The first assumption we have to make is that you are not an alien life form.....therefore you only gain weight if you take in more calories than you burn off.
Very simple....nothing mystical. The hormones of pregnancy will give you a very strong appetite and this was good 10,000 years ago. This is what got you got you out of the cave to chase down another rabbit or to fight the guys for the last piece of Zebra. But Mother Nature never intended you to walk 3 feet to find a refrigerator or to have a Taco Bell on every corner.
Soooooooo.....the hormones that were protective in the past can now get you into trouble today.
6 cups of steamed veggies have they same amount of calories as 2 slices of cheese pizza....but pizza sounds better.
Studies show that when a woman gains more than 40 lbs, the risk of bad things go up. Too much weight gain increases the chance of c-section, birth trauma to the mom, and the most important.....birth trauma to the baby. A 9 lbs baby is not healthier than a 7 pound baby.... it is just a more difficult delivery for mom and the baby. In fact the risk is so high that if the
baby is felt to be over 9 1/2 lbs......the doc is obligated to offer a c-section and this drops down to 8 1/2 lbs in the diabetic. There is SOMETIMES a genetic component and I have seen moms who did everything right but still had big babies......but they are a minority.
Most very large babies are related to mom gaining too much weight or undiagnosised diabetes. We put moms on diets all the time.
The idea that if you are hungry, then the baby is hungry..... is wishful thinking.
Sadly, the news about weight gain and pregnancy just got worse. Three articles were just published in The Journal of Obstetrics and Gynecology in October.
Study one: A review of 94,000 women looked at the weight gain during pregnancy. They found that 42% of woman gain more than the recommended 35 pounds during her pregnancy. The women who gain more than 35 pounds were compared with the 40% of the patient's who had the ideal weight gain of 25-34 pounds. The mothers who had a weight gain more than 35 pounds were more likely to have preeclampsia, large for gestational age infants, fetal distress, cephalopelvic disproportion, failed inductions and cesarean delivery.
Study two: A review of 120,000 women was done for woman who met the NIH guidelines for obesity. According to the NIH guidelines, obesity was defined as Class I (BMI 30-34.9), Class II (BMI 35-39.9), and Class III (BMI greater than 40). The optimum weight gain for Class I mothers was 10-25 pounds, for Class II mothers was the 0-9 pounds, and for Class III mothers it was a weight LOSS of 0-9 pounds. Mothers who gain more than this recommended weight had increased risk of preeclampsia, cesarean section, and large for gestational age infants.
Study three: A study of 298,000 pregnancies was reviewed. They looked at the risk factors of preeclampsia, deep venous thrombosis, shoulder dystocia, stillbirths, infant birth trauma, period or death and postpartum hemorrhage. They found that the best outcome for both mother and baby was when the average mother (BMI 20-29.4) gained between 5-22 pounds. For mothers with a BMI of 25-29.9 the ideal weight gain was less than 20 and for those with a BMI greater than 30 the ideal weight gain was less than 13 pounds. They also found that women who gained over the recommended guidelines had a 56% chance of being overweight when examined at 15 years later.
There is more data being presented that the traditional recommended weight gain may be too high and I would suspect that more patients are going to receive counseling from the physicians about weight issues. The original weight gain recommendations were from the Institute of Medicine in 1990 at a time when obesity was not a national epidemic where a 60% of the population is now overweight.
What to do with this information? You can get angry and argue with the results and tell stories of large women who had lots of weight gain and still had great and healthy pregnancies. Or you can take this information and use it as intended which is to give mothers information which they can use to have the healthiest pregnancy, lowest complications and healthiest baby.
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