Why I'm Not Tracking My Pregnancy Weight Gain

When I went into my first prenatal visit I knew ahead of time I did not want to have my weight measured or tracked throughout my pregnancy. It wasn’t so much that I didn’t want to see or know the number, but more so that I was entering my pregnancy with a BMI that was considered a “risk factor” and wanted the focus of my appointments to be based on how I and the baby were actually doing, not centered around my weight or BMI. Side note: a high BMI does not in and of itself make a pregnancy high risk.

I’m going to share how I went about talking to my OB about this decision (and how she responded) as well as address some FAQs I’ve gotten about this choice like, how do you know if the baby is growing if they aren’t tracking your weight?

At my first prenatal appointment I was about 11 weeks pregnant and the nurse who was taking my vitals insisted that she record a “pre-pregnancy weight” (yes, at 11 weeks). I didn’t have it in me to argue with her, so I did get weighed at my first appointment.

After meeting with my OB for a few minutes she told me the recommended gestational weight gain (GWG) range for my pregnancy. If you aren’t aware of how GWG recommendations work, I’ll quickly explain. Most OBs (not all) will recommend a GWG range that is based off of your pre-pregnancy BMI. The idea being that the higher your BMI, the less weight you’re recommended to gain throughout your pregnancy (if you haven’t already guessed, I think this is BS, but more on that another day). If you’re really interested to know the exact ranges, you can of course google these recommendations as I won’t be mentioning them explicitly here.

It was at this point that I said, I’d prefer not to track my weight during my pregnancy. Is this an option? She hesitantly nodded and asked if there was any particular reason I didn’t want to track my weight.

My response: I’d prefer to only take measurements that are diagnostic indicators (in this scenario it would be blood work, blood pressure, ultrasounds, etc) and focus on what I *can* control in terms of lifestyle factors like nutrition and exercise. For me, focusing primarily on how much weight I’m gaining will simply cause more stress since it is largely out of my control.

^ Feel free to steal this response if it is useful for you at any medical appointment! ^

She mentioned that the reason they track weight is to monitor for “excessive” weight gain. Note, she did not mention tracking weight to ensure adequate growth of the baby OR to monitor for excess fluid retention.

So I then asked, hypothetically if I were to gain more weight then you’re recommending, what would the intervention be? I asked this question because I knew that weight loss would not be recommended during pregnancy (and if it ever is, RUN) so I was genuinely curious to hear her response.

She then told me that she would refer me to their dietitian.

This is where I had a lot of privilege in this situation as I was able to explain that I am a dietitian, and feel confident that I don’t need to work with one. This seemed to put her at ease and she agreed to make a note in my chart to skip the weight checks as long as I agreed to eat healthy and exercise. If you happen to already be working with a Health at Every Size™ dietitian, you can also let your doctor know that you’re already working with an RD in this scenario.

That being said, it frustrated me that I had to prove that I had a four year degree and a professional license in nutrition to be let off the hook. And it really frustrated me because it was painfully clear that to her, rate of weight gain was a measure of eating and exercise habits, something that would be just as easy to have a conversation about instead of making assumptions based on the number on the scale.

At the end of all of this I simply confirmed that I was comfortable with not tracking my weight during pregnancy and if she or other providers wanted to ask me about my nutrition and exercise habits I’d be happy to have a conversation about it (spoiler: they never asked).

As I write this I am 28 weeks pregnant and have not been weighed since that first appointment! I had one nurse who asked me to step on the scale as she does everyone, and I just said “oh I’m not getting weighed - there’s a note in my chart” and she was like, “whoops!” and that was it! And yesterday the nurse I got was amazing and just asked “are we doing a weight today?” I said no and we just moved on! We love when medical providers ask for consent.

Personally, not having my weight tracked as part of my prenatal appointments has been super helpful for me, but here are some questions I’ve gotten as I shared more about this experience:

How do you make sure the baby is growing adequately without tracking your weight?

Weight gain during pregnancy does correlate with a baby's gestational weight, BUT it is not the only way to track it. My midwife is currently taking what is called a fundal height measurement (I’ve been told by my friend Amber that this basically measures the size of your uterus, and is fairly accurate across the size spectrum!). I have also been able to see that baby is growing based on the ultrasounds we have had so far. Aside from medical measurements, I can tell he is growing because his kicks are getting stronger day by day, phew!

Is there any other medical reason to track weight?

The only other reason I have heard of (and not from any of my providers) is that it can help monitor excessive weight gain due to fluid retention, which could be a marker of a more serious condition. I think this is a valid reason but I also think there are other ways to monitor fluid retention. My midwife has been checking my ankles and hands for swelling, and having me demonstrate being able to take my rings off/on as a marker. Not to mention most people are very aware when they are retaining excess fluid and don’t need a scale to tell them.

Some folks might also argue that tracking weight can be helpful for those who are struggling to gain weight throughout their pregnancy, either due to illness (like excess nausea and vomiting) or due to disordered eating. I still think these scenarios leave room to have conversations with your healthcare providers about a course of action like medication to reduce nausea and vomiting, or referral to an eating disorder dietitian to ensure adequate intake. Tracking weight doesn’t change behavior or outcomes. It just collects data.

Is there any circumstance in which tracking weight would be required?

A fun fact is that technically, nothing is required! Everything at ALL medical appointments, yes, even prenatal appointments, is a choice. Unfortunately providers don’t often frame it this way so it’s definitely not on you if you didn’t know this. Not having my weight tracked was MY choice and the one that I felt was best for me and baby. It might not be YOUR choice and that’s ok. But I share this because I think it’s important to know that you have a choice, and you have the option to weigh the pros and cons for yourself.

Through sharing this experience it made me really curious about where these GWG recommendations even came from in the first place and how fixating on them might cause more harm than good. I’m planning to send a follow-up post to this with what I’ve discovered, but in the meantime I’d love to hear from you! Post in the comments your thoughts and questions.

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