How to Manage Weight During Pregnancy

I’ve been an Online Personal Trainer / Health & Fitness Coach for many years now and have worked with women before, during and after pregnancy. Over the years I’ve read and heard of many different strategies regarding health and fitness during pregnancy, some good advice, some great advice and some absolutely terrible advice. What we should always do is seek guidance from trusted sources and qualified individuals.

It’s safe to say that all mothers want what’s best for their children and this starts from the moment they find out they are pregnant.

Once women are over the initial shock/excitement of becoming pregnant and have come to the realisation that they’ll not have a comfortable/full night sleep for the next 2 years and 9 months, they then often start looking at how they can get through pregnancy in the best, healthiest and safest possible way.

Some of the advice I’m going to share with you was published by the National Institute for Health and Clinical Excellence (NICE) as part of its public health programme. NICE produces guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector.   

https://www.nice.org.uk/guidance/ph27/chapter/1-recommendations

Calories

If you’re one of my Online Personal Training clients, then you likely have a good idea on how many calories you need per day, so I feel this is a good place to start this article. The Committee on Medical Aspects of Food Policy report on dietary reference values recommends that women should only have around 200 calories more per day in the last trimester of pregnancy (Reference - DH 1991). So let’s say for example that 2000 calories are your maintenance calories, at 2000 calories you neither gain, nor lose fat, but rather you are in complete homeostasis. After the first 6 months, you will need to consume around 200 calories extra per day, which would total up to 2200 calories for the last 3 months of your pregnancy. This would change if you were expecting twins or more.

A modest 200 calories per day does put things in perspective and debunks the myth of “eating for two”. Although we could argue that this gets women to focus on their calories too much and might lead to an overall restriction of one’s calories, restriction of calories is not recommended! So, the general consensus is that you focus on making healthy dietary choices and talk to your GP or midwife if you’re are concerned about your weight.

Obesity during pregnancy

Here in the UK, we focus on making women aware of the risk factors that are involved with being obese during pregnancy, to be proactive with your weight management rather than reactive. If you’re obese this will have a greater influence on your health and the health of your unborn child than the amount of weight you may gain during pregnancy. That is why it is important, when necessary, to lose weight before becoming pregnant.

Obese women when pregnant face an increased risk of complications during pregnancy and childbirth. These include:

• Impaired glucose tolerance and gestational diabetes,

• Miscarriage,

• Pre-eclampsia,

• Thromboembolism

• Maternal death

(Reference - Centre for Maternal and Child Enquiries and the Royal College of Obstetricians and Gynaecologists 2010).

Babies born to obese women also face several health risks. These include:

• Higher risk of death

• Stillbirth

• Congenital abnormality

• Shoulder dystocia

• Macrosomia

• Subsequent obesity

(Reference - Ramachenderan et al. 2008).

Appropriate weight gain

Appropriate weight gain is a tricky subject as there are no formal, evidence-based guidelines from the UK government or professional bodies on what constitutes appropriate weight gain during pregnancy. Having said that, the US Institute of Medicine guidelines (Reference - Rasmussen and Yaktine 2009), based on observational data, state that healthy American women who are a normal weight for their height should gain 11.5–16 kg during pregnancy. Overweight women should gain 7–11.5 kg and obese women should only put on 5–9 kg.

Exercise

With my Online Personal Training clients, I tend to just need to make some subtle tweaks to their training programme when I’m aware of their pregnancy, but overall keep things the same, we want to keep as active as long as the client feels comfortable. Exercise is not dangerous for your baby – there is some evidence that active women are less likely to experience problems in later pregnancy and labour. Recreational exercise such as swimming or brisk walking and strength conditioning exercise is safe and beneficial, the aim of the recreational exercise is to stay fit, rather than to reach peak fitness, we are not aiming for PBs (personal bests). If you have not exercised routinely then you should begin with no more than 15 minutes of continuous exercise, three times per week, increasing gradually to daily 30-minute sessions. If you’ve exercised regularly before pregnancy, they should be able to continue with no adverse effects.

Exercise tips when pregnant:

• Always warm-up before exercising

• Keep active on a daily basis

• Avoid exercise in hot weather

• Drink plenty of water and other fluids

• If you go to exercise classes, make sure your instructor is properly qualified and knows that you're pregnant

• Swimming is a good shout because the water will support your increased weight. Some local swimming pools provide aquanatal classes with qualified instructors.

Exercises to avoid when pregnant:

• Don't lie flat on your back for prolonged periods, particularly after 16 weeks, because the weight of your bump presses on the main blood vessel bringing blood back to your heart and this can make you feel faint

• Don't take part in contact sports where there's a risk of being hit

• Don't go scuba diving

Summary

Don’t take anything to the extremes, whether that’s training or nutrition, stay active for as long as comfortably possible and avoid exercises that make your feel uncomfortable in any way whilst eating a healthy balanced diet.

Pregnancy is a beautiful thing for both you and the father, enjoy it and congratulations to you both!