๐Ÿ“– 11 min read

Healthy weight gain during pregnancy depends on your pre-pregnancy weight. This guide explains recommended ranges and what to expect.

Pre-Pregnancy BMICategoryRecommended Gain
Under 18.5Underweight12.5-18 kg (28-40 lbs)
18.5-24.9Healthy weight11.5-16 kg (25-35 lbs)
25-29.9Overweight7-11.5 kg (15-25 lbs)
30 or higherObese5-9 kg (11-20 lbs)
For twins: Recommended weight gain is typically 16-24.5 kg (35-54 lbs) for healthy weight women.

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Weight Gain by Trimester

TrimesterWeeksExpected Gain
First1-120.5-2 kg (1-4.5 lbs)
Second13-260.5 kg/week (1 lb/week)
Third27-400.5 kg/week (1 lb/week)

Where the Weight Goes

Breakdown of Weight Gain (Average)

Baby: 3.4 kg (7.5 lbs)

Placenta: 0.7 kg (1.5 lbs)

Amniotic fluid: 0.9 kg (2 lbs)

Uterus growth: 0.9 kg (2 lbs)

Breast tissue: 0.9 kg (2 lbs)

Blood volume: 1.4 kg (3 lbs)

Fluid retention: 1.4 kg (3 lbs)

Fat stores: 2.7 kg (6 lbs)

Total: ~12.3 kg (27 lbs)

Healthy Eating During Pregnancy

When to Be Concerned

Speak to your midwife if:

NHS advice: Focus on eating healthily rather than "eating for two". Most women don't need to diet during pregnancy but should aim for balanced nutrition and regular gentle exercise.

How Pregnancy Weight Gain Is Calculated: The Methodology

Pregnancy weight gain recommendations are based on the Institute of Medicine (IOM) guidelines, which the NHS and NICE also reference. The methodology uses your pre-pregnancy Body Mass Index (BMI) as the starting point, with different target weight gain ranges for each BMI category. The rationale is that women who start pregnancy at a higher weight have more existing energy reserves and therefore need to gain less additional weight for a healthy pregnancy outcome.

The recommended weight gain is not simply the weight of the baby. It accounts for all pregnancy-related tissue growth: the baby (approximately 3.4kg at term), the placenta (0.7kg), amniotic fluid (0.9kg), uterine growth (0.9kg), increased breast tissue (0.9kg), expanded blood volume (1.4kg), fluid retention (1.4kg), and maternal fat stores (2.7kg for energy reserves needed for breastfeeding). Together, these total approximately 12.3kg for a healthy-weight woman, which aligns with the middle of the 11.5-16kg recommended range.

Weight gain follows a characteristic pattern across pregnancy. During the first trimester (weeks 1-12), most women gain very little -- typically 0.5 to 2kg total. Some women actually lose weight in the first trimester due to morning sickness. From the second trimester onwards, steady weight gain of approximately 0.4-0.5kg per week is expected for healthy-weight women. Weight gain accelerates slightly in the third trimester as the baby undergoes its most rapid growth phase.

For twin pregnancies, recommended weight gain is higher: 16.8-24.5kg for healthy-weight women, 14.1-22.7kg for overweight women, and 11.3-19.1kg for women with obesity. Higher-order multiples (triplets or more) require individualised guidance from a specialist obstetrician, as standardised recommendations have not been established.

UK-Specific Context: Pregnancy Weight and the NHS

The UK approach to pregnancy weight monitoring differs from many other countries. The NHS does not routinely weigh women throughout pregnancy after the initial booking appointment (typically at 8-12 weeks). This policy, established in the NICE Clinical Guideline CG62 (Antenatal Care), is based on evidence that routine weighing can cause unnecessary anxiety without improving outcomes for women with normal BMI. However, weight monitoring is recommended for women with a BMI of 30 or above, as obesity in pregnancy carries significantly increased risks.

Approximately 50% of women in England are overweight or obese when they become pregnant, according to data from the National Maternity Services Dataset. Maternal obesity is associated with increased risks of gestational diabetes, pre-eclampsia, induced labour, caesarean section, and complications for the baby including macrosomia (large birth weight) and neonatal intensive care admission. NICE recommends that women with a BMI of 30+ receive additional monitoring, including a glucose tolerance test at 24-28 weeks and consultant-led care.

