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With Mayo Clinic certified nurse-midwife Mary Murry, R.N., C.N.M.

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February 28, 2008 3:07 p.m.

Pregnancy weight gain: Know the factors

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By Mary Murry, R.N., C.N.M.

I want to thank everyone for the response to this blog. It is wonderful that we can start a community and women can find support and information. If you have a specific question you may be able to find the answer on this site. I look forward to everyone's company on their pregnancy journey.

A prenatal visit can be a joyful experience. You get to hear the baby's heart beat. You are reassured about your baby's well-being and your own health. The visit is an opportunity to ask the questions that you forgot to ask the last visit as well as all the new ones you've thought of since then.

One specific part of the prenatal visit that is dreaded by many women is getting on the scale. Have you ever noticed that the scale at the office never weighs the same as the one at home? As we step on we wonder if the scale is going to tell on us about our dietary indiscretions.

Why do we care so much about pregnancy weight gain? The research on this subject is pretty clear. The incidence of pregnancy complications is higher in the upper and lower extremes of weight gain. Generally your health care provider will give you an idea of the amount of weight gain that is optimum for you and your baby.

So, what do you do the month you get on the scale and you find you gained 8 pounds? First, forgive yourself. Secondly, remember that the 8 pounds is history now. Look at the past weeks and see if you can pinpoint any major contributing factors to your pregnancy weight gain. Once you recognize possible causes you can find ways to deal with them.

If you find you are having real problems getting a handle on your pregnancy weight gain, see if there is a nutritionist or dietitian available for you to talk to about the problem. Enjoy your food. Your weight gain is one part of your pregnancy. Don't let the scale ruin your joy and enjoyment of this pregnancy.

There are women on the other side of the needle of the scale. You get on the scale thinking you'll have gained at least 3 pounds and instead you lost a pound or gained 1/2 a pound. My advice is the same. What can you learn from it looking back on your eating habits? Sometimes just changing to a healthier diet can cause a loss.

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8 comments posted

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June 24, 2008 2:47 a.m.

I am 19 weeks pregnant and have gained about 16 pounds so far. I actually ended up losing a couple of pounds during my first trimester but the story has been quite different since I hit the second trimester. Its just such a fine line that one has to toe - eating right, catering to your fickle taste buds and keeping a calorie count. I so dread fretting over losing all the excess weight after baby is finally here. I am just hoping the weight gain does not prolong my ppd. But the very thought of having to hold a healthy little baby in my arms is completely gratifying and worth all the discomfort and pains of pregnancy.

- Teena

May 19, 2008 8:13 a.m.

I am 16weeks pregnant with my third child. I have a 4 and 2 year old. This was a suprise pregnancy and i struggled with it at first. I had just spent the last few months killing myself to lose 10 pounds (working out 5 days a week for an hour each day and ate alot healthier). So needless to say the thought of gaining the weight again was upsetting, but I decided to try to be as healthy as possible this time around. I continued working out, but reduced it to 3 days a week for 40minutes. I felt alot better about myself. But, at my OB appointment the Nurse Practioner was all over me about the fact that i had not gained enough weight (even though I gained 5 pounds at that point and was 13 weeks) and was questioned about my eating and that I was overdoing it with the exercise. My last pregnancys I gained 40lbs, and 35lbs respectively and towards the end they questioned that I gained too much each week. So I have found myself feeiling guilty and eating more and doing less to try to gain more. But then I dont feel as good about myself. I just feel like I cant win. And so I've decided for myself that I am going to continue eating healthy and staying active.

- Kate

March 27, 2008 5:05 p.m.

