A healthy diet is essential for both the mother and the fetus during pregnancy (Brown 1998). Proper maternal nutrition is important for the development of fetal cells, organs, and central nervous system, as well as allowing the fetus to store essential nutrients for optimum growth. This is especially important in the last seven months of pregnancy when the fetus's weight increases from about 1 ounce to 8 pounds. Since the time of Hippocrates, there have been many diets proposed for pregnant women. When a woman is pregnant, her needs for calories, minerals, water, vitamins, and protein all increase, so Judith Brown recommends the following: sufficient fluid (eight to ten cups per day), no restriction of salt, no alcohol, and enough fiber to prevent constipation. A pregnant woman should follow the suggested food group distributions of the Food Guide Pyramid and consume about 300 more calories per day than she did before pregnancy. It is also important for pregnant women to have specific additional nutrients. The table, referred to as the recommended dietary allowances (RDAs) for pregnancy, provided by the National Academy of Sciences, recommends certain amounts of nutrients important for pregnant women. The key nutrients include folate, vitamin D, iron, zinc, calcium, and vitamin C. There have not been any studies of the effects of low-carbohydrate diets on the fetus. Therefore, it is safest to eat foods from all groups of the Food Guide Pyramid.
The debate about weight gain in pregnancy has been heated. In 1990, the U.S. Institute of Medicine liberalized its suggested maximum weight. General recommendations are that pregnant women should gain between 25 and 35 pounds during the nine months that they are carrying a baby. Average weight gain is distributed across each of the three trimesters as follows: 3-5 pounds in the first three months, 12-14 pounds in the second trimester, and 1-2 pounds per week in the final three months of pregnancy (Murkoff et al. 2002: 169-71). Recent studies have shown that there seems to be little ill effect to fetus or mother until the weight gains exceed 33 pounds. Low maternal weight has always been seen as an indicator of potential risk for infant mortality, disability, and mental retardation (Rossner 2002).
While it is not recommended for pregnant women to radically lose weight during pregnancy because it can deprive both the fetus and mother of essential nutrients, there has not been much research on the effects of eating disorders and pregnancy. The research that has been done, however, indicates that there can be negative effects on the fetus as a result of an eating disorder in the mother. It has shown that pregnant women with eating disorders often experience hyperemesis gravidarum (a disorder that includes severe nausea and vomiting during pregnancy), miscarriage, vaginal bleeding, hypertension, and radical weight gain or weight loss. The following are the most common fetus complications: low birth weight, cesarean section, and preterm delivery. Complications also include stillbirth, cleft palate, breech delivery, fetal abnormality, and prenatal mortality.
Poor nutrition, specifically folic-acid deficiency, has also been shown to cause brain and spinal cord defects in fetuses known as neural tube defects (NTDs). A study conducted found that women who reported dieting, defined as restricting food intake, throughout the first trimester of pregnancy were more likely to have babies with NTDs (Carmichael et al 2003). This study also showed that women who reported dieting three months before they were pregnant did not generally have infants with NTDs. However, another study found that women who used laxatives, barbiturates, and diuretics before or around the time of conception were more likely to have babies who had NTDs. It is believed that the increased risk of NTDs is due to the impact of dieting on consumption, absorption, and metabolism of nutrients, such as folic acid (Carmichael et al. 2003). Therefore, proper nutritional practices by the mother are essential for the brain and spinal cord in fetal development. Research indicates that women should be very careful if they diet during pregnancy. It is essential that these women consume enough nutrients to provide for themselves as well as the child that they are carrying. Neglecting to do so can lead to many health problems for both the mother and the baby.
Once the baby has been born, many women are concerned with losing the weight they gained while pregnant. There is much literature focused on techniques of how to lose the "baby fat." Weight Watchers, in particular, has many tips for new mothers. Some of these include:
Eat healthy foods. Set realistic goals. Reduce portions.
Eat small meals frequently rather than fewer large meals. Drink plenty of water. Exercise frequently.
Pregnancy can be a major mitigating factor in clinically obese women deciding to lose weight. The fear of "heavier infants, increased likelihood of cesarean sections, [and] prolonged labor" seems to encourage weight reduction (Rossner 2002: 445). The counterargument has now officially been made by the British National Health Service, which, in August 2006, has banned funding any in-vitro-fertilization procedures for morbidly obese women as a risk to the health of mother and child. Smokers can, however, have the procedures (Waheed 2007).
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