genuinely out of control, or otherwise worrying you, it is essential that you find help and support so you can grow a healthy baby.
Where to go for help:
Your doctor/midwife is a good first base. You can also contact:
National Centre for Eating Disorders They can refer you to specialist help in your area. 01372 469493 www.eating-disorders.org.uk
Eating Disorders Association 01603 619090 Helpline 0845 634 1414 www.edauk.com
Weight charts and what to do with them
In the US, where I had Sam, my second baby, they stuck me on the scales at every antenatal appointment. At one point, I found myself apologizing to the nurse for my excessive bout of chocolate muffin-induced poundage. In Britain, doctors and midwives have realized that being constantly weighed has little medical benefit and causes many women undue anxiety and guilt. As obstetrician Lucy Chappell puts it: ‘You don’t weigh an oven to see if the cake is done.’ Your midwife usually asks your pre-pregnancy weight at your booking in appointment but is unlikely to weigh you after this unless there’s a medical reason to do so. As a rough guide don’t weigh yourself more than once a week.
How much weight you ‘should’ gain over the next nine months will depend on how fat or thin you are in your unimpregnated state. As a rough guide, if your pre-pregnancy Body Mass Index,6 is in the ‘ideal’ range, you might gain about 25–35lb over the pregnancy. Very roughly this means a gain of about 3–6lb in first trimester, about 1lb a week in second and third. Loads of women gain far more than this, and lose it (albeit annoyingly slowly) afterwards. Do not succumb to the tyranny of weight charts: gain what is right for you. If you are already overweight doctors say you should gain slightly less than the average. If you are underweight, they say you should gain more. If you’re worried about your rate of weight gain either way, talk to your doctor/midwife. For example, a really rapid weight gain (more than about 2lbs a week) could be an early sign of pre-eclampsia (pregnancy-related high blood pressure) if it is caused by fluid retention.
An experienced mother’s weight tip:
‘When I was pregnant first time around I weighed myself every morning. I avoided chocolate and anything fattening. I weighed out portions of food according to my pregnancy book’s instructions. I panicked if I had put on more than I “should”. I felt like I was on a radical diet. Once she was born, I lost the 6lb of ‘baby fat’ within a month. But I was exhausted all the time. With the other two I didn’t care (too busy to care). I ate what I wanted, when I wanted – tried to make it healthy but didn’t obsess. It was SO much more relaxing just to throw out all that weight worry for nine months. I was a stone heavier for a few months after the other two births, but it came off. And I had more energy with the second two babies. All my babies were healthy – and similar sizes – at birth. Looking back on it, that first time weight obsession was a ridiculous waste of time and energy.’ Jules (40), mother of Chloe (7), Madeleine (4) and Daniel (1)
Fat fascism
Zoe, 33, was about three stone overweight at the start of her first pregnancy. ‘Because I am fat, my GP treated me like a pariah. I was barely through the door on my first visit and he was talking about caesareans.’ In the end, Zoe gave birth to her 8lb daughter in water after a healthy pregnancy and eight hours of drug-free labour.
If you are overweight you may, like Zoe, experience confidence-sapping comments. The best advice is listen to the health professionals but get facts not opinions or knee jerk prejudices (ask, if necessary, for references so you can look yourself). Do not allow anyone to force you into believing that because you are overweight, you will necessarily have a complicated pregnancy and birth. Here are the basic things you should know about obesity and pregnancy.
Being clinically obese (two to three stone overweight, BMI over 35), rather than just a bit chubby has the following documented risks:
1 It can be harder for midwives and doctors to assess the pregnancy and labour as it is harder to feel the baby and your womb. (Some health professionals, by the way, can be offensive. ‘I can’t see baby, because of too much mummy,’ snapped one sonographer to a friend of mine, who, while plump and curvaceous is certainly not vastly overweight.)
2 You will be, statistically, more prone to pregnancy complications like hypertension, pre-eclampsia and oedema – where your body swells more because of fluid retention.
3 You have a slightly higher risk of developing gestational diabetes and consequently of having a larger than average baby.
4 You have a slightly higher chance of having a caesarean section (because of the baby’s size, or your blood pressure).
5 If you are obese and have a caesarean you have a slightly higher risk of some operative complications.
Ask your doctor to refer you to a dietician for dietary advice and support during pregnancy if you are obese, and if any of the above worry you, discuss them in detail. Most overweight women have perfectly healthy babies.
Eating: the basics
Pregnancy eaters divide roughly into two extremes: neurotic self-abnegators, who take the books literally, cut out anything fun and start weighing out grams of fat and protein. And self-indulgers, who think ‘Wey hey! Eating for two!’ and start deep frying their Mars Bars. Ideally, you want to be somewhere in between the two. ‘Before you close your mouth on a forkful of food,’ says the pregnancy book that tyrannized me the most in my first pregnancy, ‘consider “is this the best bite I can give my baby?”…if it’ll only benefit your sweet tooth or appease your appetite, put your fork down.’ Now, forgive my selfishness here, but satisfying my appetite, and even – gasp – my sweet tooth are, I believe, not an insignificant part of my overall well-being. This kind of nutritional fascism should really be outlawed by publishers of pregnancy books. You are pregnant. You are not on a diet. You are not sick. You are not going to harm your baby if you have the occasional bag of maltesers. However if you start eating in earnest for two, three or four, polishing off an entire tub of Haagen Dazs on the sofa, and generally throwing caution to the wind you will put on extra weight (just as you would if you weren’t pregnant) and you might produce a slightly bigger baby. Being really too heavy will not help you feel good later in pregnancy, and of course it’ll be harder to shift afterwards. Perhaps most important of all, you may not be giving yourself and your baby adequate nutrients if you’re eating a lot of junk.
Most pregnancy books tell you that you only need to eat about an extra 300 calories per day when you are pregnant. This in itself is shocking news if you were expecting to be wolfing down the cream buns for the next nine months. Brace yourself now because many experts say the reality is even harsher than this. The most recent Department of Health guidelines conclude that (partly because of our reduced levels of activity, and partly because our metabolism alters) pregnant women don’t strictly need any extra calories whatsoever in the first two trimesters of pregnancy. In the final trimester – hooray – we need about an extra 200 calories a day (a couple of large bananas).
Most of us, of course, eat loads more than this – because it’s socially acceptable to do so when pregnant – and so we get a bit fat. This does us, and the baby, no harm. Most of us lose it afterwards if we eat sensibly and are reasonably active. (I put on 45lb with Sam largely as a result of moving to ‘supersizing’ America. My weight gain was technically 10lb or so ‘too