Hi there. I am a (pregnant) registered dietitian who has done a lot of prenatal nutrition counseling and have seen weight gain run the gammut from very low to very high. Often times, unfortunately, patients were referred to me only when there was a problem with weight. I'm not saying every pregnant woman needs to see a dietitian, but it can certainly be helpful. At least looking at nutrition guidelines for pregnancy (this is a perfect web site for that) can be helpful. Diet and exercise is SO very important during pregnancy. I feel like exercise is underplayed a bit...I'm forgetting which book I read this in, (probably the outdated "What to Expect When Your Expecting" which I now cannot stand), it claims that you can "take it easy" if you want do during pregnancy and not exercise. I believe that to be a FALSE statement. I think this is a statement that has lead a lot of women to gain excess weight during their pregnancy, along with the "eating for two" mentality. On another note, despite what "recent studies" have claimed, breastfeeding IS a great way to help lose that pregnancy. From my own "studies" on women I've counseled, this is a TRUE statement. The body uses a lot of extra calories while breastfeeding...So if you keep your diet in check and exercise after the 6-week recovery time, the weight will come off and quickly, I might add.

- Hannah

March 26, 2008 11:35 a.m.

As a Personal Trainer who has found her way into specializing in prenatal and postpartum fitness, I have found that the weight gained with pregnancy really worries most of my clients. Like most women, most of my clients have had some sort of food issue and body dysmorphia (not seeing yourself as the size you truly are). As their pregnancies progress, I find I have to literally say to them "this is healthy weight gain". I focus on nutrition with my clients. If they are concentrating on getting enough veggies, fruits, protein, calcium, and iron, the calories follow. The worst thing that happened to one of my clients during her first pregnancy (before we worked together) was to have a nurse and a doctor make rude comments about how much weight she had gained. It wasn't horrible weight gain (40 lbs), but it just devasted her. The focus during your pregnancy should not be about the numbers on the scale, it should be about having as healthy a pregnancy as possible. As long as your doctor says you're ok, exercise all the way through. It will make you feel better. Work with someone who is familiar with the recommendations for exercise during and after pregnancy. Eat as healthy as you can. That doesn't mean you can't have a cookie, but don't let people shove food at you and don't allow yourself to eat mindlessly. Track your food intake. The same client I mentioned just gave birth last Wed. We worked out last Mon. She had a much better 2nd pregnancy. You can do it too!

- Amy in Indy

March 24, 2008 1:30 p.m.

Pregnancy is a beautiful thing, and weight gain can very from person to person. I am in my 35th week, and I have gained 35 pounds so far. This is the same amount I gained in my first pregnancy, and I was able to get back to my "normal" size (120 pounds) with exercise and diet. With this said, please don't judge a woman by the weight she gains during pregnancy, it can be very hurtful, and gaining a higher amount does not mean a woman will be overweight post pregnancy.

- Charlotte

March 4, 2008 10:54 a.m.

Thank you Stephen for your comments. Prior to writing this particular entry I look at the current standards. The current standard is from the Institute of Medicine. The Institute will be looking at the standards for weight gain in pregnancy this year and I imagine there will be changes. I did not give any specific recommendations for weight gain because it can vary from woman to woman. Pregnant women should discuss weight gain expectations with her health care provider. As Pauls put it so well, a healthy diet is the most important factor when considering weight gain in pregnancy.

- Mary Murry, MayoClinic.com

March 4, 2008 8:16 a.m.

Thank you, Stephen!!! I agree that there should be a HEALTHY diet. Not a lettuce diet with no dairy, protien, or carbs and not a diet of 12 oz steaks and baked potatoes loaded with sour cream and butter. I am, as it is, over weight pre preagnancy and am terrified to gain even the reccommended 25 pounds. Some of my girlfriends have trouble losing the 30 and 40 pounds that they have gained, and some them have gained an enormous 80 pounds! That is obsurd!

- Paula - NNY

February 29, 2008 11:46 p.m.

The studies about "low" (by United States standards) pregnancy weight gain contributing to complications are outdated and discredited. I'd expect more from the Mayo Clinic than this dusty conventional wisdom. Current recommendations are way too high and contribute to the almost inevitable gain in weight that we see here in women after they have children. Japan is an example where weight gain is very low and there are few complications and little post pregnancy weight gain.

- Stephen