Gaining weight during pregnancy is natural, expected, and healthy.
According to experts, it is important for the proper development of your baby and the healthy adaptation of your body to its new needs and functions.
Also, the nourishment and sustenance of a baby in the womb depends so much on the nutrition of the mother. Therefore, a pregnant mother is always expected to eat healthily to ensure the unborn baby received the needed nutrients.
However, for the fear of losing their shape, gaining weight and having big babies which may compel them to deliver through caesarean section, some women indulge in dieting during pregnancy which according to experts is dangerous for both mother and baby
For Rose Ufot, 29, who is 7 months pregnant with her second child, gaining weight during pregnancy is a major concern.
Rose, who is a personal assistant to a CEO of a private company in Lagos, says her concern about gaining weight during pregnancy made her avoid food that could make her gain weight as much as possible. Rose said, she does not want to lose her shape after delivery.
Sharing her experience with PUNCH HealthWise, the Akwa Ibom State indigene said,
“Having swollen face, nose, mouth and being totally out of shape can make pregnancy depressing. I don’t want to have such looks and that is why I am dieting. And it’s working for me though it’s tough to avoid food during pregnancy.
“When I gave birth to my first baby in 2020, I watched my weight closely and ate little quantities of food until I delivered. Even after my delivery, I continued dieting and was able to maintain my shape.
“Though the doctor had advised me to drop dieting and eat well because of my baby, I still don’t want to gain much weight. It is all about determination. Even some of my colleagues have asked why I never gained any weight both during and after my pregnancy.
“I do not want pregnancy to change my shape in any way. My husband admires my shape a lot and I want to remain the same person he married before pregnancy.”
According to studies, weight gain is often inevitable during pregnancy. However, findings have also confirmed that many expectant mothers nowadays indulge in dieting in order not to have big babies out of fear of CS delivery and the desire of the pregnant mothers to maintain their shape after delivery.
Physicians are, however, warning that indulging in this practice can be hazardous to both pregnant women and their unborn babies.
The health experts noted that a weight loss regimen may restrict important nutrients such as iron, folic acid, and other important vitamins and minerals.
Babies won’t attain optimal growth
A Consultant Obstetrician and Gynaecologist, Dr. Joseph Akinde, says it is not advisable for a pregnant woman to say she is dieting, warning that such a woman is doing herself harm as well as to her unborn child.
Dr. Akinde, who is a former chairman, Society of Gynaecology and Obstetrics of Nigeria, Lagos State chapter told PUNCH in an interview that children of women who did not eat well nor get enough nutrients during pregnancy do not attain optimal growth.
However, also speaking, Rose lamented that a lot of women are unhappy to lose their shape after childbirth, noting that she doesn’t want to appear on such a list.
“I have seen a lot of ladies during pregnancy; they are like three times their size before they got pregnant. And you see some of them complaining that their husbands are no longer comfortable with their looks because they no longer look sexy.
“So, because of that, even before I got married in 2019, I had already made up my mind that I was going to maintain my figure all through my childbearing period no matter what it would take.
“I avoid fatty foods, meats, and sugary things, I eat small quantities of food each time I am hungry.
“However, since I entered the third trimester in this second pregnancy, I have noticed that I am becoming darker, my mouth and nose becoming bigger by the day, unlike my first experience.
“I dislike my ugly look though I am happy to be pregnant. I am afraid I may not come back to my normal shape after my delivery.”
Another expectant mother who simply identified herself as Adejoke and works with one of the big banks in Lagos told our correspondent that she decided to go into dieting in order not to gain much weight because of the nature of her job.
The 5 months old pregnant woman who works at the customer care department of the bank said,
“This is my first pregnancy and I have heard a lot about weight gain when a woman is pregnant and how it can be prevented through dieting.
“So, I don’t eat much and I try to avoid any food or fruit that will make me gain weight. I really want to maintain my shape after childbirth.”
Mrs. Chioma Ibezim, 32, who is 8 months pregnant is another Lagos expectant mother who is into dieting.
The mother of two revealed that her major reason for going into dieting is to avoid having a big baby that will force her to deliver through CS. The businesswoman said:
“I gave birth to my first baby on November 22, 2021, through CS. At birth, she weighed 4.6kg. The doctor at the private facility where I delivered told me point-blank that I must deliver through CS and can’t have a vaginal delivery because of her size.
“We paid N280,000 for the CS which we didn’t initially plan for. So because of that, I am seriously dieting in this second pregnancy. The scan report so far shows that the baby is not big. I just have one month left before I deliver.”
Dieting by pregnant women, physicians warn, may however increase Nigeria’s already high maternal and infant mortality rate.
Physicians say the continuous high rate of maternal and child mortality in the country negates the attainment of Sustainable Development Goal 3, whose Target 1 aims to reduce the global maternal mortality rate to 70/per 100,000 live births by 2030.
Dieting during pregnancy can lead to stillbirths -UNICEF
According to UNICEF, during pregnancy, poor diets lacking in key nutrients – like iodine, iron, folate, calcium, and zinc – can cause anaemia, pre-eclampsia, haemorrhage, and death in mothers. UNICEF added:
“They can also lead to stillbirth, low birth weight, wasting, and developmental delays for children.
“Improving women’s diets, access to nutrition services, and nutrition and care practices – before and during pregnancy and while breastfeeding – is critical to preventing malnutrition in all its forms. This is particularly true for the most vulnerable mothers and babies.”
Sharing a similar experience, Mrs. Joy Adams, 34, also revealed that her fear of CS made her go into dieting.
The 6 months old pregnant Edo State indigene said,
“Vaginal delivery is easier and less expensive. I gave birth to my first baby through vaginal delivery and the next day I was out of the hospital.
