Facts About Weight Gain

• For women who were normal weight before pregnancy with a BMI of 18.5-24.9, the recommended weight gain guideline is 25-35 pounds.
• Women who are underweight, with a BMI of less than 18.5, should gain between 28-40 pounds unless your healthcare provider says differently.
• Women who begin pregnancy overweight, with a BMI of 30 or more, should strive for a weight gain of 11-20 pounds unless directed differently by your provider.
• Eating healthy meals will allow you to gain adequate amount of weight during your pregnancy. Putting on weight that is unnecessary is easy to do when you’re eating junk food and foods that are higher in fat.
• Eating a well-rounded diet is important. According to the American Congress of Obstetricians and Gynecologists, a pregnant woman of normal weight who gets less than 30 minutes of exercise a week should strive for a caloric intake of 1800/day for the first trimester, 2200/day for the second trimester, and 2400/day for the third trimester.

These calories should be attained by eating a diet of grains, dairy, protein, fruits/vegetables, and healthy fats and oils. Limiting processed foods, sugars, and extra fat can help you attain your goals.

Weight Distribution in the Average Woman

• 7 ½ lbs is about how much the baby will weigh by the end of your pregnancy.
• 1 ½ lbs is how much the placenta weighs.
• 4 lbs is attributed to increased fluid volume.
• 2 lbs is the weight of the uterus.
• 2 lbs is the weight of the breast tissue.
• 4 lbs is because of increased blood volume.
• 7 lbs is attributed to maternal stores of fat, protein, and other nutrients.
• 2 lbs for amniotic fluid.
• Total: 30 lbs

On a Trimester Basis in a Woman with a Normal Pre-Pregnancy Weight:

• First trimester: 1-4.5 pounds
• Second trimester: 1-2 pounds per week
• Third trimester: 1-2 pounds per week

Exercise During Pregnancy

In this discussion of exercise during pregnancy, you will learn which muscle groups you should concentrate on when you exercise. Tips for exercising during pregnancy are also offered. You will find out what kind of exercise you are allowed to do and when you should stop exercising. You should not exercise to lose weight while you are pregnant.

When should I start exercising?

Childbirth is among the most physically stressful challenges a woman ever faces. Regular exercise during pregnancy:

• Strengthens muscles needed for labor and delivery
• Helps reduce backaches, constipation, bloating, and swelling
• Improves posture
• Gives you energy and improves your mood
• Lessons some of the discomforts of pregnancy
• Helps you feel less tired and sleep better

Exercise in preparation for pregnancy and childbirth should begin when you’re planning to get pregnant. The sooner you begin exercising, the better you will feel. A big mistake many women make is not starting an exercise program until the last 3 months because your enlarged uterus and breasts cause a shift of the physical center of gravity, effecting your balance.

Before you begin an exercise program, discuss it with you healthcare provider. Make sure you follow his/her advice on an exercise program that is appropriate for you. If you are experiencing problems with your pregnancy, you should not exercise. Exercise can affect the amount of oxygen available to your baby.

Which muscle groups are most important to exercise?

In addition to your heart, the three muscle groups you should concentrate on during pregnancy are the muscles of your back, pelvis, and abdomen. Strengthening your abdominal muscles will make it easier to support the increasing weight of your baby. You will also be able to push with more strength and more effectively during the last phase of delivering your baby.

Strengthening your pelvic muscles will permit your vagina to widen more easily during childbirth. This will help prevent urinary problems (leaking urine when you cough or sneeze) after delivery. Strengthening back muscles and doing exercises to improve posture will minimize the strain of pregnancy on your lower back. It will prevent discomfort caused by poor posture.

What Kind of Exercise Can I Do?

Many old ideas about strenuous exercise during pregnancy have been disproved in recent years. The type and intensity of sports and exercise you participate in during pregnancy depends on your health and how active you were before you were pregnant. This is probably not a good time to take up a strenuous sport. If you were active before you become pregnant, however, there is no reason you cannot continue within reason.

Walking: If you did not do any exercise before becoming pregnant, walking is a good way to begin an exercise program.

Tennis: If you are an active tennis player, you can probably continue to play unless you have special problems or feel unusually tired. Just be aware of your change in balance and how it effects rapin movement.

