Weight Gain During Pregnancy - how much extra weight is healthy?

A recent UK-wide survey  by the Royal College of Midwives and website Netmums showed many women fail to receive adequate weight management advice during and after pregnancy.

Up to 63% of women polled confirmed that their midwife had not explained weight management issues at their first ante-natal appointment.

The poll of 6,226 women found that six out of ten felt pressurised by the celebrity culture of losing weight quickly after giving birth, and the survey also suggested that lack of care had damaged many mothers' self-esteem. When asked how they felt about their bodies whilst pregnant, comments ranged from "disgusting" to "fat, ugly and big".

Almost 50% of the women polled confessed to worrying about their weight during their pregnancies. However, many women were confused about what their correct weight should be, and significant numbers worried unnecessarily that their weight might cause problems giving birth.

Women with a Body Mass Index of 30 or over, who are classed as obese, run a greater risk of developing conditions such as pre-eclampsia and gestational diabetes during pregnancy. They are also more likely to experience miscarriages, difficult deliveries, pre-term births and caesarean sections.

As well as missing out on obesity advice during pregnancy, nine out of ten women said that, after giving birth, they had had no opportunity to discuss weight management issues or concerns with their midwife.

Overall, 84% said the general advice they received from midwives on weight management was not good.

There are no official guidelines for weight gain in pregnancy in the UK. The general advice is that you should put on somewhere between 10kg and 12.5kg (22lb to 28lb).

You need to remember that just over a third of your extra weight will come from your baby, the placenta and the amniotic fluid.

• At birth, a baby weighs about 3.3kg (7.3lb).
• The placenta weighs 0.7kg (1.5lb).
• The amniotic fluid, which supports and cushions your baby, weighs 0.8kg (1.8lb).

Even that adds up to more than many women expect. But there is still another two thirds of weight gain to explain. This can be accounted for by the changes that happen to your body while you're pregnant.

• The muscle layer of your uterus grows dramatically for labour and weighs an extra 0.9kg (2lb).
• Your blood volume increases and weighs an extra 1.2kg (2.6lb).
• You have extra fluid in your body weighing about 1.2kg (2.6lb).
• Your breasts weigh an extra 0.4kg (0.9lb).
• You'll store fat, about 4kg (8.8lb), to give you energy to breastfeed.

When you add all that up, you realise that you could weigh up to 28lbs more than your pre-pregnancy weight. This is nothing to worry about and is all properly accounted for naturally. Excessive weight gain over this limit is the only time pregnant women need to become concerned.

 This can be the hardest part for many women. The fatigue associated with labour and the initial weeks of living with your newborn make it almost impossible for many women to exercise.

Try and incorporate mild exercise into your routine from the start. Walking with a pushchair or pram is great exercise, combining cardiovascular walking with resistance training in pushing the buggy. Walk briskly, with your back straight.

Take time for yourself: leave your baby with family or friends and treat yourself, but make sure you deserve your treat by exercising first. A gentle jog followed by a big bubble bath; a swim followed by a steam or jacuzzi; Yoga followed by a nap. Do this three times per week and gradually increase the activity levels.

You will have eaten healthily throughout your pregnancy to give your baby the best possible start to life. Now that the baby is born, continue the healthy eating. You'll find the weight is easier to shift.

If at all possible, breastfeed. As the statistics above show, nearly 9lbs of weight is stored specifically for this reason. If you don't breastfeed, that's an extra 9lbs you have to exercise away.

The most important thing to remember is that exercise before, during and after pregnancy is not only possible, but desirable.

Swimming, brisk walking and strength conditioning exercise are all safe and beneficial to mother and baby, help with flexibility and joint maintenance and mother's sense of well-being, which is naturally communicated to her child.

It is important to remember, however, that the aim of recreational exercise during pregnancy is to stay fit, rather than to reach peak fitness. Ultra marathons should perhaps be put on the back burner!

Women who are not regular exercisers should begin easily, with 15 minutes of continuous exercise three times per week. When comfortable at this level, exercise should be increased to thirty minutes sessions every day.

For women who already exercise regularly before pregnancy, they should be able to continue their routine - tailored as pregnancy advances - with no adverse affects. 

If pregnancy and the delivery are both uncomplicated, a mild exercise programme consisting of walking, pelvic floor exercises and stretching may begin immediately. However, high-impact exercise should not be resumed too soon after birth.

After complicated deliveries, or lower segment caesareans, however, a medical care-giver should be consulted before resuming pre-pregnancy levels of physical activity, usually after the first check-up at 6–8 weeks after giving birth.