Healthy weight and pregnancy: why it’s important

Healthy weight is part of overall health and wellbeing. If you’re trying to get pregnant or you’re already pregnant, it can also be good for your baby’s health.

Before pregnancy
Being in a healthy weight range can improve your chances of getting pregnant. It also improves your chances of having a healthy baby.

If you’re overweight and want to get pregnant, one of the best things you can do is lose some weight before you start trying to get pregnant.

If it’s too hard for you to get to the recommended weight range, even a small weight loss can help a lot. If you can lose 5-10% of your body weight now (for example, 5-10 kg if you weigh 100 kg), you reduce your chance of health problems and complications during pregnancy. For example, you’re more likely to have healthy blood pressure and less likely to develop pre-eclampsia.

If you’re underweight and want to get pregnant, or you have diabetes or digestion problems, speak to your GP or a dietitian for advice.

During pregnancy
If you’re healthy, it can keep your baby healthy during pregnancy and birth and after birth too.

It can also be good for your child’s health much later in life. For example, it cuts the chance of your child having diabetes, obesity and heart disease during childhood and even adulthood.

It’s best to talk with your doctor about a healthy weight for your body and ask about the best weight management options for you.

Practical tips for maintaining a healthy weight in pregnancy

Focus on important foods
Rather than concentrating on what you shouldn’t be eating, focus on eating healthy foods.

Eat:

• plenty of vegetables, some fruit, wholegrain breads and cereals for a wide range of vitamins, minerals and fibre
• low-fat dairy food (or alternatives like soy, rice or oat milk products) for calcium, protein and iodine
• lean red meat for iron and protein, and oily fish like sardines for omega-3 fatty acids and protein.

If you’re filling up on healthy foods, you’ll be less hungry and less likely to choose unhealthy foods.

Eat small meals regularly
This can help you with healthy weight gain and pregnancy issues like morning sickness and heartburn. Eating regularly also boosts your metabolism, helps to steady your blood sugar levels, and stops you from getting too hungry and overeating foods with too much sugar and fat.

Drink plenty of water
Water is the best drink for good health. Aim for at least 6-8 glasses a day. It can help to keep a bottle or glass of water handy.

Flavoured milks, soft drinks and juices can lead to extra weight gain because they have high amounts of sugar.

Avoid the cravings trap
It can be easy to eat a lot of chocolate, chips, ice-cream, lollies, flavoured milks, biscuits or cakes in pregnancy and write them off as pregnancy cravings.

Keeping these foods out of your cupboard has health benefits for the whole family, not just you. It’s also a good way to set up healthy habits for your children.

Be organised
Planning and preparing meals and snacks in advance helps you make healthy food choices.

Writing a dinner menu for the week makes shopping and cooking easier. And when you stock your cupboard and fridge with grainy crackers, fruit, wholegrain bread and salad ingredients, you’ve always got a healthy snack or lunch handy.

Reward yourself with non-food treats
Pregnancy can be challenging, so it’s natural to want a few treats. The trick is looking for treats that don’t involve food!

Instead, you could treat yourself to a movie, a phone call or catch-up with a friend, or a massage from your partner or another support person.

Be active
It’s recommended that pregnant women do at least 2½ hours of moderate exercise a week, unless your midwife or doctor tells you otherwise. To get this amount of exercise during pregnancy, you can try exercising for at least 30 minutes a day, 5 days a week.

If you weren’t exercising before your pregnancy, that’s OK. You can start with light exercise and build up to moderate exercise at a pace that’s comfortable for you.

Set yourself goals
It’s best to be specific. For example, you could say, ‘I’ll eat vegies with lunch and dinner every day this week’. If you set a goal that you can measure, you’ll know whether you’re achieving it.

Get support
Many health services and maternity hospitals around Australia have dietitians and extra support for pregnant women who are overweight or underweight. Ask your midwife or doctor what’s available in your area.

Setting goals with others can make it easier for you to reach your goals. For example, you could try preparing healthy meals and exercising with family and friends.

You might also find that tracking your progress can motivate you to make healthier choices about eating and exercise during pregnancy. Your midwife or doctor can recommend some online resources or apps.

Healthy weight gain during pregnancy

Your recommended weight gain range for pregnancy will depend on what your body mass index (BMI) was before you became pregnant.

