It is important to achieve and maintain a healthy weight before during and after pregnancy by eating healthy and being physically active and gradually losing weight after pregnancy.
A healthy pregnancy depends on
- The mother’s pre-pregnancy weight
- The amount of weight gained during pregnancy
The Institute of Medicine (IOM) recommends healthy weight gain during pregnancy depending on the pre-pregnancy BMI. BMI(Body mass index) is the measure of one’s weight in relation to their height. It is calculated by a formula Weight in kg/(Height in meters)2 We generally recommend half to 2 kg weight gain in the first trimester. You should generally gain about 0.2 to 0.5 kg /week in the second and third trimester depending on the BMI.
| Pre pregnancy weight category | Body Mass Index(BMI) | Recommended weight gain(kg) |
| Underweight | Less than 18.5 | 12.5 to 18 |
| Normal Weight | 18.5 to 24.9 | 11 to 15.5 |
| Overweight | 25 to 29.9 | 6.5 to 11 |
| Obese | 30 or more | 5 to 9 |
For twin pregnancy, the IOM recommends a weight gain of 16.8–24.5 kg (37–54 lb) for women of normal weight, 14.1–22.7 kg (31–50 lb) for overweight women, and 11.3–19.1 kg (25–42 lb) for obese women.
Being obese pre-pregnancy could increase the risks of diabetes, having high blood pressure during pregnancy, and the tendency of thrombosis (forming blood clots in legs) which could travel to the lungs.
It could also increase the risk of neural tube defects(problems information of the baby’s brain and spinal cord), risk of miscarriage, and a higher possibility of the child having obesity and diabetes in their later life. However, the ideal time for an obese woman to lose weight is before pregnancy.
Weight loss is not advisable in pregnancy as the growing fetus may be harmed but they should keep the weight gain within the recommended limits.
- Gaining too much weight could increase the possibility of a big size baby, a difficult labor, or an emergency cesarean section.
- Gaining less weight during pregnancy could lead to premature delivery or a low birth weight baby and increase the chances of a cesarean section.
The right nutrition and diet modification is the key factor determining the weight gain during pregnancy.”Eat-for-two” is actually a myth, as the mother’s energy needs do not change in the first 6 months of pregnancy and increase only slightly in the last 3 months (and then only by around 200 calories per day).
The NICE guidelines recommend that Women will be more likely to achieve and maintain a healthy weight before, during, and after pregnancy if they[1]:
- Base meals on starchy foods such as potatoes, bread, rice, and pasta, choosing wholegrain where possible
- Eat fiber-rich foods such as oats, beans, peas, lentils, grains, seeds, fruit, and vegetables, as well as wholegrain bread and brown rice and pasta
- Eat at least five portions of a variety of fruit and vegetables each day, in place of foods higher in fat and calories
- Eat a low-fat diet and avoid increasing their fat and/or calorie intake
- Eat as little as possible of fried food; drinks and confectionery high in added sugars (such as cakes, pastries, and fizzy drinks); and other food high in fat and sugar (such as some take-away and fast foods)
- Eat breakfast
- Watch the portion size of meals and snacks, and how often they are eating
- Make activities such as walking, cycling, swimming, aerobics, and gardening part of everyday life and build activity into daily life – for example, by taking the stairs instead of the lift or taking a walk at lunchtime
- Minimize sedentary activities, such as sitting for long periods watching television, at a computer or playing video games
- Walk, cycle, or use another mode of transport involving physical activity.
NICE recommends that moderate-intensity physical activity does not harm the mother or the unborn child. At least 30 minutes per day of moderate-intensity activity is recommended.
- Recreational exercise such as swimming or brisk walking and strength conditioning exercise is safe and beneficial
- The aim of the recreational exercise is to stay fit, rather than to reach peak fitness
- If women have not exercised routinely they should begin with no more than 15 minutes of continuous exercise, three times per week, increasing gradually to daily 30-minute sessions[7]
- If women exercised regularly before pregnancy, they should be able to continue with no adverse effects.
Women who would find this level of physical activity difficult that it is important not to be sedentary, as far as possible. After delivery, the mother should lose weight safely and gradually.
- If pregnancy and delivery are uncomplicated, a mild exercise program consisting of walking, pelvic floor exercises, and stretching may begin immediately. But women should not resume high-impact activity too soon after giving birth.
- After complicated deliveries or caesareans, you should consult your doctor before resuming exercise.
Obese women with BMI > 30 after childbirth should diligently work towards losing weight and could see a dietician or a weight management specialist for the same. It’s always a good idea for women with babies and children to take part in a range of physical or recreational activities like swimming, organized walks, cycling, or dancing.
This not only helps them lose the pregnancy pounds but also helps in bonding with the baby and as a mood elevator. A healthy diet and regular, moderate-intensity physical activity and gradual weight loss will not adversely affect the ability to breastfeed or the quantity or quality of breast milk. In fact, besides all its benefits, breastfeeding helps in post-pregnancy weight loss naturally.
