In the latest “pregnant women are doing it all wrong” news, the weigh-in may return in an effort to stop Britain’s expectant mums piling on too many pounds.
Midwives stopped weighing pregnant women in the 1990s because there wasn’t any clinical evidence to suggest it made a difference to the health of the woman or their baby. In fact, regular weighing was thought to cause stress and anxiety.
This week the Royal College of Midwives has responded to a new study with another call for women to be given official targets for how much weight they can gain. The study, published in Diabetologia, the journal of the European Association for the Study of Diabetes, looked at mother-child pairs and found that the seven-year-olds of mothers who gained too little or too much weight in pregnancy tended to have increased risk of high blood pressure and poor body sugar control. The RCM repeated its concern that some midwives “do not have access to that most basic piece of equipment, scales”.
Healthy eating is great. A balanced diet is ideal. As many of us are now overweight, we could probably do with taking on food writer Michael Pollan’s adage: “Eat food. Not too much. Mostly plants.” The more healthy kids, the better, of course. But weigh-ins smack of a paternalistic, condescending attitude towards women, particularly pronounced in the reproductive health areas of this country, which needs to change. I saw this for the first time when I entered the world of pregnancy and motherhood and a new wing of healthcare. You may have brilliant interactions – and/or you may be treated like a stupid child and given odd, false, conflicting advice.
There are many things I didn’t realise until I experienced pregnancy. Sometimes you feel so sick you can only stomach mashed potato and pickled onion-flavour Monster Munch – for weeks on end. In the early months, protein or fresh vegetables might make you extremely nauseous, even though you know you should eat them. Or you have to eat a Rich Tea biscuit every half hour to prevent multiple vomiting. Then, one month, you might suddenly put on half a stone, even if you think you’re eating normally. As well as the weight of the baby, you are carrying extra blood, extra stored protein and fat, other extra body fluids, larger breasts, larger uterus, plasma volume, amniotic fluid and the placenta, which is an entire organ. Your metabolism slows to a sluggish chug, and exercise is harder.
There is enough to worry about in pregnancy than the fear of failing to meet weight-gain targets which don’t have enough evidence for their existence in the first place. Pregnancy is wonderful, but it is also weird and frightening. Even for those who are beyond grateful for it, it can be a distressing, depressing and isolating time. Woefully little is known about antenatal depression, anxiety and other mental disorders, but it is thought about one in 30 pregnant women will have this. Weigh-ins will cause more stress anxiety, shame and guilt – and there is enough “mum guilt” to come for most when the baby is born.
These are the changes that would help women antenatally and postnatally: less pressure to have a natural birth without pain relief, a balanced attitude towards infant feeding with less demonising of formula milk, more education in antenatal classes about the emotional and psychological transition into motherhood – matrescence – and how hormonal and neural changes can affect mood, which can affect how we eat. Seeing the same midwife all the way through. Accurate information without bias. So, for weight gain, it’s quite easy to find out that an expectant mother needs 200 calories a day extra in the final trimester. I’ve not conducted a study on it but I’m pretty sure most people don’t actually believe the “eating for two” myth even if many don’t know exactly how many calories they should be getting.
The RCM and Slimming World issued a call for a guideline on what constitutes a safe weight gain in pregnancy in the UK. At the moment, it said, midwives have to rely on their own initiative and use US guidance, and sometimes they’re embarrassed to weigh pregnant women. Guidelines are fine. Talk about healthy diets and weighing if there seems to be a problem. But official, regular weigh-ins are patronising, stressful and suggest women aren’t intelligent enough to look after their own bodies. It’s an overly simplistic and shaming effort to solve the extremely complex and sociopolitical problem of obesity.
• Lucy Jones is a freelance journalist
