Right Diet In Pregnancy .

It is important to get the nutrients you need both before getting pregnant and during your pregnancy.

In addition, there are a few special considerations for breastfeeding mothers. For more information, please see Nutrition Tips for Breastfeeding Mothers.

Calories

• Preconception — Make sure you get enough calories to maintain a reasonable weight. Adjust the number of calories you eat as needed to attain your weight gain or weight loss goals.
• Pregnancy — Increase your diet by 300 calories per day starting in the second trimester. Monitor for appropriate weight gain and adjust your diet as needed.
• Breastfeeding — Add 500 calories a day to your normal pre-pregnancy diet.

Protein

• Preconception — Protein should account for 12 percent to 20 percent of your daily calories. Make sure to eat 0.8 grams of protein per kilogram of your body weight (to convert pounds to kilograms, divide the pounds by 2.2), with a minimum of 40 grams of protein a day. For example, if you weigh 120 pounds, you should eat roughly 44 grams of protein a day.
• Pregnancy — During pregnancy, you should get a minimum of 60 grams of protein a day, which will account for approximately 20 percent to 25 percent of your calorie intake.

Carbohydrate

• Preconception — The amount of carbohydrates you should eat varies from person to person and should be based on an individualized nutritional assessment. That said, for most people, carbohydrates account for approximately 50 percent to 60 percent of their daily calories.
• Pregnancy — Some women experience gestational diabetes, or diabetes during pregnancy, which may require them to limit their carbohydrate intake to 40 percent to 50 percent of their daily calories. To learn more, please seeDietary Recommendations for Gestational Diabetes.

Fat

• Preconception — The amount of fat you should eat varies from person to person and should be based on an individualized nutritional assessment. For most people, less than 10 percent of their daily calories should come from saturated fat and up to 10 percent from polyunsaturated fat. Eating monounsaturated fat is preferred.
• Pregnancy — During pregnancy your body needs more fat. Roughly 25 percent to 35 percent of your daily calories should come from fat, depending on your carbohydrate goals. Eating monounsaturated fat is preferred over saturated varieties.

Fiber

Both before and during pregnancy it is important to eat between 20 and 35 grams of fiber each day. This is the same as the guidelines for the general population.

Sodium

Sodium intake recommendations both before and during pregnancy are the same as those for the general population: 3000 milligrams a day. In some cases, there are medical reasons to restrict the amount of sodium in your diet. Talk with your doctor if you are unsure about your sodium intake.

Alcohol

It is important not to drink alcohol both if you are planning to get pregnant and if you are pregnant. Alcohol exposure during early fetal development can cause serious problems for your baby.

Artificial Sweeteners

• Preconception — It is safe to use any artificial sweetener on the market.
• Pregnancy — The Food and Drug Administration (FDA) has approved aspartame, acesulfame-K and sucralose for use during pregnancy. Check with your doctor before using other artificial sweeteners.

Folic Acid

• Preconception — It is important to get enough folic acid, or folate, before you become pregnant. Begin adding 400 micrograms a day prior to conception to reduce risks of neural tube defects, such as spina bifida and anencephaly.
• Pregnancy — During pregnancy, increase your folic acid consumption to 600 micrograms a day.
• Breastfeeding — While breastfeeding, make sure to get 500 micrograms of folic acid a day.

Iron

• Preconception — Between the ages of 14 and 18, you need 15 milligrams of iron a day. Between 19 and 50 years of age, you should get 18 milligrams of iron a day.
• Pregnancy — During pregnancy you need more iron and should get 27 milligrams a day. Some women suffer from anemia and need even more iron, up to 60 milligrams a day as directed by their doctor.
• Breastfeeding — While breastfeeding you don't need as much iron and can reduce your intake to 9 milligrams a day, 10 milligrams a day if you are 18 years or younger.

Do not take your prenatal vitamin or iron at the same time as calcium.

