You can often hear that a pregnant woman needs to eat for two. From a medical point of view, this statement has nothing to do with the truth. Eating for two means quickly gaining body weight. And while carrying a baby, extra pounds are an additional burden on the mother's body and high risks of complications. What should be the normal weight gain in different periods of pregnancy, we will tell you in this material.
Why does weight gain during pregnancy?
Weight during pregnancy is a rather individual criterion. In some women, it may decrease in the first and third trimesters, if, for example, severe toxicosis is observed. For others, the weight is constantly growing. Initially, the weight of the expectant mother depends on her physique and body weight before pregnancy.
In women who are obese, the total weight gain during pregnancy can be half as much as the total weight gain in lean slender girls.
Weight to one degree or another during the period of bearing a child is constantly growing. However, the body weight of newborn boys and girls is on average the same - from 3000 to 4000 grams. It depends little on how many women have gained during pregnancy. - 5 or 15 kilograms. Different increases are an individual trait of expectant mothers.
The growth in body weight consists of several components:
- Kid. His weight is about a third of all my mother's gain. Usually babies are born with a weight of 2500 to 4000 grams.
- Placenta. On average, about 5% of the total weight of a pregnant woman is assigned to a "child's place". The placenta usually weighs about half a kilogram - from 400 to 600 grams.
- Amniotic fluid. The waters in which the baby swims reach a weight of one and a half kilograms by the third trimester. True, closer to childbirth, their number decreases, as well as weight. The mass of amniotic fluid is about ten percent of the total increase.
- Uterus. The main reproductive organ of a woman is constantly growing so that the baby can fit in it until the very birth. By the end of the gestation period, the weight of the uterus reaches a whole kilogram, and this is approximately 10% of the total increase.
- Chest. The female breast begins to undergo changes from the very first weeks of pregnancy, and by the time of delivery, it most often increases significantly due to the overgrown glandular tissue. It is easier for women to imagine these changes in volume.
But we are talking about mass, and therefore it is worth taking into account that the weight of the grown breast is on average about 600 grams, this is about 2-3% of the total weight gain of the expectant mother.
- Blood volume. In the body of a pregnant woman, the volume of freely circulating blood is increased by about 2 times compared with non-pregnant women. On average, the mass of blood that the heart of an expectant mother pumps is about one and a half kilograms.
- Cellular and intercellular fluids. Their mass in the body of a mother-to-be can approach 2 kilograms. And together with the volume of blood, which we talked about above, fluids account for about a quarter of all weight gain.
- Fat reserves. The body of a pregnant woman begins to take care in advance to store fat as a source of energy for the upcoming childbirth and the postpartum period. Fat in the body of the expectant mother is deposited about 3-4 kilograms, which is about 30% of the total weight gain.
Body weight changes
The dynamics of the growth of the body weight of a pregnant woman is not the same at different times:
- During the first half of the gestation period, a woman, on average, gains about 40% of the total increase.
- During the second half of pregnancy, the increase is about 60% of the total number of kilograms acquired during the entire period of bearing a child.
In the early stages, the hormone progesterone is responsible for the accumulation of fat. It launches a mass of processes in the body of the expectant mother aimed at preserving and further developing the embryo. The creation of a fat "reserve" is also one of the mechanisms for the preservation and welfare of the fetus.
In the second trimester, the placenta begins to actively grow and develop, the amount of circulating blood increases, which invariably leads to an increase in body weight. Even if in the first trimester there was weight loss due to toxicosis and lack of appetite, in the middle of pregnancy, when the nausea subsides, a woman will be able to gain everything that was not recruited earlier.
In the third trimester, the amount of amniotic fluid begins to decrease, but the weight continues to come due to the fact that the child is actively gaining in its own mass. Only in the last two to three weeks does the weight begin to decrease somewhat, since the child has already gained his weight, and the amount of amniotic fluid has reached its minimum. In addition, the body of a pregnant woman begins to physiologically prepare for childbirth, at the natural level, getting rid of all that is superfluous that can interfere with him during childbirth.
Increase rates - how to calculate?
Normal weight gain depends on how much weight the woman had before pregnancy. For a woman with her own normal weight, an increase of 10 to 15 kilograms is considered correct for the entire period of gestation. If a woman's own weight is slightly exceeded, her normal weight gain can be considered a weight not exceeding 11 kilograms. In obese women, the weight should increase by no more than 7-8 kilograms in nine months.
