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Ideally, if there is a weight problem - be it underweight or over­weight - this should be tackled in the pre-pregnancy period to optimise conditions for pregnancy. Ideally.

Since we do not live in an ideal world, we need to deal with situations where women conceive while having a significant weight problem at each end of the spectrum. General measures will be to give appropriate dietary advice and monitor its effect on the mother and the pregnancy. This may even be a multi­-disciplinary measure involving a midwife, dietician, GP, obstetrician, physician and sometimes a psychologist. It is important that each case is individualized.
In between these two groups are those women whose body ­weight is within the normal range but who may be concerned about the aftermath of pregnancy on their bodies.

Weight gained during pregnancy, which roughly averages 12 kg (just under two stone), is relatively easy to shake off in the weeks after delivery.
If you think of the fact that a third or more of this weight is the baby, water and the afterbirth - which is instantly wiped off at delivery - you can breathe a little easier. Most of the remainder is actually retained water. Adjustment in the body's physiology after delivery will lead to this water being lost through urination in the few days following delivery. The only part that may require active input from the mother is the fat mostly deposited under the skin on the abdomen, upper thighs and lower back. This is well under half a stone (2-3.5 kg). Exercise in the period after delivery will take care of this. Breast­feeding may facilitate the overall strategy.

Of course, the weight gain and speed of loss differs from one individual to another and even from one pregnancy to the next. However, the general picture is similar. Here, we answer specific questions on this important subject.

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26. Weight and Pregnancy

Underweight Overweight Obesity and delivery Weight gain BMI Calculator

By Dr Joe Kabyemela, MD