Jogging: If you jog, you probably can continue as long as you feel comfortable. Avoid becoming overheated, and stop if you feel uncomfortable or unusually tired. Remember to drink plenty of water.

Swimming: If you are a swimmer, you can continue to swim. Swimming is an excellent form of exercise. The water supports your weight while you tone and strengthen many different muscles. Scuba diving is not advised.

Golf and bowling: Both of these sports are good forms of recreation. You will just have to adjust to your enlarged abdomen. Be careful not to lose your balance.

Snow skiing, water skiing, and surfing: These sports can be dangerous because you can hit the ground or water with great force. Falling while traveling at such fast speeds could harm your baby. Talk to your healthcare provider before participating in these activities.

Climbing, hiking, and skiing above 10,000 feet: Elevation above 10,000 feet can deprive you and your baby of oxygen and cause premature labor. Avoid strenuous exercise at this altitude, especially if you normally live close to sea level.

What are the Guidelines for Exercising during Pregnancy?

Warming up and cooling down are very important. Start slowly and build up to more demanding exercises. Toward the end of an exercise session, gradually slow down your activity. Try working back through the exercise in reverse order.

Regular exercise (at least 3 times a week) is better for you than spurts of exercise followed by long periods of no activity.

Check your pulse during peak activity. Slow down your activity if your heart starts beating faster than the target range recommended by your healthcare provider. Don’t exceed a heart rate of 140 beats per minute. Exercise that is too strenuous may speed up the baby’s heartbeat to a dangerous level. In general, if you are able to carry on a conversation comfortably while exercising, your heart rate is probably within the recommended limits. Check to make sure.

Don’t try to do too much. Remember that the extra weight you are carrying will make you work harder as you exercise. Stop immediately if you feel tired, short of breath, or  dizzy.

Drink water often before, during, and after exercise to prevent dehydration. Take a break in your workout to drink more water if needed. Don’t participate in sports and exercise in which you might fall or be bumped.

Be very careful with your back. Avoid positions and exercises that increase the bend in your back. They put extra stress on the stretched abdominal muscles and compress your spinal joints. Deep knee bends, double leg raises, and straight leg toe touches also may injure the tissue that connect your back joint and legs.

Do not get overheated. Avoid outdoor exercise in hot, humid weather. Also avoid hot-tubs, whirlpools, or saunas. Becoming overheated during pregnancy increases the baby’s temperature. If the baby’s temperature increases too much, it can affect the cells developing in the baby’s nervous system and brain.

Do not exercise if you have an illness with a temperature of 100 degrees F or higher. Avoid jerky, bouncy, or high motions that require jarring or rapid changes in direction. Examples of such movements are those that can occur with contact sports, jump roping, and trampoline jumping. These motions may cause back, abdominal, pelvic, and leg pain. They could also cause you to lose your balance.

Wear a good fitting support bra to protect your enlarged breasts.

Make exercise a part of your daily life. Daily tasks can double a exercise sessions if you do the following:

• Tighten your abdominal muscles when you are standing or sitting
• Squat when you lift anything, whether it is light or heavy
• Rotate your feet anytime your feet are elevated
• Check your posture each time you pass a mirror

When Should I Stop Exercising?

You should stop exercising and call your healthcare provider if you have any unusual symptoms such as:

• Pain, including pelvic pain, uterine contractions, or chest pain
• Trouble walking
• Bleeding or leaking fluid from the vagina
• Fainting or dizziness
• An increase in shortness of breath
• Irregular heartbeat (skipped beats or very rapid beats)

Remember that it is very important to discuss you plans for exercise with your healthcare provider. If you are experiencing problems with your pregnancy, exercise is not advised. Talk to your healthcare provider if you have any questions.

*The Sports Medicine Patient Advisor

Protect your baby and yourself from Listeriosis

Pregnant women are at high risk for getting sick from Listeria, harmful bacteria found in many foods. Listeria can cause a disease called Listeriosis. Listeriosis can cause a miscarriage, premature delivery, serious sickness, or the death of a newborn baby. If you are pregnant, you need to know what foods are safe to eat.

How do I know if I have Listeriosis?

