• If the woman stopped for this pregnancy, ask: Have you been able to stay off?

  • How many cigarettes are you smoking now?

  • If specific strategies were suggested, ask questions such as:

    • What did you think of the AA (or AlaTeen) meeting?

    • Did you attend the class on using WIC foods?

    • Did you pick up your WIC vouchers?

    • How often do you eat the cereal that WIC provides?

Physical Examination

At every visit, obtain and record objective data:

  • Weigh the woman or have her weigh herself.

  • Plot her weight on the grid.

  • Check the fundal height.

  • Check for pretibial and facial edema.

Indications to assess weight gain further are shown in the box.

Weight Changes That Signal the Need for Further Evaluation in the Second and Third Trimesters

Women of at least moderate weight (Prepregnancy BMI >19.8):

  • Gain of less than 2 lb (1 kg) in any single month

Obese women:

  • Gain of less than 1 lb (0.5 kg) in any single month

All pregnant women

  • Continuing pattern of less than recommended gain or of much higher than recommended weight gain

  • Gain of more than 6.5 lb (3 kg) in any month

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