How to Maintain a Healthy Weight During Pregnancy

by Dr. Arthur Greenwood, Obstetrician and gynecologist, MedStar Medical Group Women’s Health
January 17, 2020

Whether your pregnancy was long-awaited or sudden, you probably have a few questions about how you and baby can stay healthy. As an OB/GYN, one of the most common questions I get asked is, “How much weight should I gain during pregnancy?”

There isn’t a one-size-fits-all answer—but it is an important question. Maintaining a healthy weight throughout pregnancy can reduce your risk of health complications involved with having a baby who is too big or too small.

If you gain too much weight, you may increase your risk of:

  • Preeclampsia
  • Gestational diabetes
  • Baby’s shoulder getting stuck during delivery (shoulder dystocia)
  • Unplanned C-section
  • Hard-to-shed postpartum pounds

Gaining less than the recommended weight is risky, too. Babies with a lower birth weight (less than five pounds and eight ounces) may struggle to breastfeed, fight infection, and hit developmental milestones.

So what is a healthy weight during pregnancy? Well, it depends.

Know how much weight you need to gain during pregnancy.

The amount of weight that’s healthy for you to gain may be different than other pregnant women you know. That’s because your estimated weight gain is determined based on how much you weigh before getting pregnant. If you weigh less, you may need to gain more than someone with a higher pre-pregnancy weight. If you’re starting pregnancy at a higher weight, you should aim to gain fewer pounds.

In general, here’s how much you should gain based on your pre-pregnancy body weight.

If your BMI is... You are considered... And you should gain...
Less than 18.5 Underweight 28 to 40 pounds
18.5 - 24.9 Normal weight 25 to 35 pounds
25 - 29.9 Overweight 15 to 25 pounds
Over 30 Obese 11 to 20 pounds

Keep in mind, if you are pregnant with twins or more, your recommended weight gain may be different.

Your midwife, OB/GYN, or family doctor can help you set a goal for healthy weight gain at your first-trimester appointment. They’ll also help you monitor your weight and baby’s growth throughout pregnancy.

Eat a well-balanced diet.

Carb-loaded doughnuts and bagels probably sound appealing when you’re fighting off first trimester morning sickness, but eating a balanced diet is key to maintaining a healthy weight during pregnancy. While a prenatal vitamin will help you pass along the vitamins and minerals that baby—and you—need, it’s also important that you eat nutrient-dense foods.

A healthy diet includes a variety of foods from the main food groups, as well as key nutrients:

  • Protein: Most pregnant women should eat at least 70 grams of lean protein per day. Lean protein sources include chicken, fish, eggs, beans, or even dairy. Greek yogurt is a great source of protein!
  • Fats: It might sound counter-intuitive but fats won’t actually make you fat (in moderation). During pregnancy, 20 to 35 percent of your total calories should come from healthy fats. Good fat sources include fish, such as salmon or tuna. (Do stay away from fish that is high in mercury, like shark, swordfish, king mackerel, and tilefish.)
  • Carbohydrates: Choose veggies, fruits, and whole grains as your carb sources. Do your best to stay away from junk foods, like chips and ice cream. They offer no nutritional value to you and baby, so you may find yourself still hungry and eating more.

Hint: You need fewer calories than you think.

People may encourage you to “eat for two” but the truth is, your body doesn’t actually need many extra calories during pregnancy. In fact, you only need 340 extra calories in the second trimester and 500 extra calories in the third trimester.

Exercise for 30 minutes on most days.

In addition to making healthy food choices, staying active can help you maintain a healthy weight. We recommend 30 minutes of exercise on most—or all—days, if you can. If you are just starting to exercise, try walking or swimming. If it’s too hard to find 30 minutes in your day, try breaking up your exercise into three 10-minute blocks.

Hard to find time to stay active during #pregnancy? Try breaking up exercise into three 10-minute blocks throughout the day. Learn more about maintaining a healthy weight during pregnancy via @MedStarHealth’s #LiveWellHealthy blog.

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If you were already active before pregnancy, continue exercising at a level you and your health provider are comfortable with. As you get further along in your pregnancy, be cautious with activities that put you at risk for falling. Your balance isn’t quite the same during pregnancy!

Keep an eye on weight gain guidelines by trimester.

In the first trimester, you don’t actually need extra calories to support the baby’s growth. For women starting out at a healthy weight, we recommend a weight gain of fewer than five pounds. Steady weight gain is more important as your pregnancy progresses in the second and third trimesters.

If you began pregnancy at a healthy weight, you can expect to gain one to two pounds per week from weeks 12 through 40. But this can add up fast!

Let’s say you gained the maximum recommended weight of five pounds during the first trimester. Then, you gain two pounds every week through the second trimester. By the beginning of 28 weeks of pregnancy, you would have already gained over 30 pounds—and you still have twelve weeks to go.

Having regular conversations about your weight during prenatal visits will help you stay on track to gain enough weight at the right speed. Your provider can offer ways to slow down your weight gain while ensuring the baby is getting everything they need.

Try these tips if you’re gaining weight too quickly.

If you’ve taken “eating for two” literally and find yourself nearing the high end of your range mid-pregnancy, it’s not too late. Try the following tips to get back on track.

  • Keep a food log. Writing down what you eat really helps keep you accountable in making nutritious food choices. An app like myfitnesspal can simplify tracking.
  • Exercise with other people. Ask your partner, friends, or family to get active with you. Just walking can help you manage your weight and build strength that you’ll need during labor and delivery.
  • Shrink portion sizes. Remember that you don’t need a lot of extra calories. Eating smaller meals every three hours can help you avoid overeating at mealtime.
  • Don’t forget to drink water. It’s important to stay hydrated, and you’ll feel fuller between meals and snacks.

Start at a healthy weight before getting pregnant, if possible.

Not yet pregnant? You can set yourself up for healthy pregnancy weight gain by establishing healthy food and exercise habits now. If you’re trying to conceive, healthy weight loss could actually improve your chances of getting pregnant.

If you’re not sure what your healthy starting weight should be, talk to your healthcare provider. They can help you determine a healthy range for your height, age, and activity level.

Interested in learning more about women’s health at MedStar Health? View our services here.

Do you live in St. Mary’s County and need
obstetric or gynecology services?

Consider making an appointment with Dr. Greenwood.

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Category: Living Well, Staying Active     Tags: eating healthyExercisegynecologyhealthy eatinghealthy food choiceshealthy pregnancyob/gynobstetricspregnancyWellnessWomen's Health