幾乎在所有的童話裡王子與公主的故事結束於步入禮堂的那一刻。雖然也有少數的故事(像史瑞克續集)裡會提到生孩子之後的發展。 但這些故事多著墨於孩子的天真與可愛,卻鮮少聚焦於公主成為媽媽後的觀點。比起結婚的內容,懷孕後產生的生理與心理變化在社會上是比較少被討論的話題。
尤其,懷孕時的體重增加像個雙面刃,太少有時會影響胎兒的發育,太多又會增加生產的風險。我常常被問到懷孕時增加多少體重才算是正常的。以亞洲人來說,懷一個胎兒總體重增加約在十公斤左右。體重增加的速率在第二孕期也就是三到六個月中增加最快,但體態的變化卻是在第三孕期也就是六到九個月變化最多(因為水分快速增加的原因)。總體重增加的內容最主要仍是以胎兒為主,而其中體脂肪的增加約佔了四分之一其他如胎盤與羊水都會因為生產而減輕總體重。而子宮的重量與大小會在懷孕後四到六週後逐漸恢復正常。
但因為每個人產前的體重不盡相同,所以以個人而言到底該增加多少體重才算是正常的呢?研究與臨床準則告訴我們孕前BMI是一個好的參考基準。以亞洲人來說 BMI 在 18-24的人建議增加8-10公斤,而在18-24 以外的媽媽們則需依BMI 增加或減少增加的幅度。(如BMI 30以上的人建議增加6公斤就好)另外或許也可依照每天的建議熱量標準來攝取食物並搭配每天20-30分鐘輕度至中度的運動(如快走與產婦體適能)來更確實的達到控制體重的目標。
我們總是在懷孕時高度的期待孕婦肚子的變化一天比一天大,卻要在生產後的瞬間希望媽媽們的肚子馬上恢復原狀,像什麼事情都沒發生一樣。社會的期待希望能在更多人站在孕婦、媽媽們的角度說故事後,有些許改變。
=========================================
Almost all the fairy tales end at the altar where the prince and the princess are happy forever after. Although some fairy tales like the Shrek’s have sequels on when the prince and the princess have children, they are mostly about the children and the family dynamic, little is being said about what happens to the princess when she becomes a mum. Compared to the topic of marriage, the topic of pregnancy is relatively uncommon, at least from the mothers’ perspective.
The weight gain during pregnancy is like a double-edged sword, that can be dangerous being too much or too little. Too much weight gain can put the mother at risk of difficult delivery or bleeding, whilst too little weight gain can risk the baby of prematurity or poor development. I am asked about this question almost everyday: how much weight gain is “normal” for pregnancy. In Asians, on average 10 kg is gained during a singleton pregnancy. The rate of weight gain is fastest during the 2nd trimester. However, the body shape changes the most during the 3rd trimester due to retention of water. The main components of weight gain during pregnancy include the mother’s body, baby, amniotic fluid/placenta and the womb. Most of these components will reverse after birth of the baby, only a small proportion will stay as body fat (about 25%).
Because everyone has different weight and height, it is not sensible to recommend a single number for the ideal weight gain during pregnancy. One way of doing this is the Body Mass Index (BMI). For Asians with BMI between 18-24, the ideal weight gain should be about 8 to 10 kg. (different recommendations may vary in the range of 1-2 kg) BMI outside this range should adjust their weight gain more or less than the recommended range. (For example, BMI of 30 should aim for a 6 kg weight gain). Diet control according to each trimester needs and regular exercises are good tools which can help mothers to achieve the desired weight gain.
We are always excited about the mothers’ belly being bigger everyday, but when after the baby is born, there seems to be an unrealistic expectation to recover her shape and weight almost immediately (as exemplified in many gossip magazines on how these celebrities successfully lose weight within an amazing amount of time). Hopefully when we pay more attention to mothers after they give birth perspectives can change.
Search