Pregnant women are continuously shamed for the choices they make. They’re shamed for working out, for not working out, for overeating, for not eating enough.

This noise has given way to confusion surrounding an important question: Is it safe to try to lose weight while pregnant? Iffath Hoskins, MD, an ob-gyn at NYU Langone Health, tells Health that the answer to that question is complicated.

As a general rule, women shouldn’t plan to try to shed weight while pregnant. There’s a lot going on with your body during pregnancy, and you don’t want to add extra stress to an already stressful process. “The first item to talk about is the fact that when you’re pregnant you have increased demand on your body. To try to actively lose weight is not a good idea,” Dr. Hoskins says.

She adds, “There are many reasons why [a woman] gains weight during pregnancy.” The placenta and the baby’s body cause weight gain, as does the presence of amniotic fluid in the body. But these changes contribute to temporary weight gain that should disappear with time after she gives birth. Ultimately, aiming to lose weight while pregnant is safe only under rare circumstances, Dr. Hoskins says.

Doctors take into consideration a number of factors when determining the best weight management plan for a pregnant patient. Dr. Hoskins says the following questions are among these considerations: “Is she underweight? What is her lifestyle? What work does she do? What is her usual caloric intake?” After taking these into account, “we create a customized plan for that patient,” she says.

On average, women gain 12 to 24 pounds while pregnant, explains Dr. Hoskins. “If a woman is average weight, we tell her she should expect to gain weight. But she can stay closer to the lower end,” she says. Staying closer to that end means looking at an extra 12 to 14 pounds during pregnancy. But this range won’t work for every woman. A woman could gain up to 44 pounds while pregnant and still have a healthy pregnancy, Dr. Hoskins says.

If a woman is overweight when she gets pregnant, she should try to keep her weight gain at a minimum, Dr. Hoskins says. “We advise her not to gain too much more,” she explains. “She can maintain her weight or accept her weight gain could be in the realm of 8 pounds,” she says, or about the weight of the baby.

While dieting while expecting is generally not a wise idea, exercising is—as long as you aren’t doing anything too high-risk, Dr. Hoskins says. “Exercise is good. Every pregnant [woman] should be active, but this is not a time to start a whole new [program], like training for a marathon.” Other than that, though, “weights are okay, running is okay, swimming, cycling—all these things are okay provided she’s continuing with what her body’s used to,” Dr. Hoskins says.

If you have any questions about whether or not it’s safe for you to try to lose or maintain your weight while pregnant, talk to your doctor. “Make sure you discuss it,” she advises. “Your doctor and you know best. Be very open, communicative. You can ask questions. That’s the person who’s on your side. You have a combined goal.”

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