Zinc

• Preconception — Between the ages of 14 and 18 you need 9 milligrams of zinc a day. Between 19 and 50 years of age, you should get 8 milligrams of zinc a day.
• Pregnancy — During pregnancy you need more zinc and should get 11 milligrams a day, 13 milligrams if you are 18 years old or younger.
• Breastfeeding — While breastfeeding you should get 12 milligrams of zinc a day, 14 milligrams if you are 18 years old or younger.

Calcium

Before, during and after pregnancy while breastfeeding, you need the same amount of calcium, although it does vary slightly by age. If you are 18 years old or younger, you need 1300 milligrams a day. If you are between 19 and 50 years old, you need 1000 milligrams of calcium a day.

Do not take calcium at the same time that you take iron or your prenatal vitamin.

 Reviewed by health care specialists at UCSF Medical Center.

This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.

How to Emotionally Prepare for Pregnancy?

Bringing a baby into the world can be an emotional roller coaster ride. During the nine months of pregnancy, feelings can wax and wane between excitement, joy, fear, and frustration. In the end, for most women it is a wonderful or at least, a rewarding, experience. However, how you'll feel during pregnancy is only one aspect of thinking things through carefully before becoming pregnant. The decision to bring a child into the world is one that requires carefully consideration, with the full intention to acknowledge all the responsibilities that this comes with. Many parents who get pregnant before they have fully discussed the various issues associated with pregnancy, childbirth and parenthood find themselves overwhelmed by the prospect of raising a child. By preparing emotionally for a pregnancy, you can eliminate some of the negative emotions that develop as a result of being emotionally unprepared.

Steps:

1.Speak with your partner openly about intentions and desires regarding raising a family. One of the worst mistakes that a couple can make is to delay the conversation about pregnancy and child raising until it is too late. It also unhelpful to be furtive about intentions, not talking but taking risks that expose you to pregnancy without sharing your hopes and wishes for the future with your partner. There are many important questions and concerns that should be discussed before starting a family. Some individuals have specific timelines in mind regarding a family, while others may care only about the number of children they have. Discussing all of the details surrounding raising a family is the first step in emotionally preparing for a pregnancy and is a sign that you have the maturity needed to become a parent to a small being who needs your every ounce of calm guidance. To begin your discussions about pregnancy and parenthood with your partner, try these approaches:

• If you feel uncertain, use a celebrity or television pregnancy as a springboard to discussion. Make comments about how you would feel about being pregnant like the person you're discussing and then lead into a discussion about the possibilities of pregnancy for the two of you.
• Tell your partner how you feel now about pregnancy. If you feel ready, then make this clear. Be sure that it is at a time in your lives where you're both stable enough and able to start raising a family––early on in a relationship is often an unrealistic time to raise this possibility, as is a time of emotional or financial turmoil in your lives.
• If your partner remains ambivalent, be considerate. It may take time to bring him or her around to your way of thinking and easy does it. Avoid badgering him or her, or insisting that you keep talking about it regularly. Give it a rest for a few months before returning to the discussion––this will give your partner time to think about what you've said.

2.Find useful and constructive information to inform your conversation. It's one thing to imagine what it must be like to be pregnant, and quite another to be in possession of the real facts and issues. It's recommended that you do a little research first and find useful resources to guide both of you in understanding fully what's at stake. A good place to start is with printed resources, such as self-help books, pregnancy books, parenting books, self-discovery books and resources printed by parenting and baby care groups. Such resources will help both of you to explore the health and emotional issues associated with pregnancy, including risks and stresses. Moreover, be sure to read beyond the pregnancy stage and read about early childhood, including about child raising impacts on your own choices of livelihood and lifestyle. Forewarned is forearmed and it is much better to know how you'll juggle two jobs, volunteer work, caring for an ailing parent and raising a newborn baby before you set out having a child than to find yourself suddenly having to work out the hows once the baby is born.

