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Handouts: English (57.35 K PDF) | Spanish (63.41 K PDF)

Activity 1
Pregnancy - It’s a Weighting Game

Background on Pregnancy

Begin the session by asking participants to list one thing about their eating habits that they have improved or would like to improve because they are pregnant. Tell participants: The foods you eat and drink during your pregnancy can affect the health of your baby. The mother is the developing baby’s only source of the nutrients he or she needs to grow. If the mother does not provide the nutrients that the baby needs through the foods she eats, both mother and baby are more likely to have problems during pregnancy or after delivery.

Begin the Session

(1) Catch up from last lesson: briefly review the material covered in the previous lesson. Ask participants: What have you tried from last week’s session, or what have you done differently from the last time we met? Congratulate participants on their successes and encourage them to try new skills or behaviors. (2) Today’s lesson: briefly explain its purpose and some of the activities.

1. Ask participants: Since you became pregnant, has anyone told you, “Now that you’re pregnant, you have to start eating for two”? Does that mean that you need to double your food intake? How many extra calories per day do you think the average pregnant woman needs?

   Tell participants that women who have started their pregnancy at a healthy weight for their height need about 300 calories of extra energy per day during the pregnancy, which is about 15 percent higher than a woman’s usual calorie needs. This may need to be adjusted for women who are either underweight or overweight, or who are expecting twins or triplets. Even women who are overweight at the start of pregnancy should not restrict food intake or try to lose weight. Encourage participants to talk with their health care providers for specific information about how to best meet their calorie needs during pregnancy.

2. Ask participants: How much weight do you think 300 extra calories per day will cause you to gain? How much weight do you think you should gain with your pregnancy?
3. Tell participants the recommended weight gain levels below. Tell them that these ranges are general guidelines and that participants need to follow their doctors’ advice about appropriate weight gain:
   • 25 - 35 pounds for women who begin pregnancy at a healthy weight for their height
   • 28 - 40 pounds for women who are underweight
   • 15 - 25 pounds for women who are overweight
   • At least 15 pounds for women who are significantly overweight
   • 35 - 45 pounds for women carrying twins
4. Distribute the “Healthy Weights for Adults” handout (Table 1 below) and review, to help participants assess their pre-pregnancy weight and consider how much weight gain may be appropriate for them. Remind participants that this is only a general guideline and that they need to follow their doctors’ advice about how much weight gain is appropriate for them.
5. Tell participants that these ranges allow for differences in individuals. In general, young mothers (adolescents) and African-American women should gain at the upper end of the recommended range, because both groups are more likely to have small babies. Women who are short (for example, less than 5′2″) are often encouraged to try to gain at the lower end of their range

Table 1: Healthy Weights for Adults

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Healthy Weights for Adults

Note: The higher weights in the ranges generally apply to men, and lower weights to women, because men tend to have more muscle and bone.

* Without shoes or clothes

Adapted from United States Department of Health and Human Services and Department of Agriculture. Dietary Guidelines Americans 2005. Online: http://www.healthierus.gov/dietaryguidelines/; and United States Department of Health and Human Services, National Institutes of Health, National Heart, Lung and Blood Institute. “Body Mass Index Table.” Online: http://www.nhlbi.nig.gov/guidelines/obesity/bmi_tbl.htm

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6. Discuss with participants the appropriate weight gain for each of them. If you feel that this might be a sensitive topic, or if responses seem inappropriate, you could have each participant write down on paper what they think their target weight gain should be and discuss this with them individually.
7. Ask participants to name some nutritious foods that they could add to what they usually eat to equal 300 calories.
   Note: Use visual aids to represent the following examples of foods that would supply about 300 extra calories, if possible (magazine pictures, Dairy Council Food Models, NASCO Life/form® Food Replicas, empty containers, etc.):
   • One extra serving from each of the following MyPyramid groups: the Grain Group; the Vegetable Group; the Fruit Group; and the Milk, Yogurt, and Cheese (Milk) Group; and one extra ounce of meat/protein from the Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts (Meat & Beans) Group.
   • One slice of whole grain bread, one serving of broccoli, one orange or apple, one cup of skim or 1% milk, and one extra ounce of chicken or ½ cup of beans.
   • Other examples include:
     • Three 8-ounce glasses of skim milk
     • Two 6-ounce containers of low-fat, flavored yogurt
     • A chicken leg and ½ cup of rice
     • One large tortilla and ½ cup of beans

Conclusions

Tell participants: To have a healthy baby, one does need to gain some weight. It is understandable that gaining the amount of weight needed for a healthy pregnancy is hard for some people. Women who have struggled to keep their weight under control especially might feel this way. But the weight that you gain during pregnancy does not have to be permanent and can be managed with careful attention to your eating and activity habits. The right time to begin thinking about losing weight is after the baby is born.

Check for Understanding and Behavior Change

Ask participants to state one idea that they learned and plan to use during the next week. Ask others if they also might plan to try that idea during the week. List the ideas on the flipchart or writing board.

Also ask participants:

1. From what you have learned today, how much weight do you think you might need to gain to have a healthy pregnancy?
2. How do you plan to adjust your eating habits or activity level to allow for weight gain that is healthy for you?

Thank each participant for coming. Ask for final questions and discussion. Provide some information or teaser about the next session, to encourage attendance.

References and Resources

(1) Dairy Council Food Models; (2) NASCO Life/form® Food Replicas; (3) Understanding Nutrition; (4) Dietary Guidelines for Americans 2005; (5) “Body Mass Index Table.”