The doctor will help to correctly calculate the individual increase, who will take into account all the factors affecting the weight of this expectant mother - her complexion, the presence of multiple pregnancies, etc.
On average, in the first trimester, an increase of 200 grams per week is considered the norm. Until 12 weeks, the woman's weight should increase by a maximum of 3-4 kilograms. In the second trimester, when both appetite improves and toxicosis, if any, recedes, the increase is more intense - up to 400 grams per week. At the very end of pregnancy, the increase is usually no more than 100-150 grams per week.
During the first visit to the obstetrician-gynecologist, when a woman applies for registration, her height and weight will be measured.
If the expectant mother knows her parameters before pregnancy, it is imperative to inform the doctor about them.
Based on these two values, the doctor will calculate the BMI (body mass index), which will allow you to judge the correct or excessive weight gain during the entire pregnancy. Body mass index is weight divided by height squared.
For example, a woman weighs 55 kilograms, and her height is 1 meter 60 centimeters. The calculations will look like this: 55 / (1.6 ^ 2). It turns out that this woman's BMI is about 21.5. This corresponds to normal weight, and an increase of 10-13 kilograms in this case will not be considered pathological.
Depending on how the BMI turns out, the woman will be set the maximum allowable limit for the increase:
- BMI below 18.5 - underweight, in such a woman, weight gain during pregnancy can reach up to 18 kilograms, and this will be quite normal;
- BMI from 18.5 to 25 - normal weight, gain can be from 10 to 15 kilograms;
- BMI from 25 to 30 - overweight, the gain should not exceed 9-10 kilograms;
- A BMI of 30 and above is obesity, and weight gain above 7 kilograms for the entire period of gestation will be considered a pathology.
If a woman is carrying not one baby, but twins or triplets, then the rates of addition will be completely different in comparison with a singleton pregnancy.
Rates of increase for the entire period - table:
When calculating the individual rate, different antenatal clinics use different rates of the ratio of real weight to body mass index. We have considered the most popular rating system above. However, in some consultations, doctors use a different system, the international one, according to which a BMI below 19.8 is considered normal weight, above 19.8 to 26 is overweight, and above 26 is obese.
The body mass index itself is calculated in the same way as indicated above. Based on the results obtained, you can calculate the individual gain by week and month. Depending on which system was used to calculate the BMI, the rates of increase may look like this.
Weekly gain table for different BMI calculations:
According to this table, a woman with any body mass index, no matter how it is calculated, will be easy enough to understand how much she should gain in weight by weeks and months.
However, these values are only basic, averaged, showing the rate of weight gain with different body mass index of the expectant mother before pregnancy.
The expectant mother, regardless of the rate of weight gain, may be disturbed by signs of toxicosis, indigestion, allergies. In such situations, as well as in the complex of ARVI treatment, enterosorbents can be prescribed to women, but not every drug is safe for pregnant women. Smecta is a well-known clay-based sorbent that has not been recommended for use in pregnant women since March 2019 (when the ANSM regulator, France, published information on the detection of dangerous lead in the raw material for Smecta). According to ANSM, lead from Smecta can enter the bloodstream and cause harm to the child, in particular to the brain. The Russian Society of Obstetricians and Gynecologists, based on ANSM data, does not recommend Smecta therapy in pregnant women, lactating women and infants under two years of age. Enterosgel was selected as the first choice among ROAG enterosorbents. The advantages of this tool: safety (does not enter the bloodstream); the effectiveness of the gel form (in contrast to the finely dispersed, gel sorbent Enterosgel has a beneficial effect on the state of the gastrointestinal epithelium, helps to normalize the beneficial intestinal microflora; reducing the risk of constipation when used in pregnant women due to the high content of water molecules in the formula.
The rate of weight gain in each case is individual, and only careful observation of its dynamics allows the doctor to judge whether everything is in order with the expectant mother and her baby, whether there are any pathologies of pregnancy.
How to exercise control?
The dynamics of changes in the body weight of the expectant mother is monitored at each planned visit to the doctor in the antenatal clinic. And here expectant mothers have a lot of questions related to the fact that weighing in the office shows not the same numbers as home scales.
Women should take into account that at home they are weighed in a minimum amount of clothing, while at the consultation they are dressed and shod, so an experienced doctor will always make adjustments for the outfit of a pregnant woman.