Because the illness could take weeks to show up, you may not know you have it:

• Early signs may include fever, chills, muscle aches, diarrhea, and upset stomach.
• At first you may feel like you have the flu. Later on, you could have a stiff neck, headache, convulsions, or lose your balance.
• Every year 2,500 Americans become sick from Listeriosis; 1 out of 5 die from it.

**Call your healthcare provider if you have any of the signs; it can be treated**

What should I do if I think I have Listeriosis?

• Clean: Wash hands often with soap and warm water. Use clean dishes, spoons, knives, and forks. Wash countertops with hot soapy water and clean up spills right away.
• Separate: Keep raw meat, fish, and poultry away from other food that will not be cooked.
• Cook: Cook food to a safe minimum internal temperature. Check with a food thermometer.
• Chill: Refrigerate or freeze within 2 hours; in hot weather (above 90°F), refrigerate or freeze within one hour. Don’t leave meat, fish, or poultry, or cooked food sitting out.

What can I do to keep my food safe?

• Listeria can grow in the refrigerator. The refrigerator should be at 40°F or lower, and the freezer 0°F or lower. Use the refrigerator thermometer to check your refrigerator’s temp.
• Clean up all spills in your refrigerator right away, especially juices from hot dogs, raw meat, or chicken/turkey.
• Clean inside walls and shelves of your refrigerator with hot soapy water, then rinse.
• Use precooked or ready-to-eat foods as soon as you can. Don’t store it too long.
• Wash your hands after you touch hot dogs, raw meat, poultry, seafood, or their juices.

What can I do to keep my baby and myself safe from Listeriosis?

• Do not eat hot dogs, luncheon meat, bologna, or other deli meats unless they are reheated until steaming hot.
• Do not eat refrigerated pate meat spreads from a meat counter or smoked seafood found in the refrigerated section of the store. Foods that don’t need refrigeration, like canned tuna and canned salmon, are okay to eat. Refrigerate after opening.
• Do not drink raw (unpasteurized) milk, and do not eat foods that contain it.
• Do not eat salads made in the store, such as ham salad, chicken salad, egg salad, tuna salad, or any seafood salad.
• Do not eat soft cheese such as feta, queso blanco, queso fresco, brie, camembert cheeses, bleu cheese, and panela unless it has been made with pasteurized milk. Make sure the label says, “Made with pasteurized milk.”

*For more information about food safety and recommended meat and poultry temperatures: U.S. Department of Agriculture.

Frequently asked questions and answers

Can I still drink caffeine when pregnant?

Yes, less than 200mg of caffeine or 1 cup daily

Can I use flea/tick solution on my cat or dog?

Yes

When can I find out the sex of the baby?

At 20 week U/S

Can I color my hair?

Yes, but wait until after 12 weeks

Can I get a perm?

Yes, but it may not last

Can I get a massage?

Yes, but it must be a maternity massage

Can I get a manicure/pedicure?

Yes

What can I do about leg and feet swelling?

Wear compression hose, drink lots of water, avoid salty foods, and elevate legs when possible.

What about leg cramps (charley horse)?

We are not sure what causes leg cramps, but try to straighten your leg and gently flex your ankle and toes back toward your shins several times

When do I get the glucose test?

At 28 weeks

Can I fly in an airplane?

Yes, but not after 36 weeks

What about long car rides?

Drink  plenty of water and have stretch breaks every 2 hours

Can I get in a hot tub/sauna

No, during first trimester. OK after first trimester, but get out of the water if you feel too warm.

Can I paint my nursery?

Yes

When can I first feel the baby move?

Around 17-20 weeks

Tanning beds?

Tanning beds are safe for the developing fetus but can give you skin cancer. Spray tans and self-tanning lotions are fine.

How many ultrasounds do I get in a normal pregnancy?

One in the beginning to establish a due date, and another at 20 weeks to inspect fetal anatomy

Is heavy white discharge normal?

Yes, from the hormones

Can I produce/leak breast milk?

Yes, this is normal, it can start at 20 weeks gestation

Can I still have sex while pregnant?

Yes, unless your provider tells you not to

Can I get dental work or x-rays?

Yes, we can provide a dental note if needed