and plan on staying that way.
One last note: I hate the phrase "eating for two". Yeah, there is somebody else depending on the nutrients, but they are tiny! It's not like you have to feed yourself and another adult!
I believe some women just can't help the weight gain. I only gained 34lbs with my first and was back to normal within 2 weeks of delivering. With this one however, I have gained 60+ lbs ! and I truly do not believe its because of my lifestyle. As having an ED before I got preg (and stopping during of course) I am very aware of what goes in my mouth, and the weight gain is astonishing for me , I don't understand it , I do not consume enough calories in order to be putting on the weight that I am , its just crazy and I am praying to god that it is just water weight. But none the less it will not stop me from eating until I deliver, which is actually tomorrow morning , so I guess we will see how much water weight it was ;)
i gained 27 lbs with my first child, as for my 2nd pregnancy i'm only 20 weeks along so i don't have the final weigh in yet.
I had my first child five months ago and I gained 45 pounds. I'm 5'7" and started out at 105 (yeah, "too small" supposedly). By a week I was back in my size one jeans (yay for breastfeeding!) with no problem.
I didn't have the "normal" pre-natal care unfortunately. I usually have sporadic periods (not as fun as you think. lol they catch you when you're not prepared) so it was about 10 weeks before I knew I was pregnant (because I got really, really hungry and started gaining weight). Then it took two months to get an appointment with an OB/GYN, who then informed me that I was putting my baby in danger for not having an appointment sooner. Hm... Anyway, at 24 weeks when discussing a birth plan she decided she wouldn't treat me because I wanted to try to have a natural birth, but didn't decide to tell me that until I was 28 weeks. Then it took me until I was 34 weeks to find a medical practice that would take me so far along (and it had to be in a different town because no practice in the same one would take me for fear of "stealing" a patient!). My weight was never an issue and the nurses at the final practice were surprised that I weighed what I did. But overall, weight was never discussed at all really.
Maybe because I wasn't overweight to begin with they didn't think it would be an issue? I don't know... Sorry that got so long!