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by Dr. Crystal M. Newby, MD

Weight gain is a sensitive subject for everyone. And it can feel even more sensitive and complicated in the context of pregnancy when your body is changing quickly, and in ways that are beyond your control. It is perfectly normal and even healthy to gain weight in pregnancy, but how much weight should you expect to put on, and at what rate?

Eating for Two? 

Pregnancy is the one time in a woman’s life when she might feel like she is finally able to stop watching her weight and indulge in every late night craving. On the other hand, it may be a time of anxiety for other women as they watch their bodies change and the number on the scale rise.

The overall goal for any pregnancy should not be about a particular number on a scale or comparing your baby bump to anyone else’s baby bump. It should be about achieving or maintaining your personal level of optimum health. This is best for you and for your baby.

Pregnancy Weight Gain Over Time

What is the Magic Number for Pregnancy Weight Gain?

But how much weight should a pregnant woman gain? The answer depends on your pre-pregnancy weight. For example, if you are underweight before you become pregnant, you may need gain more weight than a person who became pregnant when they were overweight. Again, the goal is about being your healthiest self.

A certain amount of weight gain is necessary for optimal neurologic (brain) development and growth of the baby, but too much weight gain may increase the possibility of developing diabetes or increased blood pressure and make it more difficult to return to your pre-pregnancy weight. Also, the necessary weight gain would be different if you are pregnant with multiples.

Weight gain in pregnancy is measured by an individual’s Body Mass Index, or BMI. BMI measures body weight in kilograms divided by the square of your height in meters and it is used to find an individual’s mass. Your BMI determines if you are of a normal weight, or underweight or overweight, irrespective of body type or build. How much weight you should gain during your pregnancy depends on your Body Mass Index (BMI). The BMI is your weight divided by your height squared (kg/m).

Recommended Pregnancy Weight Gain Chart

Pre-Pregnancy Weight by BMI Recommended Weight Gain
Less than 18.5 BMI (Underweight) 28 to 40 lb. (13 to 18 kg.)
18.5 to 24.9 BMI (Normal Weight) 25 to 35 lb. (11 to 16 kg.)
25.0 to 29.9 BMI (Overweight) 15 to 25 lb. (7 to 11 kg.)
Higher than 30 BMI (Obese) 11 to 20 lb. (5 to 9 kg.)

According to the American College of Obstetricians and Gynecologists, a person who is underweight (BMI less than 18.5) should gain between 28 and 40 pounds during pregnancy. A person of normal weight (BMI 18.5 to 24.9) should gain between 25 and 35 pounds, and an overweight person should expect to gain between 15 and 25 pounds. (These figures are based on single births, so moms of multiples – do not hold yourself to the same numbers!)

Guidelines for Pregnancy Weight Gain

According to the American College of Obstetricians and Gynecologists, a person who is underweight (BMI less than 18.5) should gain between 28 and 40 pounds during pregnancy. A person of normal weight (BMI 18.5 to 24.9) should gain between 25 and 35 pounds, and an overweight person should expect to gain between 15 and 25 pounds. (These figures are based on single births, so moms of multiples – do not hold yourself to the same numbers!)

But where do these numbers come from? After all, the weight you gain isn’t all baby! In addition to the weight of the baby, those extra pounds are gained from increases in fluid and blood volume, the placenta, enlarged breasts and uterus and extra fat and protein stores which are important for lactation.

Healthy weight gain should happen incrementally throughout pregnancy. For someone whose BMI is determined to be in the “normal” range, it is expected that she will gain between one and five pounds in the first trimester and one pound every week thereafter. That is a relatively small amount of extra weight and does not require a significant increase in daily calorie consumption. Generally speaking, women do not need to increase their caloric intake at all in the first trimester and in the second and third trimesters, women need to consume only between 300 and 450 extra calories per day.

Adjusting Diet & Calorie Intake for Pregnancy

Fighting Fit During Pregnancy

So why can’t a woman gain as much or as little weight as she wants while pregnant?

Pregnancy is extremely taxing on the body, as is giving birth. A woman will be able to cope better with the physical demands of both if she is healthy and fit. Furthermore, the amount of weight a woman gains during pregnancy can have future consequences for her personal health, but it can also affect the overall health of her child.

Gaining less than the recommended amount of weight during pregnancy can lead to low birth weights in babies, which can contribute to complications after birth, such as issues with respiration, nursing, or an infant’s ability to maintain an appropriate body temperature. An infant born with a low birth weight can also suffer from health complications later in life.

Likewise, gaining too much weight in pregnancy can cause increased health risks for both mother and child. These risks include complications during delivery, such as higher rates of cesarean deliveries.  Higher birth weights can also have lasting effects on both mother and child long after the birth. An elevated birthrate in babies may lead to childhood obesity and other related health concerns, and excessive maternal weight gain in pregnancy can make it difficult for women to return to a healthy weight after the baby is born.

Pregnancy Dietary Guidelines

To maintain a balanced and nutritious diet throughout pregnancy follow these general guidelines:

  • Total calories: 2,200 to 2,900 calories per day (depending on your starting weight). Add 340 to 452 extra calories per day in the 2nd and 3rd trimesters.
  • Total Protein: 71 grams per day
  • Total Fats: Less than 65 grams per day
  • Fiber: 28 grams per day
  • Calcium: 1000 milligrams per day
  • Iron: 30 milligrams per day
  • Fluid Intake: 8 to 10 cups per day of mostly water
  • Caffeine: 200 milligrams per day
  • Herbal tea: two 8 oz. servings

Pregnancy Dietary Guidelines Chart

FOOD GROUP NUMBER OF SERVINGS
Grains, Breads & Cereals 9
Fruits 3
Vegetables 4+
Lowfat Meat, Poultry, Fish, Eggs, Legumes   2 or more - 6 oz.
Lowfat Milk, Yogurt, Cheese 3 or 4

Pregnancy Weight is a Balancing Act

Determining the appropriate level of weight gain for a healthy pregnancy is specific to every person. Women should discuss particular personal guidelines for gaining weight throughout their pregnancy with their medical provider. The goal should be maintaining or achieving your healthiest self for you and your baby, throughout the nine months of pregnancy and beyond.

For additional information, read these articles from the CDC, The March of Dimes, and The Mayo Clinic.

Questions About Your Pregnancy Weight Gain?

Concerned about how much weight you should gain in your pregnancy, or being underweight or overweight when you’re expecting? Contact your physician at Kansas City ObGyn to schedule an appointment at (913) 948-9636 or by email.


Dr. Crystal M. Newby, MD is a physician at Kansas City ObGyn. She received her medical degree from the University of Missouri - Kansas City School of Medicine. Dr. Newby married her fellow Kansas native high school sweetheart and they have 3 daughters.