Prenatal Program

The routine "weigh-in" at the doctor's office during pregnancy visits is met with different emotions by different women. Some may have been battling with their weight for years, while others haven't stepped on a scale in the same amount of time. There are women who see the inevitable weight gain of pregnancy as "getting fat" while others see it as a sign that they are "growing the baby well." Many women worry that they are not gaining enough weight, while others give themselves carte blanche to eat for two. Only one thing is certain; there is uncertainty about the expectations of how much weight a pregnant woman should gain.

There are published guidelines for weight gain during pregnancy based on a patient's body mass index (BMI). Women who are underweight should gain between 25 and 40 lbs during pregnancy, normal weight women should gain 25-35 lbs, overweight women should gain 15-25 lbs, and obese women should gain 11-20 lbs. However, it may be appropriate for very obese patients to gain almost no weight during pregnancy, so the guidelines need to be tailored to individual patients. Interestingly, women who are underweight or of normal weight tend to underestimate the amount of weight they are supposed to gain, while women who are overweight tend to overestimate the amount of weight they think they should gain. This problem is sometimes made worse by a lack of guidance or incorrect information from doctors.

But why does weight in pregnancy even matter? Unfortunately, obesity in pregnancy is associated with many poor outcomes; miscarriage, high blood pressure, toxemia, gestational diabetes, oversized babies with huge shoulders, and even stillbirth are all nearly twice as likely in obese women. Obese women are more likely to end up with a cesarean section or a forceps or vacuum delivery, and when they do have surgery, they are more likely to have problems such as wound infections and excessive blood loss. Anesthesia is more difficult to administer to obese women, as well. Obese women may not realize that it is difficult for health care providers to ensure the wellbeing of their fetus both before and during labour, as the ability to perform proper ultrasounds and monitoring are compromised.

Pregnant women are also concerned about how much exercise is acceptable or recommended during pregnancy. The Society of Obstetricians and Gynecologists of Canada recommends that all healthy women should be encouraged to participate in aerobic and strength-conditioning exercises as part of a healthy lifestyle during their pregnancy. The Canadian guidelines go on to describe common sense recommendations for exercise in pregnancy; the goal should be fitness rather than training and one should try to avoid sports where one might lose one's balance. There is no research that exercise increases the risk of bad outcomes - just the opposite, there is mounting evidence that exercise in pregnancy may reduce bad outcomes by keeping maternal weight gain in check and improving cardiovascular health.

Another reason to watch one's weight gain in pregnancy is to minimize the amount of weight than needs to be lost once the baby is born. The old adage of "what goes up must come down" doesn't seem to apply to excessive weight gain during pregnancy. A recent study found that women who gained more than thirty-five pounds during their pregnancy were over 800% more likely to retain ten of those pounds. In fact, it is well known that high pre-pregnancy weight, excessive pregnancy weight gain, and postpartum weight retention contribute to the long-term risk of obesity in women.

Of course weight in pregnancy can be managed. Using the tools BMI has developed over the course of thousands of patients we have put together our own series of prenatal programs designed not only to help you navigate healthier pregnancies but also geared to help prepare you for the postpartum period by teaching you about healthy infant, toddler and child nutrition and feeding. BMI's innovative and forward thinking prenatal programs carry on their commitment to evidence-based practice and excellence in care and are the first of their kind in Ottawa. Overseen by Dr. Glenn Posner, Assistant Professor in the Department of Obstetrics and Gynecology at the University of Ottawa BMI's prenatal program addresses all facets of pregnancy weight gain - diet, fitness and behavior, and does so with a healthy, supportive, non-judgemental, motivational attitude.

Two options will be available: Prenatal Lite and Prenatal Core.