By now you’ve entered your second trimester and are probably realizing that one of the major wellness indicators of your growing bump is just that—how much you're growing. When it comes to weight gain and pregnancy, there’s no one size fits all standard. Instead, it’s highly individualized and should be looked at holistically with the help of your doctor to better inform how you and your baby’s health is looking. To help breakdown one of the biggest topics when it comes to prenatal wellness, we turned to Dr. Banafsheh Bayati, M.D., a board-certified OB/GYN in Santa Monica, California, to help explain everything you need to know when it comes to weight gain, your pregnancy and you.
Is there a "right" range for weight gain in your second trimester?
This is an important topic. The right range depends on your starting weight. I try not to focus on weight gain with patients, although I monitor it closely. Instead, I prefer to discuss nutrition and the patient's relationship with food and how that changes during pregnancy. I try to use these nine months as an opportunity for change. This is a once in a lifetime opportunity to become mindful about your diet and nutrition. It's a great time to kick bad habits and develop new routines and priorities for your soon-to-be growing baby and family.
It's important to realize that the baby's growth in size occurs most significantly in the third trimester. So the total weight gain in pregnancy is actually a better number to consider given how differently we all put on weight. The ideal weight gain for a patient with a normal BMI prior to pregnancy is roughly 25 to 35 pounds. If you are overweight prior to pregnancy, weight gain less than 15 to 20 pounds is ideal. If you are underweight, then it is likely that you may gain more than 30 pounds.1 I discuss nutrition each trimester and address challenges such as stress eating, how to meal prep with long work hours and commutes and to recognize habits such as processed foods, frequent take out, late-night binges, and a high sugar diet. Your pregnancy is a great time to become mindful of nutrition.
What health signs and precursors are you looking for when you monitor weight gain?
As physicians, we monitor the weight gain during pregnancy to make sure it is adequate and not excessive. For example, in the second trimester, we screen all patients for gestational diabetes. We look for trends in prior pregnancies as well as in your family history. We also monitor the baby's growth to make sure it is adequate. Prior to the third trimester, the baby's undergrowth may signal genetic or syndromic conditions that would need further evaluation. Excessive growth may signal that the conception date is wrong and possibly earlier than noted. By the third trimester, growth issues may signal environmental conditions causing inadequate or excessive growth, such as gestational diabetes for example. Certain conditions such as preeclampsia may also cause rapid weight gain due to swelling near the end of pregnancy.2 It is important to know that swelling is common near your due date which may be exacerbated by long work hours, stress, diet, and genetic predisposition without underlying complications such as preeclampsia.
What should someone do if they feel like they are under or over their optimal weight?
This is an important question to address with your individual obstetrician because the answer is best served tailored for you. Pregnancy and all that it encompasses such as weight gain are as unique as each of us is. Medicine is based on science but it is not black and white. In pregnancy, especially, we find ourselves often in the grey.
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This article is for informational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and we recommend that you always consult with your healthcare provider. To the extent that this article features the advice of physicians or medical practitioners, the views expressed are the views of the cited expert and do not necessarily represent the views of Perelel.