Antepartum teaching is mostly arithmetic and mostly specific. Recommended gain is set by pre-pregnancy body mass index, not by a single number. Energy rises by 340 then 452 kilocalories — a sandwich and a glass of milk, not a second dinner. And folic acid carries the trap that catches everyone: routine is 400 to 800 micrograms, but a prior neural-tube-defect-affected pregnancy needs 4 mg, which is ten times as much and can never be reached with extra prenatal vitamins.
Set up the patient
Discuss weight in terms of fetal growth and health, never as a moral matter. Weight conversations are a common reason patients disengage from prenatal care altogether.
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Weight-gain targetSet by pre-pregnancy body mass index