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To weigh or not to weigh in pregnancy: a retrospective study

02 November 2022
Volume 30 · Issue 11



A rise in the number of caesarean sections and the rate of birth weight over 4kg prompted an advanced midwife practitioner service to introduce routine weighing for all service users and target weight gain based on Institute of Medicine guidelines. The study's aims were to ascertain if maintaining weight gain reduced pre-eclampsia, caesarean section births, birth weight over 4kg and neonatal intensive care unit admissions.


A retrospective study of weight gain and outcomes for 53 pre- and 46 post-routine weighing service users was conducted.


Over a third (40%) of participants gained excess weight, with a 22% caesarean section rate and 22% of babies weighed over 4kg at birth. There was an overall 6% reduction in caesarean section births and a 22% reduction in babies weighing over 4kg.


Routine weighing and health promotion techniques have the potential to maximise health and wellbeing and could be a long-term investment in the health and wellbeing of mothers and babies.

The COVID-19 pandemic necessitated several lockdowns across the world to control the spread of the virus. After December 2020, Ireland went into a second COVID-19 lockdown. In May 2021, the advanced midwife practitioner service in a northwest Ireland maternity unit noticed a cluster of 12 emergency caesarean section births in a 6-week period and 31 vaginal births with all babies weighing over 4kg. The advanced midwife practitioner also noted that the majority of the 43 women in this group visually appeared to have increased their body mass index compared to that calculated at booking. The majority felt they had gained a lot of weight, with some knowing their current weight, verifying the observation.

When asked, almost all the women reported eating more, exercising less and gaining weight during pregnancy. Weight gain had been discussed at the first encounter with the advanced midwife practitioner. All women were advised that a weight gain of around 15kg was normal, with a gain of >20kg potentially increasing their risk of a caesarean section birth, raised blood pressure or a large for gestational age baby (Khanolkar et al, 2020). There was also a discussion signposting women to healthy eating in pregnancy, as per healthy Ireland and the my pregnancy book (Health Service Executive (HSE), 2018a), which every woman receives at the booking-in visit.

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