$Unique_ID{PAR00408} $Font{NP} $Pretitle{} $Title{Pregnancy: The Second Month: Ask the Doctor} $Subtitle{} $Author{ Editors of Consumer Guide Ellis, Jeffrey W Ellis, Maria} $Subject{Second Month Ask Doctor Weight Gain nutrition health Backaches leg pain cramps stretch marks Visit visits blood pressure Baby Placenta Amniotic fluid uterus breasts urine sugar protein morning sickness frequent urination breast tenderness} $Log{ Components of Weight Gain*0040801.tif} Miracle of Birth The Second Month: Ask the Doctor How Much Weight Should I Gain? From the early 1950s until the early 1970s, pregnant women were advised to gain only ten to 15 pounds during pregnancy. It was thought that by limiting weight gain in the mother, the baby's weight could be kept low. This, in turn, was supposed to reduce the problems associated with delivering a large baby and cut down on the amount of weight the mother would have to lose after delivery. Today, however, recommendations for proper weight gain during pregnancy have changed--mainly because of concern over the effects of poor weight gain on the developing baby. A certain amount of weight gain--coupled with proper nutrition--is now expected and required to ensure both your health and the health of your baby. Your doctor, therefore, will check your weight during each office visit to make certain that you are not gaining too much or too little. Optimal Weight Gain The optimal weight gain during pregnancy for an average-sized woman carrying a single baby is 24 to 30 pounds. If you were underweight before you became pregnant, you will probably be encouraged to gain closer to 30 pounds, and if you were previously overweight, you will probably be advised to gain closer to 20 pounds. During the first trimester, your weight gain will probably be between zero and four pounds. Because of morning sickness, some women gain no weight and may even lose one to two pounds. This slight weight loss is not abnormal and will not harm the baby at this stage. During the second trimester, you will normally gain from 11 to 14 pounds, and during the third trimester, an additional 11 to 13 pounds. Another way to look at this is that after the first trimester, you will gain about one pound each week. The best time to weigh yourself is first thing in the morning when you rise from bed (if you have to urinate, do so before you weigh yourself). Many women will find that they weigh one to three pounds more at night than they did in the morning. This additional weight gain during the day is caused by retention of water, usually in the legs. When you lie down at night, this excess water will reenter your bloodstream and be eliminated in your urine the next morning. For this reason, what you weigh in the morning is considered to be your true weight. It is extremely important to note that while gaining enough weight is essential, you need to be sure that you are providing you and your baby with the nutrients you both need. To learn more about proper nutrition, see the section entitled "The First Trimester: For You and Your Baby". Where Does the Weight Go? Some of the weight gained in pregnancy is accounted for by the growth of your baby and some is accounted for by the changes in your body that are necessary to support the pregnancy. During the last month of pregnancy with an average-sized baby, your weight is distributed in the following way: - Baby ......................................... 7-8 pounds - Placenta ................................... 1 1/2 pounds - Amniotic fluid ............................. 1 1/2 pounds - Increase in weight of uterus ................... 2 pounds - Increase in weight of mother's blood ......... 3-4 pounds - Increase in weight of breasts ................ 1-3 pounds The remaining six to eight pounds is accounted for by the increased fat tissue and fluid that have accumulated in the mother. Most of the fat is carried in the hips and thighs. Too Much Weight Gain Weight gain in excess of 40 pounds will, in itself, have little significant effect on your pregnancy. Your baby will not grow much larger than he would had you gained a more moderate 25 pounds. Indeed, women who gain even 80 to 100 pounds during their pregnancies frequently have babies that weigh seven to eight pounds. The major problem with excessive weight gain during pregnancy is what it does to your body. Backaches, leg pain, cramps, and stretch marks occur sooner and maybe more severe if you gain excessive weight. On the other hand, with a more moderate weight gain, you're likely to look better, feel better, and have fewer aches and pains. Additionally, the more excessive your weight gain during pregnancy, the harder it will be to take the weight off after delivery. Sudden, excessive weight gain--that is, a weight gain of two to ten pounds over a period of one to three days--is a warning sign that may indicate preeclampsia (toxemia), a serious condition associated with high blood pressure and seizures. If you experience a rapid weight gain over a period of only a few days, call your doctor immediately. Too Little Weight Gain A total weight gain of less than 15 pounds during pregnancy may cause low birth weight and growth retardation in your baby. Such babies may develop mental retardation or learning disabilities later in life. This Month's Visit During this month's office visit, the doctor will probably: - Check your weight. By now, you may have gained about one to two pounds. - Check your blood pressure. Your blood pressure should be the same as it was before pregnancy. - Check your urine for sugar and protein. You should normally have no sugar or protein in your urine. - Ask about symptoms of pregnancy. By now, you will probably be experiencing morning sickness, frequent urination, and breast tenderness. - Ask how you are feeling. Tell your doctor about any unusual symptoms that you have noticed. - Check the growth of the uterus by doing a pelvic examination. By now, the uterus will be about four times larger than it was before pregnancy. - Examine the fallopian tubes and ovaries. They should not grow in size during a normal pregnancy. - Explain to you the results of the laboratory tests performed at your last visit. Your doctor will be able to tell you your blood type, blood count, immunity to German measles, and the results of the Pap smear. No new tests need to be performed this month, unless you are ill or have developed complications. - If necessary, give you prescriptions for the relief of pregnancy symptoms. During early pregnancy, it is best to take no medication other than iron and vitamins. But if you have severe nausea and vomiting, for example, your doctor may prescribe certain safe medications to make you more comfortable.