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Weight Gain during Fertility and in Pregnancy
A huge number of women are 'constant dieters' and may keep their weight just on the limit of being healthy. Also, many of the diets that they follow are not adequate and can result in low dietary intakes of essential nutrients for pregnancy. Many women already know that if they become too thin, their periods stop, which means they are not ovulating and therefore cannot become pregnant. Women with eating disorders, such as anorexia nervosa and bulimia nervosa, are often extremely underweight. But it is not only being the right body weight that is critical for fertility - the amount of body fat you have is just as important as the products you use for food. In normal adult women, fat comprises about 28 per cent of body weight and, if it drops below 22 per cent, then ovulation will stop. Women with an average or above average body weight who exercise very rigorously may have a higher muscle content and a lower body fat, which may lead to their periods becoming irregular or stopping altogether. Sensible advice for these women would be to reduce their exercise until their body fat returns to the normal range. Many gyms have simple devices that can check your body fat level. Evidence has recently emerged about reduced fertility in overweight women. It appears the risk of infertility increases with the degree of obesity -- in other words, the greater the weight, the bigger the problem. Being significantly overweight may also affect how well your organism will respond to certain fertility treatments, such as IVF. If you are concerned that your weight may be affecting your fertility, do talk to your GP. How much weight should woman put on during pregnancy? First and foremost, it is important to accept that you are going to put on weight during pregnancy! You are meant to because your body is growing and changing to give your baby the best start in life. Here's where the extra weight comes from: • At birth, your baby will weigh approximately 3,300g (7.3lb). • Your breasts weigh an extra 400g (0.9lb) • Your blood volume increases and weighs an extra 1,200g (2.6lb) • The placenta (afterbirth), which keeps your baby nourished, weighs 600g (1.3lb) • During pregnancy, the muscle layer of your womb (uterus) grows dramatically and weighs an extra 900g (2lb) • You have extra fluid in your body, weighing 2,600g (5.7lb) • Plus, you will lay down some fat during your pregnancy to provide you with extra energy for breastfeeding. This comes to about 2,500g (5.5lb). So, in average, by the end of pregnancy you will weigh about 11,000g (24.2lb) more than you did before you became pregnant. But your own case may be strictly individual. The amount of weight any woman gain during pregnancy will depend on how heavy you were before you became pregnant. Or more accurately, on what your body mass index (BMI) was (see Calculating your Body Mass Index (BMI), below). Will I be weighed in pregnancy? Not so long ago, pregnant women used to be weighed every time they went for an antenatal check. But then doctors realised that it wasn't a particularly good way of assessing how well the pregnancy was going as this made a lot of women very anxious. Now it is considered that the weight gain in pregnancy should be related to a woman's BMI before she became pregnant. For this reason, it's now recommended that your midwife calculates your BMI when you have your booking appointment. Calculating your Body Mass Index (BMI) In order to calculate your BMI, your midwife needs to know how tall you are in metres and how heavy you are in kilograms. If you would like to have a go at doing it yourself, here's how it's done: 1. Multiply your height in metres by your height in metres. If you are 5 feet 3 inches, your height in metres is 1.6m. So multiply 1.6 by 1.6 which gives you 2.56. 2. Then divide your weight in kg by this figure. So, if you weigh 60kg, your BMI will be 60 divided by 2.56 = 23.43. Here's how your BMI is classified:
Your BMI and pregnancy weight gain In the 1990s, the Institute of Medicine in the US recommended that women should aim for a weight gain related to their pre-pregnancy BMI: • If your BMI was less than 19.8, you should aim for a weight gain of between 12.5 and 18kg (28 to 40lb). • If your BMI was between 19.8 and 26, you should aim for a weight gain of 11.5 to 16kg (25 to 35lb). • If your BMI was above 26, you should aim for a weight gain of 7 to 11.5kg (15 to 25lb). Now, let's summarise all you should know about your Body Mass Index: • If you were a normal weight, you should aim for a weight gain of around 2 stone • If you were overweight before you became pregnant, you should aim for a weight gain of around 1 stone • If you were underweight, you should aim for a weight gain of around 3 stone. If you are under 20 years of age, you should aim for a weight gain at the top end of the range for someone with your pre-pregnancy BMI. What if I'm overweight? Doctors think that women with a high BMI before pregnancy should try to limit the amount of weight they gain. Putting on a lot more weight could increase your risk of developing high blood pressure and having a big baby. Don't try to diet, though. Research shows that, for a pregnant women who is overweight - or who has put on a lot of weight in the first half of pregnancy - a low-calorie diet does not reduce your chances of developing high blood pressure or pre-eclampsia. Such a diet doesn't benefit your baby either. Instead, get some advice from your midwife or GP about how to eat a sensible, nourishing diet that will ensure you don't pile on the pounds but which still keeps you and your baby happy and healthy. It's much better to stick to a normal, well-balanced diet and just cut out sweets and things like biscuits, cakes, and ice-cream, which aren't very nutritious. What if I'm underweight? Ideally, first you must concern about your own health and healthy body weight so an underweight woman shouldn't try to become pregnant before she has got herself up to a normal weight. Being underweight can affect your fertility, but it's only a part of all. But, if you are underweight and do become pregnant, you run the risk of having a small baby and small babies sometimes have lots of problems. If you are already pregnant, do speak to your midwife, GP or practice nurse and get some advice on the best diet for you and your baby during the coming months. What if I'm diabetic? If you are diabetic, it's especially important that you should start pregnancy with a healthy BMI. If you're reading this before you get pregnant, go and see your diabetic nurse or your GP and check out your diet. If you are already pregnant, you will need to take extra care to keep your blood sugar level stable, so ask your carers for advice on the best possible diet to keep you and your baby healthy. Mostly maternity hospitals have a special team of nurses and doctors who are specially trained to look after diabetic women in pregnancy. Controlling your weight All you really need to do is to eat sensibly, bearing in mind that a pregnant woman needs approximately 2,500 calories a day. A sensible diet includes foods from all the major food groups: • about 55 per cent of your calories (the largest part) should come from bread, pasta, potatoes, rice and cereals (carbohydrates). • about 35 per cent of your calories should come from dairy products, such as butter and cheese, and from oils and nuts (fats) • about 10 per cent of your calories should come from proteins, such as meat, fish, eggs and pulses You should also understand that there's no harm in having the occasional chocolate treat but remember that the extra weight you put on during pregnancy will show all too clearly after your baby is born; losing weight in the early months of motherhood isn't going to be easy.
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