How much weight should I gain during pregnancy?

Congratulations on your pregnancy! We at Diana Health are here to support you throughout your pregnancy journey. Our mission is to optimize your health and the health of your developing baby.

Weight gain is an important yet sensitive topic to address during pregnancy and also because your health and your baby’s health are impacted by weight gain, it is important to discuss. About half of all reproductive age women are obese and another quarter are overweight (verify/cite). This means that more pregnant women are overweight or obese than are normal weight. We support body positivity and want no shame, blame, nor guilt around weight.

What is my BMI?

At your first prenatal visit, you will be weighed and your height was checked so that we can calculate your body mass index. Although BMI has its limitations, we need to start with BMI in order to know the optimal weight gain range for you during your pregnancy. You can also use the CDC’s BMI calculator to calculate your BMI.

• Normal BMI : 18.5-24.9
• Overweight: BMI 25-29.9
• Obese: BMI 30 or above

Why should I try to gain the recommended amount of weight during pregnancy?

Forty-six percent of all pregnant women who are obese gain more weight than is recommended by the Institute of Medicine guidelines. Avoiding excessive weight gain during pregnancy increases the chances of you having a healthy pregnancy and healthy baby. It is important for your health and the health of your child. According to ACOG, “the amount of weight gained during pregnancy can affect the immediate and future health of a woman and her infant.”

• Normal weight: recommend 25-35 pound weight gain for a starting BMI of 18.5-24.9
• Overweight: recommend 15-25 pound weight gain for a starting BMI of 25-29.9.
• Obese women: recommend 11-20 pound weight gain for a starting BMI of 30 or above

Extra weight gain is a significant risk factor for short-term postpartum weight retention as well as having a long-term higher weight. Gaining more than is recommended also results in a greater risk of having a cesarean delivery. For more information about weight gain during pregnancy visit this website.

Gaining less than the recommended amount of weight during pregnancy has risks too such as a premature delivery of your baby and having a baby that has a low birthweight. See the March of Dimes website for more information. Gaining less than these amounts may be safe if your baby is growing appropriately. Discuss this with your CNM/OB.

Gaining the recommended amount (not too much) increases your chances of returning to your prepregnancy weight quicker and also increases the likelihood that you will have a vaginal delivery. Also, if your weight gain during pregnancy is in the recommended range (not too little), you have an increased likelihood of having a full-term baby that has a normal birthweight.

Some women struggle with gaining weight during pregnancy, especially if they’ve struggled with eating disorders in the past. It is important to gain the recommended amount of weight during pregnancy to increase the likelihood of having a healthy baby and supporting your health postpartum. If you are struggling mentally or physically with gaining the recommended amount of weight during pregnancy, reach out to us at Diana Health so that our CNMs or Ob-Gyns can support you. If you are not a Diana Health patient, reach out to your own CNM or Ob-Gyn, or establish care with one, to discuss this with them soon. We are here to help you.

Do you have any suggestions for how I can gain the recommended amount of weight for my BMI during pregnancy?

Remember this is not about a diet nor a quick fix. We want you to have a healthy lifestyle for the rest of your life.

1. High Quality Foods: it’s not a diet but healthy eating for a lifespan, as the Dietary Guidelines for Americans states: “Make Every Bite Count”. Try to fill your plate (and your day) with high quality foods.
2. Move more: Most women can safely exercise during pregnancy but check with your practitioner to confirm it’s safe for you. You can start low and go slow, especially if you don’t currently exercise. Even a few minutes at a time is a great place to start. Eventually 150 minutes per week (30 minutes daily on most or all days of the week) is recommended for women with a healthy pregnancy.
3. Increase activity: Being sedentary has additional health risks. Can you park further away at the store, take the stairs instead of the elevator, or stand and stretch during commercials. Find ways to incorporate movement into your daily routine.
4. Plan on Breastfeeding Postpartum: Breastfeeding is best for baby x 1st year of life and may help with postpartum weight loss. If you breastfeed for at least a few months, research shows that postpartum weight loss is more rapid than for non-breastfeeding women.
5. Food log: keeping a food diary is useful in that it helps you be more aware of the amount and types of foods that you are consuming. You can use this to look for patterns (such as late night overconsumption of cookies) or share with a registered dietitian to help you with food recommendations.
6. Tracking and technology: can you use your pedometer, apple watch or fit bit to track your steps? Is there a phone app that would help you track your food intake and help you better understand the calories that you consume daily? Technology and tracking devices can support healthy behavior changes.
7. Water: sometimes thirst can be misinterpreted as hunger. Bring your water bottle with you wherever you go.
8. Substitutions: can you substitute a healthier food choice for a less healthy choice? Instead of fries, try carrots. Instead of cake for dessert, try a bowl of fruit. Instead of a doughnut, try a piece of whole grain toast.
9. Whole foods: eat mostly whole foods, fruits, vegetables, whole grains, nuts, and seeds. Eat less ultra processed foods such cookies and crackers, doughnuts and candy and less soda. Limit added sugars, solid fats, and fried foods.
10. Produce: aim to eat at least 5 portions of vegetables and fruits daily. The additional fiber can also help you with constipation and hemorrhoids that are common during pregnancy.
11. Make the healthy choice the easy choice: precut vegetables and have them handy, bring your lunch to work, stock your pantry with healthy foods.
12. Be Gentle: be gentle with yourself. It’s not all or nothing. Behavior change is hard. Remember, it’s a lifestyle and not a diet.
13. Prioritize sleep: adequate sleep supports healthy eating habits. When you are sleep deprived it is more challenging to make healthy nutrition decisions.
14. Surveillance: we recommend that you attend each prenatal visit with your CNM/OB and discuss all tests that they recommend so that you can make an educated decision. Being overweight or obese during pregnancy comes with additional risks but your practitioners know how to watch for warning signs. This is why it’s extra important to communicate closely with them.
15. Have fun: experiment with new spices, take a cooking class, involve your entire family in the kitchen, do a recipe challenge with friends. Cooking at home is associated with healthier eating compared to eating at restaurants, in general.

Diana Health and Other Health Professionals

We at Diana health want to support you throughout your pregnancy journey and that includes helping you gain a healthy amount of weight. We have Diana health resources such as courses, groups, dietitians, wellness coaches, and your CNM or OB. The American College of Obstetrics and Gynecology (ACOG) recommends nutritional counseling for all pregnant women who are above the normal BMI range and we want to support you with getting this. Also we have women’s health wellness coaches on our team helps you with behavior changes to optimize your health and weight

Remember that we’re here for you! If you aren’t a Diana Health patient and would like to be, schedule an appointment here. If you don’t see us for your healthcare, reach out to a healthcare provider in your area to support your wellbeing throughout your pregnancy journey.