Weight Gain
Q. I am three months pregnant and only weigh in at 109 - 110 lbs. Is that okay? I only weighed 107 at the beginning and I've had pretty intense morning sickness. I am 5'5" tall. Is this a normal weight?
-Anonymous, Idaho
A. Some women actually lose weight in the first trimester due to excessive morning sickness. On average, most women gain about three to four pounds in the first trimester, 14 to 16 pounds in the second and 10 to 12 in the third. Of course there's lots of variation from woman to woman regarding how much and when the weight gain happens.
With my first pregnancy, I gained 20lbs each trimester. My friend Carol lost 4lbs the first trimester and then gained 35lbs in the last two. Nancy gained 22lbs in the first trimester and 5lbs for the second and third. All of the aforementioned births and babies turned out just fine.
I wouldn't worry. It sounds like you are right on schedule.
Q. My husband and I are trying to get pregnant. With no luck, I am worried that the extra weight I carry is causing me to be unable to conceive. Do women who are overweight (slightly) have more difficulty conceiving than women who are within their normal weight range?
-Anonymous, New York
A. If you are slightly overweight (5lbs. to even 25lbs.), you should have no problem conceiving. There have been cases of women who are too overweight (or underweight) and have problems with reproduction. Your best indicator of whether your weight is interfering with conception is whether you have normal, monthly periods.
I did pregnancy both ways: the first time I started out a bit overweight and then continued to eat myself to oblivion; the second time I started at optimum weight and ate sensibly throughout. If you have a choice, I recommend starting out fit– pregnancy is a lot easier on the bod and the recovery is a lot faster.
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Q. I'm 19 weeks pregnant and my husband finds me to be very unattractive. He can't even look at me even when I have clothes on. He stated that I'm grouse and disgusting because I've gained some weight and my torso is discolored and puffy. Can I do a low carb diet without harming the baby?
-Chris, Washington
A. Unless you are gaining an unusual amount of weight, I would not attempt a diet. Most OB/GYNs say you should gain about 25-35lbs. during a pregnancy. My girlfriends and I like to stretch that rule a little to 35-50lbs. being okay. At this point in your pregnancy, you should be gaining about a pound a week. Dieting may deprive the baby of nutrients she/he needs for proper development. If you are convinced that you need to lose weight, consult your doctor before making a plan.
As for your husband, men's reactions to pregnancy can vary quite a bit. My friend Nicole's husband found her pregnancy and all of its symptoms to be fascinating and he was never more obsessed with her body. On the other hand, my friend Natalie's husband seemed to be threatened by the existence of the pending baby and withdrew physically from her until after the baby was born.
Remember that your body is a miraculous tool that is hard at work making a human life. You will notice changes as a result that may not always be glamorous. If your husband doesn't see and appreciate the beauty in your pregnancy, that's his problem. : p
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Q. I am only just pregnant and was wondering if it would be harmful to diet in the first three months. I would like to lose about 10 pounds before the second trimester comes and the weight starts to come too.
-Sue, New York
A. Unless you are obese and your doctor has told you that you must, I don't think dieting during pregnancy is a good idea. Proper nutrition and sufficient calorie intake during the first three months are especially critical to the baby's development.
The good news is that if you're worried about becoming a big fatty, you probably won't.
I did pregnancy both ways: the first time I ate like a fiend and became quite overweight. The second time I just ate when hungry and gained 20lbs. less. Of course, the second time I was much more conscientious about what I ate, as you seem to be.
Q. Can an OB/GYN really estimate the size of your baby? And, is it possible for the baby to drop its weight – let's say by 2lbs – from one week to the next?
-Fabiola, California
A. Estimate, guesstimate, same thing. By measuring your uterine growth and weight gain, an OB/GYN can guess at your baby's weight and size based on an average gestational chart. Of course, there's a lot of room for variation with amounts of placental fluid, thickness of the uterus, maternal weight gain, etc. Sometimes these estimates are accurate and sometimes they can be way off. My friend Suzanne delivered a 7lb 2oz baby, just like her doctor estimated. Wilma delivered an 11lb 4oz baby. That was about 4lbs off from her doctor's guess.
It's possible, but not usual, for a baby to drop its weight from one week to the next. It's more likely that your measurements were a little bigger the prior week due to water retention or other factors, making the baby appear to be bigger.
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Q. I am 31 weeks pregnant with my first child. I have gained 23 lbs. already, although everyone tells me that I don't look like I've gained any weight. While I continue to gain weight, I have been eating less and less and do not feel hungry at all. Is this normal? Should I try to make myself eat even though I have no desire to do so? Up until now I have eaten very well and had a diabetes test a few weeks ago that came back very good with no signs of any problems, including anemia.
-Maria, Idaho
A. It sounds as if your weight gain is right on target so you have no need for concern there.
Lack of appetite during pregnancy could be due to depression, thyroid dysfunction, diabetes, liver problems or it may just be a phase that will soon pass. Regardless of the cause, you should mention your lack of appetite to your OB/GYN and continue to get enough proper nutrition daily.
You might try drinking juice in the morning. Vitamin C has been known to stimulate the appetite. If you still are unable to eat much, I recommend drinking Ensure or a sports shake, or eating an energy bar, Total or Product 19 cereal as these items are packed with the nutrients a growing baby needs.
