How can being underweight in pregnancy affect me and my baby?

Most women who have a low BMI in pregnancy are fine, but there is an
increased risk of:

● miscarriage
● premature birth (when the baby is born before they are fully developed)
● the baby having a low birth weight
● gastroschisis (when the baby’s stomach doesn’t develop properly).

What are the reasons for underweight?

Causes of being underweight include:

● Family history. Some people have a naturally low BMI due to physical
characteristics that run in their family.
● A high metabolism
● Frequent physical activity
● Physical illness or chronic disease
● Mental illness

Is it okay to be underweight during pregnancy?

BMI is calculated by dividing your weight in kilograms by the square of your

height in meters.

The amount of weight you gain during pregnancy is important for the health of your
pregnancy and for the long-term health of you and your baby. If you were underweight
(body mass index below 18.5) before pregnancy, you should gain 28-40 pounds
during pregnancy.
● Rebecca’s BMI: 20

Pre-Pregnancy BMI Recommended Pregnancy Weight Gain

Underweight: Less than 18.5 28 to 40 pounds

Normal: 18.5 to 24.9 25 to 35 pounds

Overweight: 25 to 29.9 15 to 25 pounds

Obese: Over 30 11 to 20 pounds

Your midwife may recommend a multivitamin supplement that's suitable for

pregnancy, including folic acid, vitamin D and iron, and eating healthy extra
calories to put on weight.

Working with your healthcare provider and possibly a specialist, such as a

registered dietitian who specializes in pregnancy, can help you achieve
appropriate weight gain and nutrition throughout your pregnancy.

​ Baby: 7 to 8 pounds
​ Placenta: 1 to 2 pounds
​ Amniotic fluid: 2 pounds
​ Uterus: 2 pounds
​ Maternal breast tissue: 1 to 3 pounds
​ Maternal blood volume: 3 to 4 pounds
​ Fluids in maternal tissue: 2 to 4 pounds
​ Maternal fat and nutrient stores: 6 to 8 pounds

If you are underweight, gaining a few pounds before getting pregnant can be
helpful. This is particularly important if your pre-pregnancy diet was not
adequate nutritionally. Receiving adequate nutrition prior to pregnancy is vital
to your health and the health of your baby.

Low body weight can be a risk factor for infertility and preterm birth. Emily
Mitchell, a registered dietitian and certified diabetes educator for the Center of
Fetal Medicine, says, “If you are underweight and trying to get pregnant, aim
to gain 2 to 5 pounds and if you are unable, focus on gaining 2 to 5 pounds
during your first trimester.”

To gain this amount of weight, you’ll need to increase your calories by about
300 calories per day. (Women who are not underweight don’t typically need
extra calories during their first trimester and need roughly 340 extra calories
per day in the second trimester, and 450 extra calories per day during the third
trimester.)
A registered dietitian can suggest nutrient-dense, high-calorie food options to
help you achieve your weight goals.

Refusal of Medically Recommended Treatment During Pregnancy

In our society, we allow people the right to refuse medical treatment and the right to
refuse to subordinate their desires or needs to the needs of others. The threat to
freedom posed by forced treatment of pregnant women is not a minor threat, either. It is
rare for a woman to refuse medical advice that promises to benefit her fetus and poses
little risk to her, and it is troubling when it happens.

● Eliciting the patient’s reasoning, lived experience, and values is critically

important when engaging with a pregnant woman who refuses an intervention

that the obstetrician–gynecologist judges to be medically indicated for her

well-being, her fetus’s well-being, or both. Medical expertise is best applied when

the physician strives to understand the context within which the patient is

making her decision.

● When working to reach a resolution with a patient who has refused medically

recommended treatment, consideration should be given to the following factors:

the reliability and validity of the evidence base, the severity of the prospective

outcome, the degree of burden or risk placed on the patient, the extent to which

the pregnant woman understands the potential gravity of the situation or the risk

involved, and the degree of urgency that the case presents. Ultimately, however,

the patient should be reassured that her wishes will be respected when treatment

recommendations are refused.

