Eating for Two?

I loved being pregnant. I felt like I had a wonderful and mysterious secret in those first months – I was a sacred vessel. I stopped smoking (32 years and counting!), drinking, and was very careful about what I ate. I read everything I could find about pregnancy. And along with being careful about what I ate – I set myself to gain some weight!

Do you see pregnancy as an eating assignment?

In the latest analysis by the Centers for Disease Control (CDC) 53% of moms who got pregnant were over ideal weight when they got pregnant. (By the way, if you are worrying about your BMI and you are eight months pregnant – don’t. Go back to your prepregnancy weight to figure out your BMI.) That’s the highest number ever.

Only 30% of moms gained the right amount of weight for them during pregnancy. 48% gained more than the ideal.

So – first of all, what is the right amount to gain? Here’s the info from the Institute of Medicine’s 2009 report, which looked at many research studies before making these recommendations. Read full report.

Pre-pregnancy weight Recommended weight gain
Underweight (BMI less than 18.5) 28 to 40 pounds
Normal weight (BMI 18.5 to 24.9) 25 to 35 pounds
Overweight (BMI 25 to 29.9) 15 to 25 pounds
Obese (BMI 30 or more) 11 to 20 pounds


Over the years, weight gain recommendations have been all over the place. My mom, for instance, used to fast before her appointments. Her doctor told her not to gain more than 15 pounds. Why? Well, the theory was that there were very low rates of toxemia (what we now call preeclampsia) in Dutch women during the “Hongerwinter” in World War II when the Dutch were basically being starved out by the Nazis.

Although this wasn’t based on research – just a theory, really – preeclampsia is so scary, and so dangerous for moms and babies, that American medicine gave the “let’s just starve her” theory a try.

Well, that didn’t work too well. Cornell University did a good deal of research in the early 1980’s. What weight gain would result in a healthy baby? Their work suggested a gain of 25-40 pounds, with women who were underweight at the top end of the recommendations.

Where does the weight go?

  • Baby: 7 to 8 pounds
  • Larger breasts: 2 pounds
  • Larger uterus: 2 pounds
  • Placenta: 1 1/2 pounds
  • Amniotic fluid: 2 pounds
  • Increased blood volume: 3 to 4 pounds
  • Increased fluid volume: 3 to 4 pounds
  • Fat stores: 6 to 8 pounds

Overnight, most women lose about thirteen pounds. By the end of the week, most moms have sweated and urinated off another seven pounds – mostly the increased blood and fluid volume. That’s a total of twenty pounds in one week!

We’ll end with that good news. Next week we’ll take a look at why weight gain during pregnancy matters – for moms and babies.

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