Putting on weight

Any woman with a bump knows that during pregnancy your body is under scrutiny. Your belly becomes a hand magnet and family, friends – even colleagues – keep up a running commentary on your size and shape.

For most women, that’s just part of the pregnancy package. All the attention may be welcome, or can take some getting used to, but we see the changes in our bodies as wondrous and miraculous. They mark our progress towards motherhood and signal baby’s healthy growth and development.

But for some, the thought of putting on weight, even an amount that is normal and necessary to sustain a baby’s development, brings with it fear and loathing. “Putting on weight seems to be the number one fear now, even before the pain of childbirth,” confirms Nasreen Jaffer, a dietician with an interest in paediatric nutrition.

“I’ve always been slim and attractive, and I’ve always been conscious of my weight,” says 30-year-old Kim Barnes. “And that didn’t change when I got pregnant. I found I became more and more anxious as I started to pick up weight.
“I didn’t realise before how much I relied on my looks and how comfortable I was in the body I had known all my life. I found the changes frightening. There was a definite sense of losing control and I became insecure about how people saw me. It became my secret mission to stay slim.”

And she did. Kim started her pregnancy weighing 55 kilos and ended it at 63, gaining just eight kilos. The recommended weight gain for her body type is between 13 and 18 kilos.

Kim’s baby boy, Adam, was born with complications six weeks early. “Having him in my life is such a joy. It puts everything in perspective. My obsession with being slim seems so superficial and meaningless in the big scheme of things. A few stretchmarks and a bit of extra weight is a small price to pay for the blessing of bringing a baby into the world.

“I regret now that I was so focused on me, so enveloped in my own insecurities. I was genuinely afraid that people would stop seeing me, and only see this pregnant woman. I see now that that could have cost my baby his health and even his life.”

how do I look?
But a body changing according to a new set of rules can be particularly unnerving for women, especially those like Kim, who are used to being in control of every aspect of their lives and who define themselves by their looks. There is no doubt that the anxiety of gaining weight is related to body-image issues.

“It’s about ‘how do I look’ without any real understanding of the good nutrition your body and baby needs,” says Dr Alison Sampson, a clinical psychologist with an interest in maternal mental health and a Fit Pregnancy advisory-board member. “It’s often a competition about how little one can put on but this is not psychologically or physically healthy.”
It appears there is this unspoken attitude that slim, preferably size zero, is the most desirable form during pregnancy. If you can buck the trend, and defy nature, you are highly esteemed.

How have we gone from thinking it’s OK to pile on weight when we are pregnant to thinking we shouldn’t gain any at all? The answer, it appears, is simply a reflection of what is admired in Western society.
“I feel very strongly that the stereotypes of body image that you see in advertising, the media, and those images peddled by celebrities do not have a good influence,” says Dr Sampson. “Popular culture is not kind to women.”
Dietician Karen Protheroe agrees. “Anxiety comes from competing with and comparing ourselves to others,” she says. “When we see public figures put on very little, women who don’t look pregnant from behind or until the very end, we aspire to that and think that’s what we should all aim for.”

You only have to look at celebrities in newspapers and magazines to see what the ordinary woman is up against. “We see far too many pictures in the press of new-mum supermodels (running around to glamorous lunches, stick-thin and skin glowing), which piles on the guilt when you feel like a sack of spuds yourself,” says Grace Saunders in her book The Fabulous Mum’s Handbook.

Am I still sexy?

An underlying and often irrational fear for many women is that the love and respect they receive is dependent on how they look. This fear can be perpetuated by passing comments from male colleagues such as, “Wow, you look great. You’ve hardly put on any weight.”

“Women put so much pressure on themselves to look like and portray what they think men want to see,” says Jaffer.
Some men are turned on by pregnancy, but some switch off sexually altogether, says Dr Sampson. A husband who is uncomfortable with his partner’s changing body brings added pressure.

Kim says, “My husband made some remarks in jest, which I must say really hurt. You are vulnerable as a pregnant woman. I think men often don’t really know how much we need their support and to feel unconditionally loved.”
Johannesburg psychiatrist Dr Rykie Liebenberg says our obsession with body image and weight is more common to women and has certainly increased in recent generations.

“Pregnancy will inevitably change the body shape and weight, and reinforce the fear of fatness, the restriction of food – especially fat, carbohydrates and proteins – and the distorted perception of their bodies as fat and ugly.”
These days, there are added pressures on women to multitask and be superwoman. We work up until the last possible minute, we continue with active social lives and want to look good throughout the pregnancy. In a world where elective Caesars are common, women have come to believe they can control their bodies and the process of making and delivering a baby.

For many women, says Dr Sampson, an expanding body is a source of panic but we shouldn’t feel we have to have control over everything. “It’s perfectly natural; go with it,” she says. Giving up to the experience and letting nature take its course does not mean “eating for two”. You can still exercise and eat healthily but the primary concern should be your baby’s needs, not your image.

What about baby?

Pregnancy places extra demands on a woman’s body and she requires extra nutrition for herself and her baby. Optimal foetal growth occurs only when the mother is able to accumulate a critical amount of extra body stores during pregnancy, explains Jaffer.

Sufficient energy must be available to, firstly, supply the increased energy and nutrient demands (including some maternal-fat storage and foetal-fat storage), and, secondly, to spare protein for tissue building. If you are slim and don’t pick up enough weight to support your baby, you start burning more of your own body weight and put yourself in danger of becoming severely underweight, says exercise science advisor to Fit Pregnancy Angie Lander.

“If a woman loses weight she can’t afford, it affects her health during pregnancy and breastfeeding, and her baby won’t get the nutrients she needs,” says Lander.
The baby is spared initially; it’s your body that takes the strain and bears the brunt of reduced nutrition. This can lead to calcium being leached from your bones, the early onset of osteoporosis and a negative effect on your blood pressure.

Even more important, of course, is the impact on your developing baby. Gynaecologist and obstetrician Dr Philip Zinn says inadequate kilojoule intake can lead to foetal-growth restriction, premature birth and iron-deficiency anaemia. The evidence is in the figures: studies show that if a woman who starts her pregnancy at a normal weight gains fewer than seven kilos, her baby is at increased risk of being small for its gestational age, suffering seizures, meconium-aspiration syndrome and a prolonged hospital stay.

A study at the University of Southampton in the UK found that lower nutrition levels in pregnant women of average weight were linked to a greater thickness of their children’s arteries later in life, putting them at greater risk of developing atherosclerosis and, as a result, heart attacks and strokes. Birth defects have also been linked to pregnancy “diets”, as have neural-tube defects, in which the spinal cord and brain don’t fully develop.

post-baby body
It’s not just during pregnancy but afterwards that new moms fret about their bodies. There seems to be more pressure than ever before to return to “normal” immediately after birth. This pressure is driving more women to have cosmetic surgery – and hospitals to offer them – including breast lift, tummy tuck/lipo and vaginal reconstruction.

But, as Dr Sampson says, “It’s important to connect growth in pregnancy with nutritional needs, rather than your looks. We shouldn’t override the body’s signals and natural functions. A psychological adjustment needs to be made, an acknowledgment of our divine feminine power and our incredible ability to create a gorgeous, healthy baby.

”When we prepare physically for the changes to come, we begin this process of adjustment, and open the way for the psychological changes to follow naturally.”
It’s such a unique and sacred process, properly nurturing a baby is our privilege and our responsibility.