These remarks coming from a stranger, or a well intentioned friend, can easily be managed.

But when they're coming from a midwife, is it honest and direct medical advice, or is it just more unsolicited opinion?

Now my baby is tracking along beautifully, but dealing with issues about my growing size has taken time (and coordination and a new wardrobe).

On a recent visit to the antenatal department, I listened to remarks about my weight gain and unhealthy eating to encourage me to sign up for the Get Healthy Information and Coaching Service.

The medical advice was solicited, but was it warranted.

I was feeling really triggered, anxious about my baby's health and more self-conscious about the changes to my body.

And personal questions about my eating and exercise habits were distressing.

During the start-up phone call, I queried my eligibility and the provider told me that hospitals have referral targets to meet.

On further online analysis of the program, a referral from a general practitioner, midwife or obstetrician earns continued professional development points and it is a deliverable in the NSW Health strategic priorities.

The strategy is a focus on pregnant mothers and the first 2000 days of life, including weight loss support after the first baby, and advice for parents of a newborn up to two-year-olds; and, to increase the reach of the Get Healthy in Pregnancy service.

Healthy eating targets and weight gain guidelines are readily available during pregnancy.

But with all the other stresses in early and first time pregnancy, maybe it's time medical professionals and the state departments were able support a more holistic approach to pregnancy weight gain, and urge women to listen to their instincts and trust their gut.

If a performance framework is not in the best interest of the patient - or, in this case, patients - and only in the best interest of the provider, then its priorities need to be adjusted.

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