Weight gain during pregnancy can become almost a point of contention between patients and doctors, well-meaning family members and prospective mothers, and a source of obsessive concern for mothers-to-be. And while everyone seems to be searching for the ideal weight gain in pregnancy, it turns out that what that ideal is may depend on the country you choose to live in during your pregnancy. Because every culture has its own set of norms around what maternal health means, and these norms find their way into the medical guidelines for pregnant women. Many countries have no guidelines around pregnancy weight gain at all.

In India, where looking “healthy” means looking a little overweight, and being healthy during pregnancy involves eating ladoos by the dozen, doctors rarely rein in mothers-to-be who are gaining upwards of 30kgs during a pregnancy. A mother’s (over?)eating is considered by her social milieu to be for the benefit of the baby. There are, from our research, no specific medical guidelines issued by an Indian obstetric association regarding recommended weight gain during pregnancy, and unfortunately, very little research has been done on maternal weight gain trends and habits in developing countries where guidelines are lacking.

As a counterpoint, in Italy, doctors almost obsessively strive to keep their patients’ pregnancy weight gain under 12kgs. Some patients have reported being pressured to do C-sections at 36 or 37 weeks, just because their doctors feared weight gain over 12 kgs would result in a large baby and difficult delivery.

In the US, the general guideline followed by obstetricians is 25-30lbs (approx 11-13kgs). Patients are warned at the start of their pregnancies to keep those numbers in mind as the weeks progress.

Regardless of the variation in cultural standards for mothers’ bodies, and what that means for children’s health, there are some facts to consider. Generally, a mother who overeats during pregnancy and gains too much weight will have a bigger child; and bigger children are harder to birth vaginally. Bigger babies can lead to complications during childbirth, making the process more dangerous for baby and mother. Large babies can also trigger premature labor. (Interestingly, women who are underweight and have small babies also have a heightened risk of premature labor.)

And finally, excessive weight gain during pregnancy does make it harder for a woman to get back into shape, which is a mental as well as physical health issue for a new mother.

There is a specific range within which healthy women with uncomplicated pregnancies should stay: For women who start their pregnancies at a health rate, it’s 11 to 16 kgs. (The range varies for underweight to overweight to obese women, as the larger a woman is at the start of her pregnancy, the less weight she should gain to maintain a healthy pregnancy.) Unfortunately, deviating too far from these ranges can lead to serious complications for mother and baby.

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