The NHS Healthy Start scheme provides eligible pregnant women with vouchers worth ยฃ4.25 per week to spend on milk, fresh or frozen fruit and vegetables, and pulses. Women under 18 are eligible regardless of income. The scheme also provides free Healthy Start vitamins containing folic acid, vitamin C, and vitamin D -- the key supplements recommended during pregnancy. Many local authorities distribute these through children's centres, pharmacies, or midwife clinics.

Gestational diabetes affects approximately 5% of UK pregnancies and is more common in women who are overweight. The NHS screening test (oral glucose tolerance test or OGTT) is offered at 24-28 weeks to women with risk factors including BMI above 30, previous gestational diabetes, family history of diabetes, or South Asian, Black Caribbean, or Middle Eastern heritage. Women diagnosed with gestational diabetes receive dietary advice, blood glucose monitoring equipment, and may require insulin or metformin if diet alone does not control blood sugar levels.

NHS maternity care in the UK is free at the point of use for all residents, regardless of nationality or immigration status. This includes all antenatal appointments, scans, blood tests, labour and delivery care, and postnatal support. Midwife-led care is the default pathway for low-risk pregnancies, with obstetrician involvement for higher-risk cases. The UK has approximately 640,000 births per year, with an increasing average maternal age of 30.7 years at first birth.

Worked Examples: Pregnancy Weight Gain Tracking

Example 1: Healthy Weight Woman (BMI 23)

Pre-pregnancy weight: 64kg, Height: 167cm. Target gain: 11.5-16kg.

Week 12 (end of first trimester): Weight 65.5kg (gained 1.5kg -- on track)

Week 24: Weight 72kg (gained 8kg total -- averaging 0.5kg/week since week 12 -- on track)

Week 36: Weight 77kg (gained 13kg total -- within the 11.5-16kg target)

Expected at delivery (40 weeks): 78-79kg (total gain 14-15kg -- healthy range)

Example 2: Overweight Woman (BMI 28)

Pre-pregnancy weight: 82kg, Height: 171cm. Target gain: 7-11.5kg.

First trimester: Gained 1kg (on track)

Second trimester: Gained 4kg (total 5kg at week 26 -- on track)

Third trimester target: Gain another 2-6.5kg for a total of 7-11.5kg at delivery.

Her midwife recommends focusing on nutrient-dense foods rather than restricting calories, aiming for the lower end of the range through healthy eating and regular walking.

Example 3: Extra Calories Needed Per Trimester

A woman with a pre-pregnancy TDEE of 2,000 calories per day.

First trimester: 2,000 cal/day (no additional calories needed)

Second trimester: 2,000 + 340 = 2,340 cal/day

Third trimester: 2,000 + 450 = 2,450 cal/day

The 340-450 extra calories is modest -- equivalent to a slice of toast with peanut butter plus a banana, or a bowl of porridge with milk and fruit.

Common Mistakes and Tips

Mistake 1: "Eating for two." This is the most common myth. A full-term baby weighs approximately 3.4kg and requires only modest additional calorie intake, not double your normal consumption. The NHS explicitly advises against eating for two. You need no extra calories in the first trimester and only 200-450 extra in the second and third trimesters.
Mistake 2: Dieting during pregnancy. Pregnancy is not an appropriate time for weight loss, even if you are overweight. Severe calorie restriction can deprive the baby of essential nutrients and may be associated with low birth weight. Instead, focus on eating nutrient-dense foods and maintaining regular gentle exercise such as walking, swimming, or prenatal yoga.
Mistake 3: Comparing your weight gain to others. Every pregnancy is different. Factors including your starting weight, body composition, fluid retention, baby size, and whether you are carrying multiples all affect total weight gain. Focus on your own trajectory and discuss any concerns with your midwife rather than comparing to friends or online forums.
Tip: If you want to track your weight during pregnancy, weigh yourself once per week at the same time of day (ideally in the morning before eating) and plot your weight on a chart. This helps you see the overall trend without worrying about day-to-day fluctuations caused by fluid retention, which can be significant in the third trimester.

Frequently Asked Questions

Is it normal to lose weight in the first trimester?

Yes. Many women lose weight in the first trimester due to morning sickness (nausea and vomiting), food aversions, or simply feeling too unwell to eat normally. A loss of 1-2kg in the first trimester is generally not concerning. However, if you are losing significant weight, unable to keep any food or fluids down, or producing dark urine, contact your midwife or GP as you may have hyperemesis gravidarum, which affects approximately 1-3% of UK pregnancies and requires medical treatment.