In addition, weighing, with all the apparent ease of this procedure, requires proper preparation, otherwise the scales in the antenatal clinic will show a weight that exceeds the real one, and, moreover, it is quite significant. Before weighing yourself at home or going to an appointment with an obstetrician-gynecologist, a woman must remember the rules of correct weighing:
- it is best to weigh yourself in the morning;
- when weighing at home, measurements should be taken on the same day every week, so the dynamics will be more obvious;
- it is advisable to take measurements on an empty stomach;
- home weighing is carried out in a minimum amount of clothes, you can - naked;
- before weighing, you should definitely go to the toilet and rid the bladder of urine, and the intestines from the accumulated feces.
If the data of the weights in the antenatal clinic differ by more than a kilogram from home measurements, the woman must create a calendar in which she will indicate her gain, measured according to all the rules at home.
You can take the calendar with you to your appointment and show it to your doctor. In the medical record of a pregnant woman, the doctor draws a weight gain schedule for each appointment. The same woman can draw on her own at home, this will help to notice in time the periods when the expectant mother begins to gain too much, the periods when the weight stops or begins to fall. An uneven schedule is always an alarming sign that must be discussed with your doctor.
A strong and sharp increase may indicate the onset of gestosis, the appearance of internal edema, which are not visible during an external examination. If the weight grows slowly, changes little not only by weeks, but also by months, this may indicate various pathologies in the development of the child, the placenta, a decrease in the amount of amniotic fluid and other unpleasant processes.
Why is fast weight gain dangerous?
As we have already found out, the norms are individual, but the rate of weight gain is of great importance. Even if a woman has a weight during weighing that, according to the table, fits into the variant of the norm, but just a week ago the weight was far behind, then such an increase, although it is quite adequate, is unlikely to please the doctor.
It is important that the body weight of the expectant mother increases gradually, smoothly, at intervals that are permissible at different times.
Women tend to underestimate such a criterion as their own weight during pregnancy. On numerous forums of expectant mothers, women often speak out that the doctor "terrorizes" them, forcing them to lose weight, and amicably "competently" advise each other "not to pay attention to it."
This behavior cannot be considered responsible and adult. After all, the harm that excess weight can cause, as well as harm from lack of body weight, pose a serious danger to the health and life of the mother and child.
Excess weight during the period of bearing a child is such an increase in which:
- in a week, a woman has added more than 2 kilograms (at any gestational age);
- during the first trimester, the expectant mother “grew heavier” by 4 kilograms or more;
- if in the second trimester a woman adds more than one and a half kilograms every month;
- if in the third trimester the increase per week exceeds 800 grams.
Excess weight is a very real risk of developing late toxicosis. Swelling can be external, which a woman can easily see herself by the characteristic marks from the elastic bands of socks, if it is impossible to put on or take off a wedding ring. Swelling of the wrists, face, and ankles is common. But even if there is no visible edema, this does not mean that there are no internal edema, much more dangerous and insidious.
Normal blood flow in the mother-placenta-fetus system is impaired with edema and changes in blood pressure. As a result the baby receives less nutrients and oxygen necessary for its proper development.
Extra pounds and active weight gain in excess of the norm are dangerous and the likelihood of premature birth before 30 weeks, as well as prolonged pregnancy after 39 weeks.
An excessive increase in 30% of cases leads to early aging of the placenta, which means that the baby will not receive in the last weeks of pregnancy, which are so important for him, a large amount of nutrients that are very necessary for him in preparation for the upcoming birth.
Extra pounds often lead to the appearance of hemorrhoids, varicose veins, as well as the appearance of weakness of labor forces during childbirth, as a result of which doctors have to carry out an unscheduled emergency caesarean section to save the child's life.
Why is the lack of mass dangerous?
Lack of body weight during pregnancy leads to various forms of fetal malnutrition. The kid does not receive the substances and vitamins he needs. In 80% of cases in women with too little increase, babies are born weaker, with a small body weight, severe hypotrophy (insufficient amount of subcutaneous fat).Such children are more difficult to adapt to the environment, it is harder for them to process thermoregulation.
Delayed intrauterine development increases the risk of congenital neurological diseases, as well as hormonal disorders, the consequences of which can affect any system and any organ in the baby's body.
Sometimes a small set or no increase is associated with the fact that a woman literally starves, does not finish eating. This happens not only in socially disadvantaged families, but also in expectant mothers with a complete lack of appetite against the background of toxicosis of pregnant women. This leads to a deficiency in estrogen levels, and the likelihood of early miscarriage, termination of pregnancy and premature birth in the middle and at the end of gestation increases tenfold.