• Draw on naturally available, realistic sources of information––family members and friends who have already experienced raising children. Discuss the emotional nature of pregnancy and parenthood with trusted friends and family members. Individuals who have experience with pregnancy and parenthood can provide you with helpful advice and resources that can prepare you for the emotional changes that you will experience and the lingering emotional transformation caused by a newborn baby.

3.Consider starting a journal in which you can document all the feelings associated with the emotional pregnancy journey, including the decision to try to get pregnant. You might not even be the type who keeps a diary normally but this is probably the one time in your life when you'll love being able to look back and see what you experienced, as well as let your child read the entries some day. There is also a more practical element to doing this––it enables you to keep track of the highs and lows of your feelings and moods, which can be vital in reminding you that you are sane, it's just that tiredness and feeling a little blue at times can turn you into someone you least expected! A journal can be many things––it can help you organize your thoughts as you collect information from various sources, it can be a place for expressing your feelings, it can be where you keep price comparisons for all the baby items you think you need to get and it can be a place to keep medical notes too.

• Be sure to include information that you receive from conversations with your spouse or partner, suggestions from friends and family members as well as the facts that you absorb from print resources. Nurse and doctor suggestions that are helpful rather than medical in nature can also be kept in the journal for referring back to––in particular, midwives will have much helpful advice in general to impart.

4.Invest in a suitable method of contraception until you are ready to intentionally create a child. The most common cause of feeling emotionally unprepared is an accidental pregnancy. Your concerns can range from whether you've consumed alcohol during the baby's first weeks of formation, whether you've had adequate nutrition to give the baby the best start in life, through to whether you're actually ready at this point in time. Avoid these worries by properly planning when you want to conceive and only remove contraception from your regular routine when you choose the time. This way, you will both maintain control over the outcome and start off with the desire to create a family on your own terms.

5.Evaluate the financial ramifications of a pregnancy and of raising a child. Financial instability can contribute to emotional unpreparedness surrounding a pregnancy. Children are little "cost centers" and it's essential to have the means to care for a child properly or you'll risk feeling overwhelmed and possibly even resentful. Discuss the financial details openly with your partner, including expectations about who will take time off work and when, if at all, the partner principally responsible for at-home baby care will return to work. If you choose to be a stay-at-home mom or dad, there will need to be very clear financial strategies set in place to ensure that this decision doesn't mean you're stretched beyond your abilities financially. Be realistic here––thinking everything will be okay when you're already up to your eyeballs in debt is irresponsible. Clear the decks as much as possible where debts are concerned and remember that clean, used goods are fine for baby––you don't need the very latest or best in everything, provided what you buy is safe and clean.

6.Take care of your body physically. Caring for the physical needs of your pregnant body can help to prepare you emotionally for a pregnancy. Many women experience intense emotions as a result of hormone fluctuations and the dramatic changes that their bodies encounter during a pregnancy. Some women are shocked to find that they have "mommy brain" and can't think straight during some or all of the pregnancy. While this doesn't happen to all pregnant women, for those who do experience it, it can be very distracting. This might mean considering reduced duties if working, scheduling earlier bedtimes and getting help with things that you find tax your energy too much.

• Complications like diabetes or drastic weight gain can contribute to emotional stability during a pregnancy. If you have medical complications or weight issues, be in regular contact with your doctor and other relevant medical carers to ensure that you are getting the correct care at all times. Remember that no question is a stupid question––if you have a worry, you have a right to raise it and seek reassurance.
• By exercising regularly and eating a healthy diet, you can take greater physical control over your body. In turn, this can help to create better emotional control.