Q. I am extremely overweight. My periods are normal. I do not have PCOS (Polycystic Ovarian Syndrome) and I can feel when I ovulate. What are the fertility concerns with being obese? Can you explain insulin resistance and how it affects the hormones and how to reverse it? How long does it take to reverse? I have two children now and would like a third, but I don't seem to be getting any smaller over the years and it seems like it took losing weight for me to be able to conceive my second child.
-Anonymous, Wisconsin
A. If you are having normal periods, you are most likely ovulating regularly, which means you don't need to worry about PCOS or insulin resistance. PCOS can cause your body to be resistant to insulin, leading to the release of more and more insulin to compensate. The ovaries of PCOS women are sensitive to high blood levels of insulin and respond by overproducing androgens such as testosterone. This disrupts the feedback between the ovaries and the pituitary gland. Then the pituitary gland produces too much luteinizing hormone, which leads to more even production of androgens. The immature follicles in the ovaries then fail to convert the excess androgens to estrogen, which inhibits ovulation. Ovulation doesn't take place because the egg couldn't develop properly, and the immature egg, instead of being released from the ovary, becomes a tiny cyst that starts producing its own supply of androgens, which interferes with next month's developing follicle.
There may be no medical term for your fertility problem, but it probably has something to do with your obesity, especially since you mention it took losing weight to get pregnant the last time. Sometimes your body will not allow a pregnancy to develop because conditions are not right to physically carry a baby to term. I think losing weight now will give you the best chance for getting pregnant and delivering a healthy baby. If you are seriously motivated to get pregnant, you can use that same motivation to diet. And remember, the thinner you are before pregnancy, the thinner you will be after. It's much easier to lose those pregnancy pounds when you are not overweight in the first place.
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Q. I had my second C-section a year and a half ago. All was going well until five days after the procedure. I began to bleed profusely from my abdomen and was in excruciating pain. As it turned out, ALL of my internal sutures had broken (called an abdominal dehiscence). This was NOT doctor error. They broke opposite of the knotted end. But, I could have died. I was put into emergency surgery to be sewn back together. It was so scary. My husband is a nervous wreck about having another child and we do want more. I am insisting that the odds of that happening again are rare. What precautions could we take to assure a safer outcome? I am very overweight and wonder if this could have contributed to the situation. Are there safety measures for overweight C-section patients?
-Jackie, Wisconsin
A. Your weight problem was most likely the cause of your broken sutures from the C-section. If you get pregnant and have another C-section without first addressing your weight issue, I think your chances for this happening again are very high. This area of your uterus is already weakened and prone to opening again with excess stress. Depending on how your uterus healed, you may even be at risk for the scar opening again during pregnancy. If you really want another child, I think you should thoroughly discuss the risks of your scar opening with your doctor and make a plan to lose weight now.
Q. Before I was pregnant I weighed 140 pounds and I'm 5'7. About five months into my pregnancy I started gaining five pounds a week. My doctor said that I had high blood pressure and put me on medication right away. Because of that I retained a lot of water weight. I gained 100 pounds. I really was good about what I ate during my pregnancy. I don't really know how much fat weight I gained. Can you tell me how to get rid of that water weight quickly? I'm not breastfeeding.
-Anonymous, Arizona
A. Excess water weight can be shed by perspiring heavily, taking a diuretic or dehydrating yourself by not drinking, none of which will take off more than a few pounds for a few hours.
If you really want to lose weight, you've got to do it the old-fashioned way:- diet and exercise. The hard part is finding the will power to start. I've found my "one part torture, one part nurture" regimen to work best for me.
The torture is the diet part. It's best to immediately switch to a low-calorie, low-carb diet plan. There are lots of diets out there to choose from. You can shop around and see what suits you best. I did the SlimFast diet. Since I work a lot and don't have time to prepare my meals, it was easy to just grab a shake for a meal. The first three days of the diet are torture. After that, the stomach begins to shrink and the habits of eating start to change.
The nurture part is the exercise. The key is to start out slowly. Don't work out so hard that you become so sore that you never want to do it again. For example, you can start by walking 15 minutes a day. By the end of the week you may want to increase your time. A week later you may want to increase your speed to a fast walk. Another week later you may want to try running for a few minutes and then walk the rest. Before you know it, you'll be thin and doing 10K races, like I am now.
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Q. I am pregnant with twins and am concerned about whether they are gaining enough weight. I've had a hard time eating because of feeling so full, being exhausted and simply not being hungry. I am just starting my seventh month and have gained about 15lbs. I'm very athletic and started with a normal weight. What are some guidelines for weight gain for a woman pregnant with twins?
-Anonymous, California
A. Most OB/GYNs will recommend a weight gain of 35 to 45lbs. above your pre-pregnancy weight for twins. Not only is this weight gain going towards two babies' weight, but you should also remember that you will be carrying an extra placenta and amniotic fluid as well. At your stage of pregnancy, you should be gaining about 1 1/2lbs. a week. I can understand it's difficult to eat with all the stomach discomforts associated with pregnancy (times two), but I think you should try to gain more weight to give your babies the best chance possible for healthy development and delivery.
You might try eating several small meals a day instead of just a few large ones. It will be much easier to digest. Also, supplement your six to eight meals a day with snacks like calorie-packed energy bars or drinks such as Ensure. Do check the ingredients on the energy bars and drinks and avoid ones containing stimulants or too many chemicals. And, don't forget to visit your local bakery often. Although I wasn't pregnant with twins, I made a habit of having at least one giant (big as my size 8 shoe!) chocolate éclair each week.
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