How quickly should I lose the baby weight after delivery?

The NHS advises a gradual return to pre-pregnancy weight over 6-12 months. Most women lose approximately 5-6kg immediately at delivery (baby, placenta, amniotic fluid, blood loss) and another 2-3kg in the first week as excess fluid is expelled. The remaining pregnancy weight should be lost gradually through healthy eating and gentle exercise, not crash dieting. If breastfeeding, you need approximately 500 extra calories per day, so extreme calorie restriction is not appropriate. Your 6-week postnatal check is a good time to discuss weight management with your GP.

Does breastfeeding help with weight loss?

Breastfeeding burns approximately 300-500 calories per day, which can support gradual weight loss. However, breastfeeding also increases appetite, and some women find they maintain or even gain weight while breastfeeding. The NHS recommends focusing on a balanced diet rather than calorie counting while breastfeeding. Most women who breastfeed exclusively for 6 months find they gradually return to close to their pre-pregnancy weight within 12-18 months.

What if I gain more than the recommended amount?

Excessive weight gain in pregnancy increases risks of gestational diabetes, pre-eclampsia, and delivery complications. However, gaining slightly more than the guideline range is common and not necessarily dangerous. Speak to your midwife if you are gaining weight rapidly (more than 1kg per week in the second or third trimester) or if your total gain is tracking significantly above the recommended range. They may refer you to a dietitian for personalised guidance. Never attempt to lose weight during pregnancy without medical supervision.

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NHS Pregnancy Supplements 2025

SupplementWhenAmount
Folic acidPre-conception to 12 weeks400mcg daily
Vitamin DThroughout pregnancy10mcg daily
IronIf deficient (GP advised)As prescribed
Healthy Start: If you're on certain benefits, you may qualify for free vitamins and food vouchers through the NHS Healthy Start scheme.

Foods to Avoid UK

NHS Maternity Care Timeline

WeekAppointmentWeight Check
8-12Booking appointmentYes - baseline
11-14Dating scanNo
16Antenatal checkOnly if concerns
18-21Anomaly scanNo
25-40Regular checksOnly if concerns
What are the NHS guidelines for exercise during pregnancy and how does it affect weight gain?
The NHS recommends that pregnant women aim for 150 minutes of moderate-intensity activity per week, which can include brisk walking, swimming, prenatal yoga, and stationary cycling. Exercise during pregnancy helps manage healthy weight gain, reduces the risk of gestational diabetes by up to 30%, improves mood and sleep quality, and can help prepare the body for labour. You should avoid contact sports, activities with a risk of falling (such as horse riding or skiing), scuba diving, and exercising at altitude above 2,500 metres. If you were not active before pregnancy, start gradually with 15-minute sessions and build up. Pelvic floor exercises are particularly important throughout pregnancy and postpartum. Always stop exercising and seek medical advice if you experience vaginal bleeding, dizziness, chest pain, or calf pain. Your midwife can provide personalised guidance based on your individual circumstances and any pregnancy complications.
How does gestational diabetes relate to pregnancy weight gain?
Gestational diabetes mellitus (GDM) affects approximately 4-5% of pregnancies in the UK and is more common in women who gain excessive weight during pregnancy, have a pre-pregnancy BMI over 30, are over 25 with South Asian, Black, or Middle Eastern heritage, or have a family history of diabetes. The NHS screens for GDM between 24-28 weeks using an oral glucose tolerance test (OGTT). If diagnosed, management typically involves dietary changes (focusing on low-glycaemic-index carbohydrates, regular meals, and controlled portions), blood glucose monitoring, and in some cases medication such as metformin or insulin. Well-managed GDM usually resolves after delivery, but women who have had GDM have a 50% lifetime risk of developing Type 2 diabetes. The NHS offers annual blood glucose screening after a GDM pregnancy. Maintaining a healthy weight before and during pregnancy is one of the most effective ways to reduce GDM risk.
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Dr. Sarah Chen, PhD

Dr. Sarah Chen, PhD

Research Scientist, Public Health

Sarah holds a PhD in Public Health from the University of Edinburgh and has published research on UK health metrics and obesity trends. She translates complex medical data into practical, accessible guidance for everyday readers.

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Last updated: February 2026 | NHS pregnancy guidelines verified