Pregnancy weight gain: How much is too much or too little?

Your unborn baby’s body grows from the nutrients it receives from you. So undoubtedly you will gain extra weight to support your baby. How much will you need to gain depends on your pre-pregnancy weight and your body mass index (BMI).

Your body mass index

Measuring BMI is a relatively new approach to understanding weight and its connection to your overall health. BMI is a measure of your body fat based on your height and weight. This is such an important health factor that the America College of Obstetricians and Gynecologists (ACOD) recommends that a BMI be recorded for all women at their first prenatal visit. A woman entering pregnancy at an unhealthy weight or high BMI increases the risk of a number of disorders during pregnancy, including hypertension and diabetes. Your doctor will need to be aware of these risk factors so that she can try to prevent the onset of the disorder or be prepared to manage it should you start to experience symptoms.

This is a subject that should touch a nerve with a good number of us since over half of all black women, 56 percent, have high BMIs, placing them in the obese category. If you have three friends, chances are that two of you are obese. This book exists to celebrate and inform the pregnant black woman. We wouldn’t be sincere if we said we weren’t worried about that statistic.

BMI	CATEGORY
< (less than) 18.5	Underweight
18.5-24.9	Normal Weight
25-29.9	Overweight
30-34.9	Obese Class I
35-39.9	Obese Class II
40 and above	Obese Class II

 

Read more: Is my belly too big? Too small? Why size doesn’t matter

So what’s the plan for the pregnant woman who has a high BMI? In view of associated risks, ACOG recommends the following:

• Overweight women (BMI of 25 to 29.9) are advised to gain no more than 15 to 25 pounds during pregnancy.
• Obese woman (BMI of 30 and higher) should gain 11 to 20 pounds during pregnancy.
• Obese women should be offered and should consider nutrition consultation and are encouraged to follow an exercise program.
• All women should be screened for gestational diabetes at the initial prenatal visit with repeated screening later in the pregnancy if the results are negative.
• Women with a BMI of 35 or greater who have pre-existing medical conditions, such as hypertension or diabetes, may benefit from a cardiac evaluation.

 

Gaining weight

The American College of Obstetrics and Gynecologists recommends that women who begin pregnancy at a healthy weight (not underweight and not overweight) gain 25 to 35 pounds during the entire pregnancy. This weight gain should be spread across the entire three trimesters; about 5 pounds in the first trimester and about 1 pound every week for the rest of the pregnancy. That may sound like a lot of weight, but even the most disciplined woman can fall into the thinking of “well, I’m eating for two so I can have another slice . . .” and before you know it, 25 pounds turns into 45 pounds easily.

It is sometimes recommended that the underweight woman gain more weight during pregnancy. The exact amount of weight gain for an underweight woman is based upon her individual needs. If you are either underweight, overweight or obese, your health-care practitioner will more than likely put you on an individualized weight-control plan.

An excerpt from Allen-Campbell, Yvette and Greenidge-Hewitt, Suzanne MD: Black, Pregnant & Loving It. Salem, Massachusetts: Page Street Publishers, 2016