Prenatal Care: Weight Gain & Other Changes

Medically reviewed by Joan Lingen, MDWritten by the Healthline Editorial Team on March 15, 2012

Weight Gain

How much weight should you gain? Doctors recommend between 25 and 35 pounds for women who start their pregnancy at their ideal weight. For women who are above their ideal weight when they become pregnant, 20 to 25 pounds should be sufficient, and if you are obese, fewer than 20 pounds is recommended. Women who are underweight at the time of conception should probably gain 30 to 40 pounds. The goal is to have a fat reserve for the baby so that no matter what happens on any given day, the baby has a constant energy supply. Once the baby is born, you use the calories stored in fat to produce milk.

Keep in mind that weight gain in the first trimester is highly variable. There are women that gain up to 10 pounds from retaining fluids (water weight) and others that lose weight because they have been vomiting so much. As long as you are not underweight and losing weight, you don't need to be concerned.

It is sometimes hard in these early stages of weight gain to figure out what to wear because while you are not yet showing and maternity clothes are unnecessary, your regular clothes don't look or feel the same. Now is the time to start buying loose fitting, non-maternity skirts and pants with elastic waists that are a size larger than you normally wear. You won't be able to wear them for the entire pregnancy, but you will be able to wear them again once the baby is born.

Breast Changes

Breast changes are usually the first visible signs of pregnancy. The breasts, responding to the hormones estrogen and progesterone, begin to change as early as a few weeks' gestation-they may become swollen, warm and tender, heavy and sore. Some women notice a tingling sensation in the nipples as well. These changes occur as the breasts' milk-producing glands develop and their blood supply increases. Symptoms of breast changes are generally the most apparent during the first months of pregnancy.

During your first trimester, you can expect to increase a cup size. Thereafter, your cup size may go up once more. Of the 25 pounds that women on average gain during their pregnancy, two pounds go to the breasts. These breast changes may be more noticeable and uncomfortable for you if you naturally have small breasts or if this is your first pregnancy.

Other breast changes that you may notice include:

  • darkening around the nipple (the areola);
  • increase in the bumpiness of the areolar glands;
  • the appearance of more veins in the breast; and
  • occasional shooting pains.

To help relieve soreness, some women enjoy breast massage and warm showers. If the new size of your breasts is making you uncomfortable, you may want to purchase a support bra, which can be worn throughout the day and even during sleep.

Pelvic Discomfort and Abdominal Fullness/Bloating

You don't have to be showing to feel the changes in your pelvis. Don't be alarmed if you feel "full" in your belly, cramps, or pain when you shift positions. Your uterus is growing to accommodate your baby. As it expands, your uterus stretches the ligaments that support it in the pelvic cavity. You may find that certain positions are more comfortable than others because there is less tension on these ligaments. Stick to these, and shift positions slowly.

Other Physical Changes

Some of the other changes that may occur during the first trimester include staining/spotting (as the embryo implants itself in the uterus, it hits blood vessels that can then bleed) and itchy skin (more of a problem later in pregnancy).

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