How much weight should you gain during pregnancy?

The amount of weight gain during the course of a woman’s pregnancy has long been the object of debate among those in the medical community. “This has been highly controversial for a long time in the United States,” says Dr. Francine H. Einstein, assistant professor in maternal-fetal medicine at Montefiore Medical Center in the Bronx, N.Y. “In the early 1900s, physicians, concerned with complications resulting from excessive weight gain, recommended tight restrictions on weight gain, ideally 15 pounds. Later, it was recognized that poor weight gain in pregnancy was associated with low birth weight. As a result, the weight gain recommendations were liberalized and subsequently the trend has been for increasing maternal weight gain and birth weight.”

There are serious risks and complications associated with too much or too little weight gain during the course of pregnancy.

Dr. Einstein says today, fueled by the obesity epidemic, the debate continues and concerns about overgrown babies, Cesarean delivery and maternal obesity are echoed from 50 years ago.

Due to the ongoing concerns, the Institute of Medicine (IOM), based out of Washington, D.C., issued specific guidelines in 1990 about the amount of weight gain during pregnancy. Dependent on how much a woman weighed prior to conception, the IOM concluded the weight gain guidelines for pregnant women are the following: Underweight: 29 to 40 pounds; Normal weight: 25 to 35 pounds; Overweight: 15 to 25 pounds; Obese: at least 15 pounds.

Examining the Guidelines

Dr. Santosh Pandipati, fellow in maternal-fetal medicine, Department of Obstetrics and Gynecology at the University of Colorado Health Sciences Center in Denver, Colo., states the IOM recommendations are based on, “the initial body mass index (BMI) of the patient. Generally, the higher the BMI at the start of pregnancy, the lower the recommended weight gain. Women who follow the IOM guidelines have been shown to have the healthiest pregnancy outcomes as compared to women who gain below or above the recommendations.”