7.Prepare for the birth––and after the birth––during a pregnancy. Many women and their partners find emotional relief and stability when they tackle pregnancy-related tasks one at a time. Planning a baby shower, decorating a baby nursery, purchasing baby clothing and accessories, purchasing maternity attire and picking out a baby name are all simple, easy tasks that can be completed in stages so that a pregnancy doesn't become overwhelming. Moreover, be sure to attend birthing classes regularly and inquire about after-birth baby care classes too––you can never learn too early what you'll soon have to know how to do. Consider drawing up a timetable plan and marking in suitable times for each thing you'd like achieved. Most of all, aim to be as rested, contented and un-rushed as possible. Pregnancy can feel like forever but it is a time in which you can really nurture yourself as well as the baby and should ultimately be a time of personal contentment, if you let it be. Don't try to keep doing everything you've already done––dust bunnies can wait, as can hosting the dinner party for the curious.

• Be aware that many women experience what is commonly called "nesting instinct" toward the end of pregnancy, a period of intense activity arising out of a boost of energy that lets you get baby's room and requirements ready. This can help you to get those last minute things organized with pep.

8.Communicate regularly during a pregnancy. The best way to emotionally prepare before and during a pregnancy is to regularly communicate about your fears, your hopes, your desires and your anxiety. Communicating with your partner, your parents, siblings and friends will help to ease the emotional burden that is often associated with a pregnancy. You are going through a physically and emotionally challenging time and it is important to use the support of others to bolster your morale and to help you feel like you can cope. Even if you live far away from most family members, there are always hospital and midwife resources on which you can draw for added support, and the internet can be another source of support by checking out pregnancy forums and the like. Join a few online mom's groups when you've had a look around for ones you like––they're super for reassurance at 3 AM in the morning!

How to Manage Physical Changes in Pregnancy Through Diet?

Pregnancy is full of changes; each change has a marked reason and contribution towards baby’s development. Every physical and emotional change has little bit of discomfort to accompany. But such discomforts can be overcome if simple home remedies are followed. Let us see some of the methods.

1.Nausea or vomiting: take lemon with honey to eliminate fatigue and nauseated feeling. Lemon / orange peeled, cooked with jaggery and made as lemon marmalade by seasoning it with little cinnamon helps in the same.

2.Flatulence or Indigestion: drink warm jeera (boiled cumin seeds) water throughout the pregnancy. It helps in mobilizing nutrients to baby by enhanced digestion, avoids or eases flatulence, and helps in active digestion.

3.Anxiety: Drink sweetening cardamom with boiled milk to help soothe your mind and keep your body relaxed. The combination triggers the neurotransmitters to secret the serotonin to ease the mind.

4.Sluggishness/ fatigue: Try ginger or pepper tea in the evenings. It helps to keep your mind revived, fresh and energetic.

5.Anemia: Have the first morsel of food with curry leaves, salt, jeera powder, asafetida and melted ghee. It helps to keep your appetite satiated, provides you daily dose of natural iron. –( this tip is quite Indian type but foods like dates taken does the same thing).

6.Constipation: Eat spinach. They are juicy, fibrous and rich in antioxidants, iron, calcium, vitamins and folic acid to give you a great nutrient capsule for constipation. Make a soup, dhal, spinach rice or spinach seasoned wheat noodles or curries.

7.Heart burn: Drink diluted butter milk (diluted yogurt which is slightly sour and contains active good bacteria) with coriander. Add a little rock salt and little ginger. It helps in quenching thirst, keeps you cool and hydrated.

8.Aches and pain: Try garlic (2 or 3 in number) cooked with milk. It helps in controlling lipids and mobilizes fat and relieves aches and pain from weight bearing joints if there is gas trapped inside joints.

9.Hunger pranks: serve yourself with almonds, walnuts, pistas and raisins (each 3 in number) when you feel hungry. Chew them like a toffee, slowly and it helps in controlling between hunger pranks.

Tips :
1.Have a healthy pregnancy!!!

Back pain during pregnancy: 7 tips for relief

Back pain during pregnancy isn't surprising, but it still deserves attention. Consider seven ways to relieve back pain during pregnancy — from good posture and physical activity to complementary therapies.

