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This year the Institute of Medicine issued new guidelines for how much weight you should gain if you're pregnant. It was the first time in nearly 20 years the IOM had updated its recommendations. One new study aims to keep women who are obese from gaining any additional weight at all. That's something that's hard for me to fathom.
When I got pregnant last year, I was not obese, but I was certainly over what the charts said my "normal" weight should be. No medical professional expressed a concern about my weight or told me how much I could gain without worry. When I wasn't at work or at the doctor's office, it seemed like I was either eating to satisfy a craving or ravenous hunger, popping antacids or propping my feet up to get the swelling in my legs and ankles down. (Or all three at once!) I can't imagine trying to work, maintain sanity and have to worry about not gaining any weight.
Researchers say obesity rates in the U.S. are getting steadily worse. And that — along with other serious implications — means that nearly half of American women who get pregnant are either overweight or obese. That means they're at greater risk of developing gestational diabetes, preeclampsia and hypertension. And it's more likely that their babies will be prone to obesity.
Are you pregnant or thinking of becoming pregnant? Are you overweight or obese? Are you worried about the effect of your weight on your health or the health of your baby? If you've had a baby, what role did weight play in your pregnancy?
GUESTS:
- Vic Stevens: Principle investigator of the Healthy Moms study
- Cindy McEvoy: Neonatologist at OHSU and co-investigator of the Healthy Moms study
- Elizabeth Collins: Naturopathic doctor and midwife at the Natural Childbirth and Family Clinic
Tagged as: obesity · pregnancy
Photo credit: blinzelblinzel / Creative Commons
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repeatedly witnessing the ridiculousness of the hospital system was part of the reason i chose homebirth midwives for my prenatal care and births. i got a full hour of their time and wisdom during every visit and we talked extensively about nourishing my babies and my pregnancies. the only time we talked about weight gain guidelines was to laugh about how they are always trying to squeeze the curves of pregnant women into their straight and narrow definitions of "health".
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In my personal experience the doulas don't do any better a job as a whole, it is very provider specific. It isn't accurate or fair to generalize it in such a way. Instead, the PARENTS must accept the responsibility of educating themselves, doing the work necessary to stay active and healthy during pregnancy and improving their diet permanently.
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Is weight a reliable indicator of health? What happened to body mass calculation?
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Body mass index is what they're using as their benchmark. But since height doesn't change, and since BMI is based on the relationship between weight and height, weight is what these doctors seem to be focusing on.
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I am sending this comment again b/c I think it did not go through......
I understand the focus on the prenatal mother's weight and I agree fully, but we should also take into account the postnatals mother's weight, as well. Taking care of a new born, no leass a toddler takes a tremendous amount of physical energy. I couldn't imagine caring for my infant with another with another 50 pounds on my body. I wonder how a mother's interaction with her infant and subsequent care is affected by her level of obesity.
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So many women can understand a desire to lose baby weight because exercise after pregnancy can become harder when you have a little baby to look after. You have to be careful though because we are tempted to use crash diets after pregnancy because we get desperate. We need to do it the healthy and correct way.
Be sure to bring a friend along for support and motivation. It's one of my favorite things that has helped me!
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In relation to the comment about children being more likely to have health tourbles and to be overweight when they are older - wouldn't it make sense that those of us who are overweight already may have poorer habits and therefor teach our children our poorer habits which would lead to the problems when they are older? How can we know that is has anything to do with what the mother's weight is during pregnancy?
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As a scientist, I have some trouble with the way they seem to be going about this "study." Emblematic of this is the title: "Healthy Moms".
This suggests a foregone conclusion -- that applying these principles to overweight women will result in them being "Healthy Moms". If they already know this, why do a study? If they don't, it's misleading . . .
An program which "aims to show" something in particular isn't a study, it's a publicity campaign.
