Eating a range of nutritious food and staying physically active supports baby’s development in utero and helps to prepare the mother’s body for labour and recovery.[1] A woman’s gestational weight gain (GWG) and health behaviours during pregnancy are strong predictors of pregnancy complications and child health outcomes including childhood obesity.[2, 3]
- Use positive, health-focused language that minimises judgment.
- Pre-conception: Ask women about planning a pregnancy, and ask permission to discuss and assess preconception weight and explain its relevance.
- Antenatal: Calculate BMI at entry to care, weigh and plot at every antenatal visit.
- Pre-conception: Advise women of their weight range.
- Antenatal: Advise women of recommended GWG based on their pre-pregnancy BMI. Regularly monitor and discuss pattern and rate of weight gain. Encourage self-monitoring. Provide general information on optimal nutrition, physical activity and sedentary time.
Arrange referral to allied health services for women identified as at-risk. Ask women for follow-up appointment for weight monitoring.
Preconception BMI, and the amount and rate of weight gained during pregnancy influences pregnancy outcomes.[3]
Explain the purpose of assessing health behaviours, weight and weight gain during pregnancy and discuss sensitively and without judgement. With women’s consent, BMI should be calculated at their first antenatal visit and at every following visit and plotted on GWG charts.[1] This will allow for monitoring of healthy weight gain.
- Pregnancy weight gain chart for BMI less than 25kg/m2
- Pregnancy weight gain chart for BMI 25kg/m2 or over
It is important that all conversations are approached sensitively and respectfully. Women living with higher body weights are vulnerable to weight stigma when accessing maternity services. Compassionate care, free from stigma is fundamental in encouraging positive relationships and continuity of maternity care.[4]
Resources below can assist you to discuss and assess healthy gestational weight gain:
Resource
Author
Advise, assist, and empower women.
Provide women with appropriate advice on the benefits of a healthy diet and regular physical activity during pregnancy. Where behaviour changes are required, you can work with individuals to create SMART goals which are achievable and sustainable, and which are more likely to become habits.
Healthy eating:
The Healthy Eating during pregnancy resource outlines the amount of food and drinks adults are recommended to consume each day, along with tips and information.
Physical Activity
The guidelines for physical activity during pregnancy provides information on the amount and type of activity recommended during pregnancy.
Further resources below can be used to educate and advise women to adopt healthy behaviour changes that will help them work towards achieving their health goals:
Resource
Author
Patient information: Pregnancy after bariatric surgery or with a weight above a healthy range
Qhealth
Patient information: Pregnancy after bariatric surgery or with a weight above a healthy range
Qhealth
When supporting individuals with health behaviours and weight management, it is important to arrange follow-up appointments to continue to monitor progress and provide or coordinate required support. Antenatal interventions that support healthy gestational weight gain are effective and supported by strong evidence.[5]
Consider Referral:
Women with a BMI above or below a healthy weight range, or who are gaining weight during pregnancy at a rate above or below recommendations may benefit from referral for nutrition advice from an accredited practicing dietitian.[4] When making referrals, consider access to and costs of care and develop alternative care pathways for women who experience health inequalities as a result of social and cultural barriers.
Up-to-date information about the assessment and management of a range of conditions can be found on HealthPathways, find your local HealthPathways website here.
Programs and resources listed below may help facilitate health behaviour change for individuals, or provide additional support or management where appropriate:
Resource
Author
Health professionals are recommended to upskill in best-practice prevention, treatment, and management of individuals with overweight or obesity to continue to deliver care with empathy, confidence and success.
Further resources to upskill in prevention, treatment and management of overweight and obesity during pregnancy can be found below:
Resource
Format
Author
Supporting alcohol-free pregnancy and safe breastfeeding
eLearning
Foundation for Alcohol Research and Education
Clinical guidelines which may assist clinicians supporting healthy weight management in pregnancy are included below:
Resource
Author
- Department of Health (2020) Clinical Practice Guidelines: Pregnancy Care.
Canberra: Australian Government Department of Health. - Rath SR, Marsh JA, Newnham JP, Zhu K, Atkinson HC, Mountain J, et al. Parental pre‐pregnancy BMI is a dominant early‐life risk factor influencing BMI of offspring in adulthood. Obesity Science & Practice. 2016; 2:48-57
- e Jersey S, Guthrie T, Tyler J, Yin Ling W, Powlesland H, Byrne B, et al. Evaluating the integration of a pregnancy weight gain chart into routine antenatal care. Maternal & Child Nutrition. 2018
- Queensland Clinical Guidelines. Obesity and pregnancy (including post bariatric surgery). Guideline No. MN21.14-V6-R26. Queensland Health. 2021. Available from: http://www.health.qld.gov.au/qcg
- (i-WIP), T. I. (2017). Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials. BMJ, doi: https://doi.org/10.1136/bmj.j3119.
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Last updated 4 January 2024