Back pain during pregnancy is a common complaint — and it's no wonder. You're gaining weight, your center of gravity changes and your hormones are relaxing the ligaments in your pelvis. Often, however, you can prevent or ease back pain during pregnancy. Consider seven ways to give pregnancy back pain the boot.

No. 1: Practice good posture

As your baby grows, your center of gravity shifts forward. To avoid falling forward, you might compensate by leaning back — which can strain the muscles in your lower back and contribute to back pain during pregnancy. Keep these principles of good posture in mind:

• Stand up straight and tall.
• Hold your chest high.
• Keep your shoulders back and relaxed.
• Don't lock your knees.

When you stand, use a comfortably wide stance for the best support. If you must stand for long periods of time, rest one foot on a low step stool — and take time for frequent breaks.

Good posture also means sitting with care. Choose a chair that supports your back, or place a small pillow behind your lower back. Consider propping your feet on a low stool.

No. 2: Get the right gear

Wear low-heeled — not flat — shoes with good arch support.

You might also consider wearing a maternity support belt. Although research on the effectiveness of maternity support belts is limited, some women find the additional support helpful.

No. 3: Lift properly

When lifting a small object, squat down and lift with your legs. Don't bend at the waist or lift with your back. It's also important to know your limits. Ask for help if you need it.

No. 4: Sleep on your side

Sleep on your side, not your back. Keep one or both knees bent. Consider using pregnancy or support pillows between your bent knees, under your abdomen and behind your back.

No. 5: Try heat, cold or massage

Use a heating pad to apply heat to your back, or try ice packs. Rubbing your back also might help.

No. 6: Include physical activity in your daily routine

Regular physical activity can keep your back strong and might actually relieve back pain during pregnancy. With your health care provider's OK, try gentle activities — such as walking or water exercise.

You might also stretch your lower back. Rest on your hands and knees with your head in line with your back. Pull in your stomach, rounding your back slightly. Hold for several seconds, then relax your stomach and back — keeping your back as flat as possible. Gradually work up to 10 repetitions. Ask your health care provider about other stretching exercises, too.

No. 7: Consider complementary therapies

Some research suggests that acupuncture can help relieve back pain during pregnancy. Chiropractic treatment seems to provide comfort for some women as well. If you're considering a complementary therapy, discuss the options with your health care provider.

Know when to consult your health care provider

If you have severe back pain during pregnancy or back pain that lasts more than two weeks, talk to your health care provider. He or she might recommend medication such as acetaminophen (Tylenol, others) or other treatments.

Keep in mind that back pain during pregnancy might be a sign of preterm labor. Also, back pain during pregnancy that's accompanied by vaginal bleeding, fever or burning during urination could be a sign of an underlying problem that needs prompt attention. If you're concerned about your back pain, contact your health care provider right away.

Here are 7 changes that may need immediate action.

Discovering that you are expecting is emotional and exciting. Especially if it's your first baby, you may have a lot of questions about what's normal, what's not, and when you should call your doctor.

Most women will have healthy pregnancies. Taking care of yourself and heeding any changes in your health will probably go a long way towards easing your mind. Many of the changes your body will go through while pregnant are perfectly normal. Still, some deserve swift attention.

Here are seven symptoms, what they may mean, and what you should do about them. Of course, you should feel free to raise questions with your doctor at any point during your pregnancy, even if it's not on this list.

1. Vaginal Bleeding

What it may mean: "Some spotting is normal, but heavy bleeding could be a sign of miscarriage or ectopic pregnancy," says Natali Aziz, MD, a maternal-fetal medicine specialist at Lucile Packard Children's Hospital in Palo Alto, Calif.  "The brighter red the bleeding, the more significant it is," she says. 

"If you have bleeding and bad cramping similar to period cramps, this can be a sign of threatened miscarriage," says maternal-fetal medicine specialist Manju Monga, MD, of the University of Texas Health Science Center at Houston. "If this is coupled with sharp lower abdominal pain, it may be a sign of ectopic pregnancy," a serious complication that occurs when the fertilized egg implants outside the uterus, usually in the fallopian tubes.