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I have had issue with how much weight women in this country put on during pregnancy. It has become accepted that while pregnant a woman can eat whatever she wants, and how much she wants. I have never seen a 50 lb baby, but I have seen women gain between 50 and 90 lbs during pregnancy. If the mom was already obese before the pregnancy, and ADDED 50 lbs it is plain common sense that is not healthy for mom or baby. I think everyone can agree moms exercising and eating healthy produces healthier babies, so WHY don't women do so? Has the American woman become so lazy and self centered that they rationalize away the health of their child?
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I was back down to my pre-pregnancy weight two weeks after my daughter's birth. But in the first 22 months of her life, I've gained about 7 pounds. How much of the struggle to lose weight after childbirth has to do with having been pregnant, and how much is due to the realities of being a parent? I've found, as a breastfeeding mother, that it's been difficult to adjust my diet appropriately as my daughter's nursing habits have changed. Thanks for this topic!
Martha in Portland
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Seriously!?! This discussion just perpetuates the myths of obese people. That if we would just "eat right" and eat the things our doctors tell us to that we'll lose weight and be healthy. Don't you think that each and every one of us have tried and tried? Especially women who are planning to get pregnant? It's not that easy. Get real, people and stop making it sound like we just don't do "what we're supposed to."
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As it was mentioned in this very program this morning - look at film and pictures of the same cities and towns early in the 20th century. Trying to FIND an obese person in those pictures and films is like finding Waldo. The level of personal responsibility in this country has become a joke. It is the medical establishment and providers FAULT is what your contention is? Seriously?!? Are you saying you get 10-15 servings of fruits and vegetables and high quality low fat protien and you are still gaining weight?
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During my 1st pregancy i gained upwards of 40lbs. But it all melted away w/ breastfeeding. I'm wondering how breastfeeding factors into this discussion?
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I just gave birth to a 10 lb baby 3 weeks ago. I would be considered "overweight" according to the BMI. I gained 30lbs during the pregnancy. I had a quick easy birth, less than 4 hours from first contraction until I pushed the baby out (home water birth). You all had a nurse on there talking about how overweight/obese women make larger babies that can lead to c-section or complicated deliveries. Well I think that statement leaves out important information... for one, Drs are now doing late pregnancy ultrasounds estimating the weight of the baby, if the baby is "big" they are suggesting the mom be induced because of course (sarcasm) there is no weigh a mom could birth a large baby with out medical help. The inductions when the mom and baby aren't ready are what are leading to increasing c-sections with larger women/babies.My first baby was your typical 8lber and that labor and delivery was 10 million times harder than my 10 lb baby.
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Two comments:
1. I think sugar might eventually become the focus of this line of research. I am interested in the effects of sugar specifically on baby and mother during and after pregnancy.
2.I wasn't overweight before pregnancy, but I've never been skinny and I have always struggled with body image. Pregnancy was the firsttime in my life that I gave myself permission to eat what I wanted (I ate a really good meals, but let my sweet tooth run wild a bit too). I gave myself permission to gain weight. It was thrilling. Of course, the post pregnancy hangover leaves me with more weight than I want, but it
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I'm 26 weeks pregnant with our first child. Pre-pregnancy, I weighed about 105 pounds and I'm 5' 3". During the first 23 weeks of my pregnancy, I gained around 20 pounds. At first, I was concerned that I was gaining too much weight, even though it all seemed to be going to my abdomen area. Now my weight has leveled off, and I haven't gained a pound (I actually lost 2 pounds without changing my eating habits) in the last 3 1/2 weeks. I received comments from random women saying that I was too small for how far along I was, and I started to panic and worry that my baby wasn't developing normally. I talked to my midwife that she assured me that every woman gains weight and maintains their weight differently, depending on how their body works.
My point is that I think it is the general trend in this country to accept that (and maybe even encourage?) women will gain a ridiculous amount of weight during their pregancy because it's somehow deemed as "healthy" and that they're "eating for two." And, in effect, just because I wasn't as big as some women think I should be, they made me feel like I was doing something wrong.
