Individual Health Needs in Pregnancy with Dr. Kimberley Sampson
What if we treated pregnancy as more than just a countdown to baby?
What if we gave women the kind of real, supportive, evidence-based care they actually deserve during one of the most intense and life-changing experiences of their lives?
That’s exactly the kind of conversation we’re having today. Because let’s be honest, mom’s health goals in pregnancy often get overlooked in the broader women’s health conversation. We talk a lot about fertility. We talk about postpartum. But those nine months in between? Silence.
That’s why I’m so excited to share insights from Dr. Kimberley Sampson. She’s a board-certified OB/GYN, plus she’s certified in lifestyle medicine and obesity medicine. She’s the chair of Obstetrics and Gynecology at Southwestern Vermont Medical Center, teaches at Dartmouth, and is VP of the New England Obesity Society. Basically, she’s the real deal when it comes to compassionate, evidence-based care.
If you’ve ever felt like pregnancy care leaves out the actual person who’s, you know, actually pregnant, you’re not alone. Let’s talk about how we can do better.
Why Weight During Pregnancy Deserves More Attention
Menopause is finally getting the attention it deserves, which is awesome. But can we take a second to talk about how pregnancy kind of gets skipped over in the women’s health conversation? Like hello, it’s one of the most intense times in a woman’s life. And yet, when it comes to weight, nutrition, and just feeling okay in your body, it’s like... crickets.
We hear so much about losing weight before getting pregnant and then “bouncing back” after. But what about the nine months in between? That part matters too. A lot.
So many women are left wondering—how much weight should I gain? Is it ever safe to lose weight during pregnancy? What should I actually eat? But these questions don’t always get answered, partly because most appointments are quick and super baby-focused. And that can make moms feel like they’re just along for the ride instead of being cared for as whole people.
When I was in family medicine training and delivering babies, I saw how different every pregnancy really is. But here’s a not-so-fun fact: doctors usually get paid one flat rate for prenatal care and delivery, no matter how many conversations or complications come up. So it’s not exactly set up to support longer visits or personalized care. And honestly, pregnancy should never be one-size-fits-all.
That’s actually a big reason I moved into obesity and lifestyle medicine. I wanted to make space for deeper conversations—about weight, movement, nutrition, and how all of that plays into things like gestational diabetes, high blood pressure, and even birth outcomes.
Pregnancy is not just a pause between pre-baby and postpartum life. It’s a major chapter—and women deserve real, evidence-based support through all of it. Because when we take care of moms during pregnancy, we’re setting up healthier outcomes for everyone.
Let’s Rethink How We Talk About Nutrition During Pregnancy
Pregnancy is such a big deal—physically, emotionally, and yes, nutritionally. But somehow, the way we talk about nutrition during those nine months is either super unclear or just... not very helpful. A lot of women feel unsure about what’s okay to eat, what’s not, and whether it’s even okay to ask their doctor questions about food and weight gain.
Sometimes they’re handed a long list of foods to avoid—like, here’s everything you can’t eat, good luck. Other times, the topic doesn’t even come up, as if it’s too awkward or sensitive to discuss. And that silence? It adds more pressure, especially when random people or influencers start tossing around opinions and outdated advice.
Even when providers want to help, they’re not always trained to have these conversations in a clear and kind way. Plus, with how short appointments usually are, there’s not much time to get into the real-life stuff—like cravings, exhaustion, or food aversions. That’s part of why more providers are learning about lifestyle and obesity medicine. It’s not just about numbers or meal plans. It’s about guiding women through one of the most vulnerable, intense seasons of their lives.
And let’s be real—the advice to just “eat better” or “move more” doesn’t really hit the mark here. Everything’s shifting. Hormones, appetite, energy levels. So the usual rules don’t always apply. And while we hear a lot about fertility nutrition or postpartum recovery, the months during pregnancy often get glossed over.
There’s also a ton of confusion. Like, no, pregnancy isn’t the time to lose weight. The real goal is supporting healthy weight gain in a way that nourishes both the baby and the mom—without turning it into this super strict or anxiety-filled experience.
That’s why these conversations matter. Not just for physical health, but also for confidence and peace of mind. Women deserve honest, supportive info about what good nutrition in pregnancy actually looks like. Not judgment. Not guesswork. Just real, clear guidance.
Someone recently asked if it’s okay to lose weight while pregnant. It’s a valid question—and one that a lot of people are probably thinking but don’t feel comfortable asking. The answer? Pregnancy naturally comes with weight gain, and that’s expected. The focus should be on balanced, nourishing meals that support both mom and baby—not weight loss.
At the end of the day, we need to normalize these conversations. Pregnancy nutrition shouldn’t be this vague or overwhelming topic. It’s a key part of women’s health, and it deserves way more attention, empathy, and support than it usually gets.
When Guidance Is Missing: Supporting Pregnant Women Through the Silence
One of the biggest gaps in pregnancy care is support around weight, nutrition, and movement. Many women go through pregnancy without a single real conversation about these things. Not because they don’t matter, but because providers often don’t know how to bring it up. Appointments are short, the topic feels sensitive, and many simply aren’t trained to handle it well.