What to do: "Call your doctor," Monga says. "Your doctor will likely do anultrasound, an exam, and some blood work based on your symptoms." Though most spotting or light bleeding may not be a serious problem, "you don’t want to ignore it if it is associated with cramping, heavy bleeding, or abdominal pain."

2. Excessive Nausea and Vomiting.

It's normal to have some nausea and vomiting during your first trimester. Most pregnant women go through that.

But if it's severe or makes you dehydrated, that's something to heed.

What it may mean: “Vomiting that interferes with your day-to-day activities can lead to weight loss, dizziness, dehydration, and an imbalance of electrolytes,” Aziz says.

What to do:  Tell your doctor. “You may need hospitalization to treat the dehydration, and many medications are available to control nausea," Aziz says.

Bottom line: "Nausea and vomiting are normal occurrences during pregnancy, but the extremes can cause problems," says ob-gyn Stanley M. Berry, MD, of William Beaumont Hospital in  Royal Oak, Mich. "The majority of women who have nausea and vomiting in their first trimester will go on to have normal, healthy pregnancies."

3. High Fever

A fever greater than 101 degrees Fahrenheit or 38 Celsius during pregnancy may be serious.

What it may mean: It could be a sign of infection, which could affect the baby.\

Fevers during pregnancy that are accompanied with rash and joint pain may be a sign of infection such as cytomegalovirus (CMV), toxoplasma, and parvovirus. "CMV is the most common cause of congenital deafness, and it is not as uncommon as we think," Aziz says. 

What to do:  "Report any fever plus upper respiratory symptoms, body ache, andflu-like symptoms or rashes and joint pain to your doctor," Aziz says. And get your yearly flu vaccine.

4. Vaginal Discharge and Itching

Some vaginal discharge is normal. But in some cases, "These may be be signs of treatable infections or sexually transmitted diseases that can have important consequences in pregnancy," Aziz says.

What this may mean: If it's an infection, it could harm the baby.

What to do: Don't be shy. Let your ob-gyn know what is going on down there because if there's a problem, treating it could make a difference to your baby.

5. Pain or Burning During Urination

What this may mean: "These can be signs of bladder or urinary tract infections, and if left untreated, they can lead to more serious illness, infection, pre-term labor, and pre-term birth," Aziz says.

What to do: If it's an infection, treating it can relieve your pain, and help assure a healthy pregnancy.

6. Leg or Calf Pain or Swelling on One Side/ Severe Headache

This won't happen in most pregnancies. But pregnancy does mean a greater chance of developing a blood clot.  

A blood clot in the calf may result in pain or swelling and can result in a blood clot that travels to the lung, which could be fatal.

A blood clot in the brain may be heralded by a severe headache. There are other possible causes of bad headaches during pregnancy.

What to do: If you have a history of blood clots, or if you get a severe headache, consult your doctor.

7. Flare-Ups of Chronic Diseases.

Women who have certain preexisting medical conditions -- such as thyroid disease,diabetes, high blood pressure, asthma, and/or lupus -- should note any changes in their condition during pregnancy.

What it may mean: If your underlying disease is flaring up or not well-controlled, it can have serious consequences for your health -- and your baby's.  

For example, "if your thyroid hormone is too high or low, you can be at an increased risk of miscarriage," says Gayle Olson, MD, a maternal-fetal specialist at the University of Texas Medical Brach in Galveston. Or, "if your blood sugar levels are not tightly controlled, you may be at increased risk of miscarriage or fetal abnormalities," she says.

The bottom line: "Any flare in an underlying condition is a red flag and should be followed up," Olson says.

Still, most women will have healthy pregnancies, Berry says, so try to enjoy your pregnancy.

"Stress is no good and the more positive the attitude, the better things are for mom and baby," he says. So make sure you have good prenatal care and a healthy diet, and get proper rest and take your prenatal vitamins.

