Ask the Expert

The healthy ups and downs of pregnancy

2012-08-18T12:00:00Z The healthy ups and downs of pregnancyBy Lesly Bailey nwitimes.com
August 18, 2012 12:00 pm  • 

Pregnancy is a journey in weight gain and loss that may be different for each individual woman, but can be the same healthy process for all women. Dr. Douglas Dedelow, an obstetrician and gynecologist with the Community Healthcare System, says women should strive to start a pregnancy with a solid, healthy base.

How should women prepare for pregnancy?

They want to put themselves in the best physical shape they can be on many levels, including being at an appropriate weight if possible. An ideal BMI is between 19 and 26. Those that cannot achieve that can start eating right with a well-balanced diet and by avoiding fast foods. It’s better to put yourself in a position to be going into a pregnancy with a healthy diet as opposed to catching up once the pregnancy begins. Exercise is an important part as well as avoiding alcohol, tobacco and drug use.

What is a key component of the nutritional side of preparation?

We are trying to encourage women to take a multivitamin every day whether they are trying to get pregnant or not, as a large number of pregnancies are unplanned. Folic acid is encouraged by the March of Dimes to decrease the risk of birth defects. Women of reproductive age should be taking 400 micrograms of folic acid every day.

How should women work with their doctors leading up to pregnancy?

If women are planning a pregnancy, they should sit down with their doctors and discuss their medical history as well as rule out any medical problems that may cause potential issues. These may need to be addressed prior to the pregnancy. It is also beneficial to outline any genetic and family history that may affect the pregnancy.

What are the guidelines for a healthy weight gain?

How much weight a woman should gain depends on where she starts. If she is underweight, we encourage 35 to 45 pounds and for those who are obese, 10 pounds. Women on average should gain between 25 and 30 and those considered overweight but not obese should gain about 15 to 20 pounds. More weight gain doesn’t translate to a healthier pregnancy. Some women believe you have to put on a lot of weight.

What are the issues that can arise if a woman gains too much or too little?

Being underweight can translate to growth issues and small babies, which may sound good for delivery, but can lead to neurological or developmental problems during childhood. At the opposite end, obese women can have a multitude of issues from larger babies and hypertension to gestational diabetes and delivery problems. If a woman is gaining too much weight, she can develop a bigger baby than if she had a more normal weight gain process, and that can lead to a difficult delivery.

What advice do you give patients who are struggling to keep their weight gain on track?

I certainly strive to be positive and encouraging when women are struggling. It’s very important to encourage patients to stick with it. If a patient seems to be doing all the right things, I may suggest they have a dietary consult with a nutritionist. An expert can look at their situation and caloric intake and really pinpoint where they are either lacking or doing things in excess. Just because you eat a small portion—it may have a ton of calories in it and not everyone realizes that fact. A consult also outlines an appropriate diet and caloric needs for different trimesters. We try to be as supportive as possible if a woman is really struggling. Maybe we will uncover an eating disorder or stress outside the pregnancy—you know how complex life is—and we try to help them with that issue or problem.

What should women expect after pregnancy?

They should continue to do the right things and maintain exercise and diet plans. Weight loss is dependent on the mom and how she can get back to a normal routine. The more weight she puts on the tougher it is to take it off. If you start at 130 pounds and gain 60, it is going to take longer and there is more work involved. Generally, it all comes down to desire to get the weight off, but it can be tough and women have to be realistic about what they can achieve.

 

Dr. Dedelow has offices in Hobart, Valparaiso, Winfield and Portage and is affiliated with Community Hospital in Munster and St. Mary Medical Center in Hobart. Visit comhs.org for more information.

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