Trying to get pregnant? Make sure you know the bottom line on baby-making—what you don't understand can affect your bub-to-be's health.
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Three decades ago, maternal-fetal medicine specialist Yvonne Thornton, M.D., was determinedly shedding the 67 pounds she gained during her first pregnancy when she found out she was expecting another baby. Thornton vowed not to let that derail her healthy eating habits again. “There was a strong dictum back then that no matter what you weighed, you should gain 26 to 35 pounds during pregnancy or risk fetal death,” says Thornton, now an OB-GYN professor at New York Medical College.
Nearly 30 percent of American women today are obese when they begin their pregnancies. This means they have a body mass index (BMI) of 30 or higher, as would a 5-foot-4-inch woman who weighs 175 pounds. Now, how much weight these women should gain while pregnant is being debated.
Gestational diabetes mellitus (GDM), or high blood sugar during pregnancy, used to be relatively rare, occurring in about 3 percent to 4 percent of pregnancies. But in recent years, the rate has doubled— now, up to 6 percent to 8 percent of moms-to-be are diagnosed with this prenatal complication. And new recommendations lowering the cutoff point for diagnosis may lead to an even more dramatic increase.
From traditional meals with family to laid-back gatherings with friends, this time of year is a minefield of social activities centered around food and drink. “Most people hang up their diet hat during the holidays because they feel they can get back on the program later,” says Elisa Zied, M.S., R.D., an American Dietetic Association spokeswoman and author of Nutrition at Your Fingertips. But when you’re pregnant, you don’t have the luxury of giving up a healthy eating plan—even for a few weeks.
How much weight to gain during pregnancy is a tricky issue. Guidelines exist, but health experts are reviewing them because so many women of child-bearing age are now overweight.
If you want your baby to develop healthy eating patterns, don’t load up on cheeseburgers and milkshakes while you’re pregnant. Research on rats found that a high-fat prenatal diet produces permanent changes in the offspring’s brain that ultimately lead to overeating and obesity. Study author Sarah F. Leibowitz, Ph.D., says that triglycerides, unhealthy fats that are elevated in the blood after high-fat meals, stimulate brain chemicals that cause us to eat more. In her study, she fed pregnant rats a high-fat diet, then replaced it with a normal diet just before they gave birth.
In increasing number of American women who want to get pregnant soon might want to reconsider their timing: They’re overweight. A study that looked at 53,000 pregnant women’s weight at their first prenatal visit found that the average had increased by 20 percent from 1980 to 1999. That’s bad news for them and their babies.
Erika Stehl stood in front of her full-length mirror, fighting back tears. Barely nine weeks pregnant, her favorite jeans were already way too snug. “After a lifetime of trying to stay slim, I’m in a panic just thinking about piling on 25 to 35 pounds—or maybe even much more,” says Stehl, a freelance social worker in Port Washington, N.Y.
From the outset, I had no trouble accepting two immutable laws of nature: 1) Pregnant women get big. 2) Over time, they get bigger. In fact, I greatly enjoyed this process, as evidenced by my avid waddling. I waddled before I was even showing — maybe as early as conception. I waddled excessively in my second trimester. I went whole hog in my third.
At first, I was one of those “you-can’t-even-tell-you’re-pregnant-from-the-back” people. (As if pregnancy ought to be a period of clever camouflage: “You’re six months? You look three at the most!”)
If you’ve worked long and hard to be fit and trim, you may not take kindly to the idea of pregnancy’s portliness. While you might envy a friend who slipped back into her old jeans a week after delivery, gaining weight is now part of the program.
Kelly O’Dea Landes, 35, a clinical social worker from Marion, Mass., struggled with eating disorders in her early 20s but, at 5 feet 1 inch, had leveled out at 98 pounds when she got pregnant at age 33. “I was running about 30 miles a week, and my obstetrician, who was conservative, told me to stop exercising, cold turkey,” she says. “He also told me to expect to gain more weight than the average woman because I was underweight. I thought, OK, so he’s telling me I’m going to be short and fat.”
If you’re confused about pregnancy weight gain, it’s no wonder: In one recent study, 49 percent of doctors gave their pregnant patients the wrong advice, and 27 percent gave no advice at all. And up to half of normal-weight women, and nearly two-thirds of overweight ones, gain too much during pregnancy. What’s more, it’s no longer enough to worry about how much to gain: When you put on “baby fat” affects how much you’ll hang onto afterward.