Eating (Well) for Two (cont.)
You should also be drinking at least eight 8-ounce glasses of fluid a day, mostly water if possible, since dehydration can bring on premature labor. Fluids also will help reduce muscle cramps, swelling and urinary tract infections. "I tell patients to drink, drink, drink. Their urine should be so pale they can't see it in the toilet," says certified nurse-midwife Katherine Puls. If drinking with food exacerbates morning sickness, try filling your quota between meals rather than with them.
A Pregnant Pause on Thinness
One thing to keep in mind is that you'll gain about 25 to 35 pounds during your pregnancy. That isn't always easy to take, especially as the scale tips into never-before-seen territory, and you start feeling more and more like a beached whale. Most women will gain about 2 to 4 pounds during the first trimester, although some will stay the same or even lose a few pounds until morning sickness passes. A weekly gain of 1 pound during the second and third trimesters is common as your baby grows faster.
"Women get really uptight because for so long they've been fighting to keep their weight in line and now all of a sudden we're telling them to gain this much weight," says Ward. "But if you don't eat enough and gain enough weight, you'll have a baby that could be affected for the rest of its life because you wanted to preserve your figure." Women who don't gain enough weight in pregnancy are more likely to have small babies, and those smaller than 5 ½ pounds have a harder time surviving.
The gain can be especially difficult for those who battle anorexia or bulimia, but often the responsibility of bringing a new life safely into the world is enough impetus for women to overcome their eating disorders, if only temporarily. Puls often recommends keeping a daily planner to record what you've eaten, since eating disorders are often associated with control.
"I was not going to hurt my babies," says one woman, who did not want her name used because she still battles anorexia. During both her pregnancies, she managed to eat three meals a day and get the recommended nutrition. She gained 33 pounds each time, and her babies, both healthy, weighed 8 pounds. "Those are the only times since I was 18 years old that I didn't have an eating disorder," she concedes. Still, it was a struggle, and she obsessed about her weight. "I was really paranoid. But if I was good ... then on the days I weighed in, I'd go to the bakery after and reward myself with a smiley cookie."
If you are either under- or overweight, make sure you've discussed with your doctor or midwife an appropriate weight range to target. Women who start out underweight will probably have to gain more than the average mom-to-be, and those who weigh too much may be advised to gain less, in addition to being monitored for associated problems, such as high blood pressure and diabetes. If you're carrying twins, the American College of Obstetricians and Gynecologists recommends a weight gain of 45 pounds.
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