But pregnancy is often a motivating time. People are already making changes for their baby, like quitting smoking or avoiding alcohol. That’s the perfect window to talk about habits that support both mom and baby. Even if weight isn’t mentioned, there are natural ways in through blood pressure, blood sugar, or basic nutrition.
For those with tough pregnancies, like severe nausea or early weight loss, the focus shifts to nourishment and day-to-day well-being. That’s where extra help matters. Dietitians, physical therapists, and other specialists can give advice that actually fits real life.
Movement often gets misunderstood. It’s not about hitting the gym. Gentle activity is usually safe and can help with pregnancy, labor, and recovery. Unless there’s a medical reason to avoid it, staying active is a big plus.
It’s not about perfect numbers. It’s about real support, honest conversations, and meeting women where they are.
Moving Safely Through Pregnancy
When it comes to exercise during pregnancy, one general rule of thumb applies: if you were doing it before pregnancy and it’s not a contact sport, chances are it’s safe to continue within reason. Think walking, swimming, yoga, strength training, whatever felt good and safe before will likely still serve you now.
But this isn’t the time to try something completely new and risky. Activities like horseback riding, skiing, or anything that increases the chance of falling? Not ideal, especially if you weren’t already doing them. Pregnancy just isn’t the moment to push your luck.
Here’s the thing: exercise during pregnancy isn’t about following a rigid list of dos and don’ts. It’s about tuning in and being honest about what feels right for your body. The goal isn’t about handing out blanket rules; it’s about focusing on and figuring out what works best for each person.
And it’s not just about staying in shape. Movement supports mood, energy, blood sugar, sleep, and even your recovery after birth. It can be one of the most grounding things you do during this wild, in-between season.
That said, it’s also not the time to go from zero to intense. Easing in and keeping things consistent is way better than overdoing it and ending up injured or burned out.
Bottom line? If it feels good and you’ve done it before, great—keep going. If it’s new, intense, or makes you nervous, it can probably wait.
How Hard Can You Work Out While Pregnant?
One of the most common questions during pregnancy is: How hard can I actually work out? Is it okay to get your heart rate up? Can you still push yourself a little?
It really depends, because every pregnancy feels different. Some days, especially in the first trimester, you might feel completely wiped out or nauseous. And on those days? Rest is the right call. You’re not lazy. You’re literally growing a human.
But if you’ve got energy, move your body. A walk, a stretch, or a little gentle movement can feel surprisingly good.
If you were active before pregnancy, you can usually keep doing what you were doing, just in a way that feels more comfortable. Your body is changing, so it's totally normal if your workouts feel different now. You might need to slow down, take more breaks, or skip things that used to feel easy.
The most important thing is listening to your body. If you’re out of breath, slow it down. If something feels weird, don’t do it. And don’t stress about fitness trackers or numbers unless they’re actually helping you.
Some people feel stronger in their second trimester, and others don’t. There’s no rulebook. Pregnancy looks different for everyone.
Exercise doesn’t have to be intense to be worth it. Walking counts. Stretching counts. Prenatal yoga totally counts. Let your movement match how you feel.
You’re doing something incredible. Move in a way that honors that.
Pregnancy Food Rules (That Actually Make Sense)
Nutrition during pregnancy is such a hot topic and somehow still totally confusing. Between all the unsolicited advice, the internet spirals, and your aunt’s stories from the 90s, it’s hard to know what’s actually real. So here’s the deal: when it comes to food during pregnancy, it’s less about being perfect and more about understanding why some things are off-limits.
Basically, you're not just feeding yourself anymore. You're protecting a growing baby who’s more sensitive to things like bacteria from certain foods. That’s why doctors suggest avoiding raw or undercooked meats, eggs, and seafood, along with unpasteurized stuff like soft cheeses and fresh apple cider. It’s not that these foods are evil or anything—they just come with a little extra risk right now.
Same goes for deli meats unless they’re heated until steaming. And even things like pre-washed veggies? Still give them a rinse, because you never know where they’ve been.
Even if you're doing everything right, surprises can still happen. There have been recalls on totally unexpected foods like ice cream, so the goal here isn’t to panic. It’s to stay informed, stay calm, and make choices that feel both smart and doable.
Pregnancy already comes with enough pressure. The truth is, you can’t eliminate every risk and no one’s expecting you to. You’re doing your best, and that’s enough.
Being Part of the Pregnancy Care Team
For clinicians tuning in, especially those in lifestyle medicine, nutrition, or obesity care—it’s still super important to feel confident helping pregnant patients, even if you’re not their main maternity provider. You can always check in with their OB or midwife to make sure everyone's on the same page, but there's a lot you can do to support them.
Encourage patients to keep checking in as things shift because they will. Appetite changes, cravings, food aversions... totally normal. What they need might look different week to week, and that’s okay. The key is reminding them that it’s not about getting everything perfect. It’s about staying realistic, paying attention to what their body needs, and being a little more gentle with themselves while everything’s changing.
Pregnancy deserves more than just checklists and generic advice. It’s a big deal—and women deserve care that meets the moment.
If this episode gave you something to think about, send it to a friend, a colleague, or someone who’s expecting. And hit follow so you don’t miss what’s coming next.
Talk soon!
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