LACK OF PRENATAL CARE (TASK 1)

Lack of access, transportation, social support, and social determinants of

health are some reasons cited for late or no prenatal care, and differences in
mortality. Hence, innovative prenatal care models have been developed as an
alternative to traditional prenatal care. Alternative models include group
prenatal care, initially described in the early 1990s and primarily limited to
low-risk patients cared for by a midwife. Group prenatal care allows more time
for provider-patient interaction to address not only clinical issues but
behavioral, social, and psychological topics in a setting that allows for time for
social support. Over the last decade, other formats of group prenatal care have
evolved to supplement the care delivered outside of the prenatal care visit,
including telephone calls, home visits, and text messaging.

Poor home condition/Inadequate living space as evidenced by They lived in a rented shack of
mixed materials with a bedroom, a bathroom and toilet and a small multi-purpose room
(living and dining room and kitchen).

The human mind and body are interconnected and can be affected by many
things, including the environment you live in. A peaceful and visually appealing
home setting can create a greater sense of wellbeing than a cluttered, chaotic
home. Even the color of your walls and furnishings can affect your mental health.

How does your living space affect you?

A clean and organized living space helps you achieve clarity of mind and boosts
your productivity. It also helps you relax as opposed to making you more
stressed.

Living in cramped spaces can pose health risks. If your perception of your home
is that it's a busy or lonely, negative, dark, and cramped space, you might feel
increased stress and anxiety. Living alone in a small space can elicit feelings of
confinement or that you are trapped.
Prenatal care can help keep you and your baby healthy. Babies of mothers who do not get
prenatal care are three times more likely to have a low birth weight and five times more likely to die
than those born to mothers who do get care. Doctors can spot health problems early when they see
mothers regularly.

Prenatal care allows doctors to spot problems like anemia or gestational diabetes.
Then, treatment can ensue. Prenatal care is an opportunity for the mother to learn more
about labor and delivery. Knowing what to expect can put a mother's mind at ease and
help her decide on the best plan for her and her baby.

The important goal of prenatal care is to accommodate pregnant women with regular check-ups and
check both the mother and child health.

#1. Reduced risk of birth defects and pregnancy complications

Prenatal care’s primary role and responsibility are to reduce the risk of birth defects and pregnancy

complications for a safe labour. Most of the pregnancies are normal and healthy, but detecting a

pregnancy complication on rare accounts can be difficult on your own. In such a scenario, prenatal

care will do the job for you. Regular meetups with the doctor will help you analyze such difficulties.

#2. Analyze the baby growth and development

Yes, the challenging part of the pregnancy is guessing the baby’s health. It is quite difficult to analyze

baby growth from the general lookout of the mother. Prenatal care will allow you to explore the

baby’s growth and development at every stage and help you with the appropriate process.

#3. Personal health progress and lifestyle tips

A prenatal check-up is not all about the baby’s health and growth; it also addresses your personal

health and growth. Your body will undergo many changes during the process and requires equal

attention. Necessary guidance will be provided to ensure your health is hale and sound. Prenatal

care will allow you to know the lifestyle tips that will make your pregnancy period more smooth and

joyful.

#4. Regular testing opportunities

Regular prenatal checks will allow you to take up the necessary testing. These tests include scans

and checking of the foetus for the conditions that might affect the baby’s health. They will help in

measuring the position and growth of your baby inside the womb.

#5. Nutrition care

Apart from the general lifestyle changes, the nutritional needs of your body change. Eating healthy

and avoiding some foods is vital for a successful pregnancy. Your doctor will provide you with

important dietary information during prenatal visits.

If you are underweight, you may be at greater risk of certain health conditions, including
malnutrition, osteoporosis, decreased muscle strength, hypothermia and lowered
immunity. You are more likely to die at a younger age. Underweight women have less
chance of becoming pregnant than women who are a healthy weight.

For all other measures of health (including general health, physical health, disability,
and cancer) the health of the underweight class is significantly worse than that of
the overweight.

Most women who have a low BMI in pregnancy are fine, but there is an increased risk
of: miscarriage. premature birth (when the baby is born before they are fully
developed) the baby having a low birth weight.

Babies born to mothers who are underweight (women with BMIs lower than 18.5) are at
higher risk for health problems, including:4
● Premature birth (also called preterm birth), or childbirth before 37 weeks of
pregnancy
● Low birth weight (smaller than 5 1/2 pounds). These infants are at risk for health
and development problems as they get older.