“My second child, I gave birth to him through CS and I stayed in the hospital for two weeks because I had an infection after the surgery. He weighed 4.4kg at birth. I don’t want to go through a similar experience.
“So, because of that, I avoid food a lot even when I am hungry, though it has not been easy. My doctor had warned me to stop starving myself for the sake of my baby. But I have not heeded his advice.”
Mrs. Alice Mbah and other expectant mothers who equally spoke shared similar experiences of going into dieting despite being warned by their physicians of the possible consequences of their actions, especially on their unborn babies.
Weight gain inevitable during pregnancy -Gynaecologist
Experts who spoke with PUNCH said poor nutrition during pregnancy is a major public health problem in Nigeria.
Giving insight into the risk of dieting during pregnancy, Dr. Akinde said:
“Dieting during pregnancy is a foolish thing to do to the unborn baby. You know that the baby is an obligate parasite. What do I mean by that? Whether the mother likes it or not, the baby will collect all the nutrients it needs for its growth from the mother even if the mother starves herself.
“If a mother is not eating for one reason or another and she is not getting enough nutrients, the baby will extract what it needs for its growth such that the woman will now be at risk.
“The woman may have anemia. She may end up having the baby quite alright, but she may lose her life because of inadequate blood in her system.
“So, it is not advisable for a pregnant woman to say she is dieting. Ideally, a woman should gain 12kg in pregnancy. So, there is no way a woman with a normal pregnancy will not gain weight. She will surely gain weight.”
Continuing, the gynaecologist said,
“But if a woman says she doesn’t want to add weight when she is pregnant, then that woman should not get pregnant at all.
“She will do herself a lot of harm if she puts herself on a starvation diet. If she doesn’t want to eat for fear of weight gain, the baby will not attain the optimal growth it should have attained and the life of the woman will also be at risk.
“And a woman that doesn’t want to look ugly during pregnancy should not get pregnant at all.
“Getting pregnant is a biological function conferred on a woman by God. If she doesn’t want to live up to that function, then she should not get pregnant in the first instance.”
Dieting during pregnancy leads to poor brain development in babies
The President, Federation of African Nutrition Societies, Prof. Ngozi Nnam, said that it was wrong for pregnant women to joke about their diet, especially during the first trimester of pregnancy.
According to the nutritionist, poor nutrition, particularly during the first trimester of pregnancy often leads to the poor brain development of babies.
Nnam, a professor of Community and Public Health Nutrition at the University of Nigeria, Nsukka, stressed that proper diet in pregnancy was crucial to ensuring optimal development of the foetus.
Prof. Nnam revealed that studies have confirmed that a major danger of poor nutrition in pregnancy is poor brain development of babies.
The nutritionist said, “Poor nutrition will cause inadequate development of the baby because nutrients are required for cells of the foetus to develop properly.
“Nutrients such as iron are very important in the development of the cells. When a pregnant woman stops taking foods rich in iron, she will be deficient in iron and that deficiency will affect the foetus and the cells will not form properly and this will lead to malformation when the baby is born.”
Already, there is compelling evidence from epidemiologic studies that poor nutrition during pregnancy, in the form of insufficient intake, low protein, or deficiencies in micronutrients, is associated with poor developmental outcomes in children including lower cognitive functioning, deficits in attention, and disruptive behavior problems.
In a study published in Science Daily titled, ‘Poor diet during pregnancy may have a long-term impact on child’s Health’, the authors said mothers who eat an unhealthy diet during pregnancy may be putting their children at risk of developing long-term, irreversible health issues including obesity, raised levels of cholesterol and blood sugar.
“It seems that a mother’s diet whilst pregnant and breastfeeding is very important for the long-term health of her child.
“We always say ‘you are what you eat. In fact, it may also be true that ‘you are what your mother ate.’ This does not mean that obesity and poor health are inevitable and it is important that we take care of ourselves and live a healthy lifestyle. But it does mean that mothers must eat responsibly whilst pregnant,”
the authors said.
Reasons for CS – Expert
A Professor of Obstetrics and Gynaecology, Prof. Innocent Ujah, said the increase in CS cases is due to repeat procedures.
The consultant obstetrician and gynecological surgeon also said maternal deaths from CS in Nigeria are not significant at all.
On why many Nigerian women are delivering their babies through CS, the professor explained,
“The reason for the increase in CS is because of repeat CS. There are some women who after the first and second CS, depending on the cause, will have a repeat CS.
“Once a woman has a second CS, she will also most likely have a repeat CS because if we don’t do that when next she is trying to deliver, the uterus may rupture and she may bleed to death.
“Now, the reasons for doing the first CS are many. If the baby is breached, particularly if it is a first-time mother, the delivery will definitely be by CS.
“Also, if the baby is lying transverse, it has to be delivered by CS. If there is a foetal distress and if the woman has placenta previa, the baby will be delivered by CS.
“If the birth canal is small, a CS has to be performed. If a woman delivers by CS twice, it means that the rest of her delivery will be by CS.”
The gynaecologist who is the immediate past president of the Nigerian Medical Association noted that CS is an acceptable mode of delivery.
He called on the government to make antenatal care, delivery, and CS free for all pregnant women.
Nigeria’s maternal mortality rate is 512 per 100,000 live births, according to the 2018 Nigeria Demographic and Health Survey.
In 2015, Nigeria’s estimated maternal mortality ratio was over 800 per 100,000 live births, with approximately 58,000 maternal deaths during that year.
In comparison, the total number of maternal deaths in 2015 in the 46 most developed countries was 1,700, resulting in a maternal mortality ratio of 12 maternal deaths per 100,000 live births.
The World Health Organisation says a Nigerian woman has a one-in-22 lifetime risk of dying during pregnancy, childbirth, or postpartum/post-abortion; whereas in developed countries, the lifetime risk is one in 4,900.