Weight gain, specifically how much is too much, is a frequent topic during many prenatal appointments. I often hear patients, their mothers and/or partners using the phrase “eating for two” as a recommendation, excuse or sometimes even as encouragement to eat more while pregnant. However, the additional caloric requirements during pregnancy are not as much as one might think. Specifically, in the second and third trimester, caloric intake should increase by only 340 and 450 calories per day, respectively. Three hundred calories is not much: a large coffee with scone or muffin, a bowl of cereal and banana, a peanut butter sandwich and apple.

Healthy Weight Gain in Pregnancy

There are healthy limits to how much weight a woman should gain during pregnancy that depend on her weight prior to the pregnancy, as measured by her body mass index (BMI):

 Pre-pregnancy Weight Classification  Total Weight Gain During Pregnancy
 Underweight (BMI <18.5)  28–40 pounds
 Normal weight (BMI 18.5 to 24.9)  25–35 pounds
 Overweight (BMI 25.0 to 29.9)  15–25 pounds
 Obese (BMI ≥30.0)  11–20 pounds

*Weight gain recommendations differ for women expecting twins and triplets.

Exercise During Pregnancy

In the absence of any medical or obstetrical complications, expecting mothers should exercise at least 30 minutes on most, if not all, days of the week. Pregnant women should avoid exercises where they spend a majority of time lying on their back or are motionless, and recreational activities that have a high potential for falling and physical contact. All exercise should be preceded and followed with a 10 to 15-minute “warm-up” and “cool down” period. Stretching before and after any exercise is a great way to minimize sore muscles the following day.

For patients who did not exercise regularly before becoming pregnant, pregnancy is a great time to start a healthy habit! I encourage my patients to start by taking family walks around the neighborhood after dinner; it is a great way for them to spend time with their partners and children, and avoid the all-too-convenient couch after supper. As always, women should talk to their prenatal care provider before starting any exercise regimen.

Postpartum Weight Retention

Weight retention is commonly referred to as “baby weight;” it is the difference between a woman’s postpartum and pre-pregnancy weight. After delivery, a woman loses 10 to 13 pounds almost immediately because of delivery of the infant, placenta, amniotic fluid and blood loss. Unfortunately, most of this weight loss will not be noticed until one to two weeks after delivery, as there is temporary weight gain due to fluid retention.

At six weeks postpartum, less than 30% of all women have returned to their pre-pregnancy weight. A majority of patients will lose approximately half of their pregnancy weight during the first 12 weeks after delivery, and the remainder over the following six months to one year, although the weight loss typically occurs at a much slower rate. The average weight gain after pregnancy varies from one to 12 pounds, with the latter more characteristic of women who gained more than 35 pounds during their pregnancy. Net weight gain after pregnancy can vary significantly between individuals, given their ethnicity, pre-pregnancy weight, baseline activity levels and time before returning to work.

Losing the Baby Weight

Many women strongly desire to return to their pre-pregnancy weight after delivery. Setting and reaching this goal is also very important medically, as women who are overweight are at higher risk of developing diabetes and obesity, as well as gestational diabetes and hypertension with their subsequent pregnancies.

As always, weight loss is best achieved with a combination of healthy diet and exercise. Women should speak with their obstetrician or nurse midwife before re-initiating their exercise routines postpartum, as recommendations may differ depending on the type of delivery. For example, weight lifting restrictions are different for a woman who has had Cesarean section compared to a woman who has had a vaginal delivery. As a general rule, exercise routines and their intensities should increase gradually. If there were no complications during delivery, walking, light stretching and Kegel exercises can be initiated after discharge. Women who are breastfeeding should exercise after breastfeeding or pumping and wear a support bra, instead of a sport bra, to prevent breast compression.

Women’s Healthcare Associates wants you to have the healthiest pregnancy possible. Contact us to schedule your prenatal care.