Insufficient weight gain is less than 800 grams in the first trimester, less than 5 kilograms in the second and less than 7 kilograms in the third trimester, closer to 36 weeks of gestation.
What to do if you are overweight?
If the weight is gained too sharply, in jumps, intermediate weighings show that the increase is pathological, the woman is prescribed an analysis for hormones, because in addition to overeating, the reason for this "behavior" of body weight may also lie in hormonal imbalance.
If this version is confirmed, then the woman is given hormone therapy, as a result of which the hormonal background is restored, and problems with intensive weight gain are solved.
If the reason is overeating and low physical activity (and many pregnant women, alas, are sure that it is necessary to eat for two, and it is harmful to load oneself with walking and swimming), then a woman is recommended a universal diet for pregnant women.
The expectant mother should eat 5-6 times a day, every 3-4 hours, except for the time allotted for a night's sleep.
Single portions should be reduced to such a volume that the amount of food can visually fit in the palm of a woman if she folds them in a boat.
After 28-29 weeks, it is allowed to arrange fasting days. Once a week, a pregnant woman is allowed to take a pound of low-fat cottage cheese or 400 grams of boiled buckwheat, or a liter of fermented milk products for 5-6 times. Sugar and salt on fasting days are completely prohibited.
Depending on how intense the increase in body weight is, the woman is set the number of calories that can be gained per day. Most often it is 2200-2500 Kcal. Diet websites have counters that allow you to quickly find out the number of calories in both individual foods and ready meals. This will help you easily calculate the menu for the week, month and every day.
The last meal is taken no later than 2-3 hours before going to bed. All dishes are prepared without frying, deep frying, and an abundance of spices. They also monitor the drinking regime - a woman should consume from 1.5 to 2 liters of clean water per day.
Allowed foods and dishes - cabbage, zucchini, cereals, apricots, watermelon, apples, buckwheat, oatmeal, rice, milk, beef, veal, turkey, chicken, rabbit, cottage cheese without a high fat content.
Prohibited foods - chocolate, baked goods, fatty pork, smoked sausages and fish, all fried, salted, pickled, peas, beans, semolina, barley, fast food, ice cream, condensed milk, grapes, bananas, canned food (meat and fish ).
The amount of salt is reduced to 5 grams per day. It is generally better to refuse sugar, replacing it with slow carbohydrates (sweet fruits and cereals). Carbonated drinks, syrups, beer are not allowed.
To help pregnant women who are trying to take their weight under control and reduce it, there are special gymnastic exercises, walks in the fresh air, swimming, yoga. If there are no contraindications, the doctor will definitely advise you to increase physical activity... This will help, together with the nutritional correction, bring the increase to the permissible rates.
Actions in case of insufficient gain
If the woman's weight is insufficient, there is a deficiency, the doctor will also be obliged to give a referral for examination by a gastroenterologist and endocrinologist. If a woman does not have diseases of the gastrointestinal tract or hormonal "problems", she will also undergo nutritional correction.
The calorie content of her daily diet should exceed 2500 - 3000 Kcal. The diet must include butter - butter and vegetable, pearl barley and semolina, peas and beans, buns, fatty fish and meat.
The prohibition, as with excess weight, applies to smoked, pickled and fried. Otherwise, the approach to diet is the same. Preferably split meals, with a normal portion size, make sure that the content of fats, carbohydrates and proteins in her diet is sufficient. In addition to correcting nutrition, the doctor prescribes vitamin complexes so that the child with the mother's blood can receive the necessary nutrients.
If a woman has severe toxicosis, in which in the literal sense of the word "a piece does not fit in the throat," the woman will have to adapt to this unpleasant condition and force herself to eat at least in small portions in between attacks of toxicosis.
To do this, choose the moments in which the occurrence of nausea is unlikely.
Many expectant mothers with painful toxicosis eat at night in bed or try to eat only in the fresh air.
If, together with insufficient weight gain, fetal growth retardation is diagnosed, the woman will have to undergo treatment in a hospital setting, where she will be injected and dripped with the necessary drugs that improve uteroplacental blood flow, vitamins, and will also give all recommendations for organizing high-calorie nutrition.
Usually, after such measures, the body weight of the expectant mother increases, and, although the average increase passes along the lower limit of the norm, it still fits into it. Such a pregnant woman may be shown more frequent ultrasound scans to monitor the development of the placenta, the child, and also to conduct a preliminary analysis of his estimated body weight.
An obstetrician-gynecologist will tell you about important facts about weight during pregnancy in the next video.
