You’re Pregnant: How Much Weight Is Safe to Gain?

Packing on the pounds during pregnancy makes it harder to lose weight after the baby’s birth

For many women, a positive pregnancy test signals a license to pig out or “eat for two.” But indulging in everything in sight is not only unnecessary, but also potentially dangerous—for both mom and baby. This is especially true for us, since four out of five black women tend to be overweight or obese long before getting pregnant.
Being heavy at conception puts a pregnant woman at increased risk of having a miscarriage, developing gestational diabetes or pre-eclampsia. They are at higher likelihood of being placed on modified bed rest, developing infections and blood clots, and needing C-section delivery. And packing on the pounds during pregnancy makes it much harder to lose the weight after the baby’s birth. Institute of Medicine data show black women retain more pounds after giving birth than our white or Latina sisters.
So how do we get a handle on this growing problem? The IOM recommends normal-weight women gain 25 to 35 pounds during pregnancy, overweight women 15 to 25 pounds and obese women 11 to 20 pounds. “You’re not eating for two,” said Janice Henderson, M.D., of Johns Hopkins. “Don’t double up every meal.” In fact, Dr. Henderson said pregnant women only need 1,800 to 2,400 calories a day, and they don’t need any extra calories at all during the first trimester. She counsels her patients to take in 340 extra calories a day in the second trimester and 400 in the third. (Think: a slice of bread with peanut butter and a glass of milk.)
Of course, this doesn’t mean pregnant women, inching close to the recommended weight gain, should go on a diet. Nor should you obsess about the numbers. In fact, experts say the focus should be on healthy living before, during and after baby.
Pre-conception. Fertility, said Dr. Henderson, is often reduced in obese women. She also pointed out that obese women tend to have nutrient deficiencies, like folate and vitamin B12, and many already have health issues. So don’t wait until the pink line shows up on the pregnancy test; schedule an appointment to talk to your ob/gyn or midwife about health status and weight concerns.
“If you are overweight or obese, lose weight pre-conception,” Dr. Henderson said. “If you have other medical problems, get them under control.” (She even suggests that a woman with a BMI greater than 40 consider weight-loss surgery.)
While pregnant. Don’t eat unlimited amounts of every food under the sun. That thinking is obsolete, explained Yvonne Thornton, M.D., clinical professor of obstetrics and gynecology at New York Medical College. “Focus on healthy eating and portion control,” Dr. Henderson said.
Keep it moving. Unless there’s a medical reason to avoid physical activity, pregnant women should aim for 30 minutes of moderate exercise most days of week. It’ll boost energy and help keep weight gain under control. If you haven’t been exercising regularly before pregnancy, don’t start training for a triathlon. Walking should do the trick. But if you were active before, you can continue aerobic activity and resistance training (light weights only). Consider a prenatal yoga class.
“Set one goal related to eating each week and one for physical activity,” Dr. Henderson said. “Be specific. Instead of ‘I’m going to gym this week,’ say ‘I’m going to the gym Tuesday, Wednesday and Friday.”
And don’t try to go it alone. Keep regular prenatal visits and talk to your provider about diet and exercise.