First Trimester of Pregnancy

Wow, there's a lot going on in there as your baby begins to develop and your pregnant body starts to go through some (big!) changes. Here's more about what to expect in the first trimester of pregnancy.

You may not look pregnant yet, but chances are you're feeling it. That's because a flood of pregnancy hormones is prepping your body to play baby hostess for the next nine months. And that means you could be in line for a bunch of wackypregnancy symptoms from breast changes to bloating to fatigue to flatulence. Sure, you might be less than thrilled with some of the stuff you'll be coping with (did we mention heartburn and constipation?), but remember that these temporary discomforts are part of the incredible process that's happening inside: You're growing a child! 

During the first trimester alone your baby changes from a single fertilized cell (a zygote) to the embryo that implants itself in your uterine wall to a peach-sized bundle of growing limbs and body systems. So much happens in so little time: Organs take shape, baby starts to move (aroundweek eight of pregnancy), and hair follicles and nail beds form. More major first-trimester milestones include the formation of muscles, the production of white blood cells to fight off germs, and the development of vocal cords (I want Mommy!). 

For Mom, a lot happens quickly in the first trimester as well. At some point, you'll likely have a routine ultrasound to make sure things are progressing as they should, and ascreening (done through a blood test between 11 and 14 weeks of pregnancy) to look for chromosomal abnormalities such as Down syndrome and congenital heart defects. 

In terms of day-to-day stuff, by week five of pregnancy you may be well into morning-sickness malaise (which, unfortunately, doesn't just strike in the morning!). By week six, you might be wondering who replaced your boobs with those alien orbs (so tender, so tingly, and sooo big!). Pregnancy mood swings may hit by week seven, leaving you feeling up, then down, then up again — and that was just in the past five minutes! Weeks eight through 12 bring a laundry list of other possible pregnancy symptoms, including metallic taste, food aversions, and headaches. 

The thing to keep in mind when it comes to pregnancy woes during the first trimester is that every woman is different, so while your neighbor may have moaned about endlessly peeing, that may not happen to you at all. And just because your mom or sister reported cramping or spotting doesn't mean you'll do the same. No matter what symptoms you do have, take heart in knowing that most lessen or disappear as your pregnancy evolves. 

Your first ob-gyn visit may well be the longest as the doctor goes over your medical history and performs a thorough physical exam. You'll likely undergo a battery of tests including a Pap smear, urinalysis, and blood work to determine your blood type and Rh status, hCG levels, and the presence of any infections. You might also be screened for genetic illnesses or diabetes, depending on your family history. And while your practitioner is asking you lots of questions, be prepared to ask plenty of your own. Now's the time to inquire about prenatal vitamins, GERD, weight gain, sexual desire (or lack thereof), or anything (really…anything!) you might be concerned about. 

Weight gain during pregnancy

Being pregnant inevitably means you will gain weight. However, how much weight you gain varies from woman to woman. Whilst it often becomes a source of concern for many pregnant women many caregivers have become less inclined to regularly weigh expectant mums as part of their routine care. Frequent weighing can often only create anxiety for women about 'not putting on enough' or 'putting on too much' weight.

It is fairly common for caregivers to ask you to weigh yourself as part of yourfirst pregnancy visit. This is aimed at having a 'baseline' weight in case the doctor needs to prescribe drug dosages calculated on your average weight at some stage. However, beyond this weighing during pregnancy becomes a little irrelevant. Even so, some caregivers still continue to weigh women as part of their routine antenatal visits.

About weight gain:

Whatever your weight was before your pregnancy, and regardless of how much weight you are (or are not) putting on, it is important to have a well-balanced diet with plenty of carbohydrates, protein and fresh fruits and vegetables, with not too many fatty and sugary foods. Pregnancy is not an appropriate time to diet, nor is it an excuse to 'eat for two'! If you have a special diet, or any health conditions that require diet modification (such asdiabetes), you should consult with a dietician about planning your weekly meals.