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Thank you for the wonderful commentary on such an important topic. However, as a practicing ob/gyn, I am concerned that not one of your guests is an ob/gyn or perinatologist (high risk ob physician). As part of my practice, I discuss nutrition and appropriate weight gain at every visit with my ob patients. Obesity leads to so many complications that we deal with every day. The risk to the mother includes challenging vaginal deliveries, preeclampsia, gestational diabetes, risk of surgical intervention, and risk of surgical complications if patients do need a cesarean section. Complications later in life include endometrial cancer, breast cancer, severe urinary incontinence, diabetes, osteoarthritis, high blood pressure, and heart disease. The questions from the people writing in are good ones, and I encourage patients to bring those questions to their ob/gyn or primary care physician who deals with those complications most often. I am saddened by people who report not enough time with their physicians, but remember, health is a proactive endeavor. Patients must pursue what is in their best interest in partnership with their physician. The reality is that pregnant moms need only an additional 300-400 calories a day while pregnant. We have to let go of the image of eating for two.
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The comment about the overall increase in obesity over the last forty years is what struck me. Looking at photographs, etc as proof.
Can it be that the increase in Conservatism over the last forty years of De-Regulation, consolidation of small farms into giant corporate farms and industrial food corporations, and getting rid of the "Truth In Advertising Law" has brought us this result, that Conservatism is unhealthy as well as politically un-wise?
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I work with a program that helps women who had gestational diabetes after they deliver. This program is supported by the Southwest Washington Medical Center Foundation grant. We support lacation and attendance at a Small Steps for a Healthy Family monthly class. Goals of the program are to help women reach their pre-pregnancy weight, to be more active and to introduce healthy habits and food to their children.
While tracking data, I've found a few obese women who have maintained their weight during pregnancy and had healthy babies. After 3 months of breast feeding these women have lost weight and feel much better. Its an excellent time to intervene. I just wish more women accepted this program. Life is busy for young families.
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Uggh….another program about obesity and no mention about the controversy of calling it an “obesity epidemic”. A whole show on a study that is still underway? As if women are not bombarded enough with images and advice about how they should look, now the powerful time of pregnancy is reduced to dieting. Let’s make mothers feel guilty about their bodies as they are creating life. Sounds good…..All of the numbers about the obese in our country are based on the BMI scale which is an enormously flawed measurement tool. The multi-billion dollar weightless and beauty industry have largely defined this epidemic and while there correlations between weight and certain diseases causality is yet to be proven. The caller, Jennifer touched on how the women she see’s who are overweight are dealing with multiple problems associated with poverty. The obesity issue is a poverty issue, an “overweight” person who exercises frequently and has good health care has better health outcomes than a thin person who doesn’t.
Think Out Loud has done several shows about obesity without mention (at least that I have heard) of the sad reality that 1 in 8 adolescent girls report starving themselves. 81% of 10 year olds are afraid of being fat. 51% of 9 and 10 year old girls feel better about themselves if they are on a diet. 40% of mothers tell their adolescent daughters to diet. Dieting does not work and usually causes more health problems then being overweight in the first place.
Please bring some balance on this topic!!!!!
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Thank you for sharing your experience! Surely, the pregnant are worrying about this.
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Comments are now closed.
as a birth doula, i spend a significant amount of time discussing diet and nutrition with my clients. i would say over 90% of them do not get ANY nutritional counseling from their primary care provider - which makes sense when you consider that the average time a pregnant woman actually gets to interact with her OB is around 5 minutes per visit.
i think it is ridiculous for the IOM to push weight restrictions for pregnancy gain unless hospital care providers are able to dramatically change how they do their prenatal care and nutritional education. pregnant women need a lot of high quality protein, minerals, and good fats on a daily basis in order to grow a healthy baby and have a safe and healthy pregnancy. if all a women has is a target weight, she is likely to cut out essential nourishment to meet that goal which could lead to the very problems they are trying to prevent like preeclampsia.