The Australian Dietary Guidelines recommend that women who are:

• underweight (BMI under 18.5) gain 12.5-18 kg
• at a healthy weight (BMI 18.5-24.9) gain 11.5-16 kg
• overweight (BMI 25-29.9) gain 7-11.5 kg
• obese (BMI over 30) gain 5-9 kg.

If women have a BMI over 40, many doctors say they should gain less than 5 kg in pregnancy.

BMI gives a general guide to weight gain, but the recommendations for you might also depend on other factors – for example, if you have an Asian background or a lot of muscle. Your midwife or doctor will talk with you about what’s right for you.

Checking your weight during pregnancy
If you start pregnancy outside a healthy weight range, your weight should be checked at each antenatal appointment. If it isn’t, it’s a good idea to ask to be weighed or create a simple chart to track it yourself.

At your appointments, you can also ask about:

• why you’ve gained a certain amount of weight
• how to reduce weight gain in pregnancy
• how you can achieve your recommended weight gain – for example, healthy food alternatives
• how other things in your life might be affecting your weight.

Body mass index (BMI) identifies healthy, underweight, overweight and obese weight ranges. Your BMI is based on your weight and height. You can use a simple BMI calculator to find out which weight category you fall into. It’s best to use your pre-pregnancy weight.

Risks of underweight, overweight or obesity during pregnancy

Many women who are outside a healthy weight range have healthy pregnancies and babies. But there are health risks linked with being underweight, overweight or obese in pregnancy.

These risks increase if you gain too much or too little weight while you’re pregnant, even if you were at a healthy weight before pregnancy. The further your pre-pregnancy BMI or weight gain is from the recommended range, the higher the risk.

Underweight or not enough weight gain in birthing mothers
Increased risks for birthing mothers and babies include:

• miscarriage
• placental abruption
• premature birth
• low birth weight or babies being smaller than expected for their age.

Overweight, obesity or too much weight gain in birthing mothers
Increased risks for birthing mothers include:

• gestational diabetes, pre-eclampsia and urinary incontinence
• birth interventions like induction of labour and caesareans
• premature birth
• infection and/or longer healing time after a caesarean section
• postnatal depression.

Increased risks for babies include:

• stillbirth
• higher birth weight or being bigger than expected
• time in a neonatal intensive care unit (NICU)
• congenital heart disease
• overweight or obesity later in life.

If you do what you can to stay healthy and stick to the recommended weight gain guidelines for pregnancy, these health complications are less likely.

Weight loss after birth

It’s important to keep eating well and doing moderate physical activity after the birth. This will give you more energy to care for your new baby.

If you’re overweight or obese after giving birth, there are a couple of other ways to get to a healthy weight.

Breastfeed
Breastfeeding combined with a healthy diet can help with weight loss after birth because it burns extra calories. Breastmilk is all your baby needs until around 6 months.

Plan for weight loss
It’s a good idea to plan for losing weight once you’ve recovered from birth.

In the early weeks after birth, you can begin by just walking with your baby in a pram, baby carrier or sling. You could also join a community-run or private weight loss group or use a gym that offers child care. Many early childhood centres run free walking or exercise groups for new birthing mothers. There are also many free online workouts that you could try at home.

Your GP, dietitian or child and family health nurse could help with ideas and contacts, or you could look online for weight loss or exercise groups near you.

Weight management: other things to consider

Weight management is a complex issue.

Your mood and emotions can affect your ability to eat healthy food and be active. If you’re not getting enough sleep, it can be harder to eat well too. Physical symptoms like back pain can also get in the way of exercise.

Talking to your midwife or doctor about these issues and getting support can help you work out what’s affecting your eating habits and lifestyle. They might raise some of these issues in your antenatal appointments. But if the issues don’t come up, it’s a good idea for you to ask.

Your body image might also change in pregnancy. You can talk to your midwife or doctor about changes in your body and how you feel about these changes.

Where to get help with weight management

You can get help with and motivation for healthy living and weight management from:

• your GP, obstetrician or midwife
• a child and family health nurse
• family and friends
• a dietitian – find an Accredited Practising Dietitian
• a physiotherapist
• the Australian Breastfeeding Association
• local walking groups.