Many information sources and pregnancy books will try to provide guides about the 'recommended weight gain' during pregnancy. These are usually along the lines of 'putting on 2- 3 kg in the first 20 weeks, then ½ a kilo per week until the baby is due, averaging 12-14 kg in total. While this may be true for some in women, in practise this is rarely the case.

Many women will put on most of their pregnancy weight gain during the first 20 weeks, or only gain a few kilograms up until 12 to 16 weeks of the pregnancy, then experience a large 'growth spurt' during the middle of their pregnancy up until about 32 weeks, slowing down their weight gain over the next 4 to 6 weeks and then losing 1 to 2 kg just prior to going into labour. A woman's overall weight gain when carrying a single baby may be as little as 8 kg, or as much as 20 kg.

NOTE: For conversion, 1 kg = approx. 2.2 lbs. To convert pounds into kilograms you divide the number of pounds by 2.2 (for example, 22 lbs ÷ 2.2 = 10 kg).

The 'average' weight gain of around 12 to14 kg can be physically attributed to:

baby = 3 to 4 kg

placenta = 0.5 kg

amniotic fluid = 1 kg

uterus = 1 kg

blood volume = 1.5 kg

breasts = 0.5 kg

Fat stores for breastfeeding = 3.5 kg

Fluid retention = 1.5 kg

Individual differences:

Each woman's body responds differently to their pregnancy and there are many reasons why individual women will put on more or less weight, at various stages of their pregnancy and yet still be classified as being 'normal' for pregnancy. This is particularly the case for women who were not within their 'ideal weight range' before they conceived. You can read about the concept of ideal weight ranges here.

While it can be difficult to generalise for each woman, the following are a few suggestions that may explain why you are gaining weight the way you are:

• Women who were relatively 'underweight' for their height before they conceived often find that their body naturally 'adjusts' by putting on more weight during pregnancy. This is because necessary fat stores are being laid down by the body to maintain the pregnancy and support breastfeeding after the birth. If this is the case, the woman's weight will increase by a certain amount (to be more in line with her 'ideal weight range' for her height), as well as her expected pregnancy weight gain. Even though the woman does not really look overweight, she has put on quite a few more kilograms than expected.

• Women who were relatively 'overweight' for their height before they conceived often find that they put on very little weight during pregnancy (or perhaps even naturally lose some weight at different stages). This is because the existing fat stores become depleted by the increased physical needs of the pregnancy and an increased metabolism. This is normal and regarded as being safe if you continue to eat a well-balanced diet.

• If you are excessively sick during the earlier months of pregnancy, you may find you do not put on any weight for a while (or possibly even lose weight). Usually when the nausea and/or vomiting settles, your appetite returns and you have a 'growth spurt' for a few weeks, as your body 'catches up'. Of course if your vomiting gets to the point where you are becoming dehydrated, it may be necessary to see your caregiver and be admitted to the hospital for a drip in the vein, and/or medications to help stop the vomiting. You can read more in morning sickness.

• Some women retain more fluid than others. Fluid retention and swelling (or oedema) affects about 65% of healthy pregnant women with a normal blood pressure, usually after about 20 weeks of the pregnancy.
• Most women carrying twins, triplets or more will put on more weight, however it is not 'double' or 'triple' the expected amount. Many women carrying multiples find that their weight gain is not that much different from women having a single baby. As a guide for twins you may put on up to 15 to 20 kgs (or more) and for triplets it may be up to 20 to 25 kgs (or more). Be aware that with triplets or quads, your babies will probably be born premature (less than 37 weeks) and therefore your weight gain will generally be put on early and more quickly.

Our thoughts...

Unfortunately, many pregnant women spend a lot of time and energy worrying about their weight gain. This is no doubt a reflection of our society's obsession with weight and how we look. An obstetrician we know once said, "The worst thing you can give a pregnant woman is a set of scales!" and we tend to agree with him.