Embracing Motherhood at Your Fittest: Why the right time to work on yourselves is NOW

Dr Isra Halim
Dr Isra Halim

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My work place is currently bitten by the pregnancy bug- from colleagues delivering babies this week, to those due in the coming weeks, and those trying to conceive in the near future. The other day, a tea break conversation over maternal nutrition was interrupted by this 32 year old planning her 2nd pregnancy. Now, Mrs. A isn’t exactly lean to begin with. At 5 feet, 4 inches, she stands a cherubic mess at 89kgs. She pitched into the conversation, I will diet too, but not now.. till I have a baby, because the weight gain during pregnancy is inevitable. I shall ‘wait’ till then.”

By the way, her first born is now 7 years, and she has been ‘waiting’ since then, accumulating over months what she thinks will ‘shed’ once she starts breastfeeding her future kid- FAT !! What followed was a detailed conversation over losing weight before planning a baby- pre pregnancy nutrition and weight. Excerpts from the conversation: A. Pregnancy weight gain is NOT fat gain alone. i. Much of the weight is due to ‘water’ to support the growing fetus- its circulation, the amniotic fluid that cushions the baby, etc ii. A full term pregnancy accounts for 2.5-4 kgs of baby weight approximately iii. Only the remaining few kgs of weight gain account for the mother’s fat gain per se. B. How much weight gain is a healthy gain? As MBBS students, we would mug up the magic number of 11 kg gain for a full term pregnancy meticulously divided into absolute numbers for every three months (trimester). The recent recommendations are more evidence-based. Weight gained during a pregnancy actually depends on body mass index (BMI) BEFORE pregnancy- a marker that tells you whether you are underweight, normal, overweight or obese. Studies suggest that women overweight before pregnancy, should put on not more than 5-8.5 kgs of weight during their pregnancy. C. But more the weight of a female, the healthier her baby is?? Kareena Kapoor had a baby Taimur, without having to put on extra kgs before she conceived. The mother’s weight ‘alone’ is not the only indicator of a healthy baby weight- before or even during the pregnancy. Excess weight surely is a warning sign of her progressing to maternal diabetes (gestational diabetes mellitus) or hypertension (Pre-eclampsia and Eclampsia), besides a host of other complications. Hungry for more science, I read up recent literature on pre-pregnancy weight gain and here are some alarming stats I come across. Women who are obese BEFORE pregnancy have: i. A 6-fold risk of developing Diabetes ii. Are twice as likely to develop heart diseases iii. Are twice as likely to develop hormonal diseases (Raise your hands if you are or were a hypothyroid mum!) iv. 2.4 times more likely to develop psychiatric diseases, including post-partum depression. v. Are more likely to give birth to a whole generation of overweight brats! Worse, these effects have not been studied on a short-term basis alone. Obese women develop these diseases as long as 17 years after conception. Read it to believe it! (Moll U, Olsson H, Landin-Olsson M. Impact of pregestational weight and weight gain during pregnancy on long-term risk for diseases. PloS one. 2017 Jan 3;12(1):e0168543.) The 2009 Institute of Medicine and National Research Council Guidelines for Obese women support weight loss before pregnancy, to improve menstrual function, metabolic parameters and reduce infertility. Transformation stories at SQUATS are fraught with such examples. The American Council of Obstetricians and Gynaecologists also recommends women to lose weight BEFORE and not during pregnancy. The fitter you are before pregnancy, the faster you will bounce back into shape after it!! Meanwhile, Mrs. A, is all set to join the fitness bandwagon before the stork comes home. Fit mom- fit baby coming soon. Never too early to work on the finest version of yourself, girls!

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