It has lately been brought to our attention that pregnant women are gaining too much weight. Half of normal weight women gain more than the recommended amount. The number climbs—as the recommended weight gain drops—for overweight and obese women.
Too much weight gain is becoming an ever-greater cause for concern for both pregnant women and their babies. For women, excessive weight gain is tied to health problems during pregnancy and a greater chance of obesity afterwards. (The more weight you gain, the harder it is to lose). And since a mom’s weight gain has been linked to her baby’s weight, gaining a lot in pregnancy makes it more likely that your baby will be large, harder to deliver, and at greater risk of certain health problems. High birth weight babies are also more likely to be obese as children.
So. Doctors are highly motivated to find ways of helping pregnant women stay within the recommended weight gain guidelines. And it seems they may have found at least a clue to a way to make that happen.
A multi-location study followed 400 pregnant women in various weight ranges. The women were split into two groups. One group received standard obstetric care with minimal counseling about weight gain, diet or activity level. The other group was given specific calorie goals, ranging from 1500 to 2800 calories a day, depending on starting weight. They were urged to exercise regularly, either by walking (10,000 steps a day as measured by a pedometer) or 30 minutes of moderate physical activity of their choice most days of the week. The women in the second group were also counseled individually by a nutritionist, and received check-in calls from a healthcare provider throughout pregnancy. The frequency of the calls increased if weight gain began to exceed ideal guidelines.
The results: Many more women were able to stay within weight gain recommendations. This method was most effective for normal weight women and less so for overweight or obese women. It’s not clear why this is, but I’m guessing the fact that it’s a whole lot easier to stay on a 2800 calorie a day diet than a 1400 calorie one might have something to do with it. And then, there’s the possibility that overweight and obese women may have a different relationship to exercise, and the complex relationships to food, and too many other factors to try to figure out.
Women who received help with diet and exercise were almost twice as likely to return to pre-pregnancy weight within six months after birth. This increase was seen in the full range of women: normal, overweight and obese.
I’d be interested in knowing how the women in this study felt throughout the program. Were the check ins invasive, or helpful? Did they feel supported, or micromanaged? I’m wary of things that make women feel like they’re under a microscope. But if weight gain is such an important issue, then pregnant women are absolutely going to need tools and support to stay within the boundaries. Managing weight is not easy for most women at any time, and arguably much harder while pregnant. Just giving the women the numbers and sending them on their way is a setup for failure…and guilt. I’m not sure if the care the women received in this study is realistic for pregnancies across the board (health care being what it is) but what if it were? Would you be into it?