Focus on pregnancy weight gain a bit heavy handed

PUBLISHED : Tuesday, 14 May, 2013, 12:00am
UPDATED : Tuesday, 14 May, 2013, 12:00pm

It was a depressing morning. At an antenatal check-up I was told, not once, but twice, that I was fat.

"Aiyaaaah! Weight gain," the midwife cried when I stood on the scales. Minutes later, as I lay on the examination bed, the doctor grabbed some of my expanding stomach and said: "This is not uterus. This is fat!"

I have never been called fat before. I am naturally thin, I exercise regularly and eat healthy food. Yes, I have a hearty appetite and it has increased in pregnancy. I have allowed myself more than my normal quota of doughnuts and cake, but, damn it, I am pregnant.

A French friend tells me not worry: "They're comparing us to Chinese women, so, obviously, we're off the scale."

Is this true, I ask Karin Siegler, a midwife and director of Wellness and Birth pre- and post-natal services.

"Local doctors and nurses are always telling Western women they are too heavy because they are compared to Asian women," Siegler says. "Chinese women have a different metabolic system. They don't gain as much weight during pregnancy and their babies are often smaller."

Western health professionals generally don't specify how many kilograms a woman should gain during pregnancy because it depends on her original weight, Siegler says.

When pregnant, I have a much sweeter tooth. I had enormous chocolate cravings during my first pregnancy and the desire to consume cake is back with a vengeance.

"Cravings of sweet things are a problem of diet," says Siegler. "It means your blood sugar level is dropping too low. This is not surprising because your baby is absorbing a lot of your food. You need to eat more frequently than the usual three times a day when pregnant. If you eat things like nuts, seeds and fruit between healthy meals, the cravings will go. The key is to eat regularly."

Siegler says weight gain is more than just about fat. "A lot has to do with the baby's size, the placenta, growing breasts, the amount of amniotic fluid, water retention, more blood, the uterus," he says.

Oh goodie. I can say: "It's not me, it's my huge placenta." But I know I need to be sensible, not least because I want to fit into my pre-pregnancy jeans quickly after delivering.

But can it be bad for the baby to put on too much weight?

"Yes," Siegler says. "If a woman gains too much weight, her baby can get gestational diabetes. These babies don't mature as quickly in the womb and struggle to maintain good blood sugar levels after birth."

That's enough to make you put the biscuit down and reach for a carrot.

"Some [Western] women eat way too little in pregnancy to try to stop the baby getting too heavy because they're worried about the birth. This happens a lot in Hong Kong because women are told they are too big. This is dangerous because then the baby doesn't get the right nutrition to grow," Siegler says.

"Our babies are generally bigger. After birth, Western women are more likely to breastfeed than Asian women. It's well known that breastfed babies gain weight at a much lower rate than formula-fed babies. Then, the same women who, when pregnant, were told they were too big and their babies were too big, get told their babies aren't gaining enough weight after birth and are too small. It's crazy."

Siegler firmly believes that nutritional advice should be given to all pregnant women and that the focus on weight gain and constant scanning of women to check the size of their baby should be dropped from common practice in Hong Kong.

I couldn't agree more. Now, pass me that carrot, my placenta is hungry.