Weight Gains

A healthy pregnancy is worth the weight, but bigger isn't better.


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.

You shouldn't go hog wild, of course. The best way to ensure that you and your baby enjoy a problem-free pregnancy is to keep your total weight gain—determined by your weight when you conceived—within the guidelines set by the National Academy of Sciences

. The American College of Obstetricians and Gynecologists (ACOG) advises that you put on pounds gradually—beginning in the second trimester. There are real dangers, however, in gaining too little.

When Thin Isn't In

"Women who are thin at the time they get pregnant and gain too little weight are more likely to deliver babies who are premature or small," says Robert L. Goldenberg, M.D., professor of obstetrics and gynecology at the University of Alabama. "The thinner you are, the greater your risk."

"Low prepregnancy weight and inadequate weight gain during pregnancy are dominant contributors to intrauterine growth retardation and low birth weight," reads an ACOG bulletin. However, a woman who starts out underweight, then gains the recommended amount of weight improves the likelihood that she will have a full-term baby.

The Risks of Gaining Too Much

Women who are of normal weight when they conceive but who go on to gain too much may confront another set of problems: gestational diabetes, high blood pressure and even preeclampsia (a dangerous condition characterized by high blood pressure, fluid retention and loss of protein through urine), according to Scott D. Hayworth, M.D., president of the Westchester Obstetrical and Gynecological Society in New York.

The more excessive weight you gain while pregnant, the bigger your infant may be. "Larger babies are more difficult to deliver naturally, increasing the chances of a cesarean," says Richard H. Schwarz, M.D., an obstetric consultant to the national March of Dimes.

Among the more common difficulties extra pounds create are back strain and pain, and a harder struggle shedding the weight postpartum.

Women who are heavy to begin with not only face these serious complications, but also increase the risks to their babies. The Journal of the American Medical Association reported in April 1996 that women weighing more than 175 pounds when they conceived were twice as likely to deliver infants with neural tube defects. Although the study did not contain data on height, the average height for American women is 5 feet 4 inches and the range of weight considered normal is 116 to 152 pounds.

Making Healthy Gains

If you are of normal weight, you don't have to eat more than usual during the first 12 weeks; your fetus's nutritional needs are minimal. After that, spread your weight gain out over your second and third trimesters. While it will fluctuate from week to week, on average you should gain about a pound per week, depending on your starting weight. Adding 300 extra calories a day after the first 12 weeks will do the trick.

If you are starting out on the heavier side, avoid dieting the first trimester and focus on a well-balanced diet. When the second trimester rolls around, aim for the gradual weight gain recommended by the National Academy of Sciences. As was true in your nonpregnant state, a good way to control your weight is by exercising moderately three to five times a week, doing an activity you enjoy.