Women who gain either too little or too much weight during pregnancy are at increased risk for preterm delivery, regardless of their weight before pregnancy. Overweight moms are at greater risk, too, for pregnancy complications, including gestational diabetes, high blood pressure and preeclampsia. They're also more likely to give birth to larger babies, go through more complicated labors, and have C-sections, and are more prone to surgical complications when having them.
Current guidelines call for women of normal weight to gain 25 to 35 pounds, underweight women up to 40 pounds, and overweight women 15 to 25 pounds. But in light of the obesity epidemic, some experts are questioning the latter recommendation. "Research is showing that most women gain too much weight during pregnancy," says Raul Artal, M.D., chairman of the department of obstetrics, gynecology and women's health at Saint Louis University. "If you're overweight or obese [to start], be careful not to gain too much weight, if any." Ask your doctor what's right for you.
Pregnancy is not the time to diet, either, so don't stop eating or start skipping meals as your weight increases. "Restricting calories and other nutrients can lead to stunted growth and slow development of your baby, and a host of problems whenhe is born," says Heather Blazier, R.D., L.D., a clinical dietitian at the Medical College of Georgia in Augusta. But do cut out empty junk-food calories.
4. Surround yourself with support
Practical and emotional support can be crucial in helping you stay healthy and avoid prenatal anxiety and depression, both common but underreported problems. Your circle could include your partner, family members, friends and co-workers, a childbirth instructor and fellow students, a La Leche League leader, your doctor or midwife, and the doula you hire to help you through labor, delivery and afterward.
Continuous support during labor has been shown to lower a mother's need for pain medication and her risk for interventions, including C-sections, and to lead to a more satisfying delivery. "It's important to have a sympathetic caregiver, but also to seek the support of friends or childbirth groups as a way of lowering stress, preventing isolation and dealing with depression during and after pregnancy," says U.S. Surgeon General Richard Carmona, M.D., M.P.H., F.A.C.S.