Gestational weight gain above or below the recommendations by the Institute of Medicine has been shown to increase risks of adverse outcomes. However, guidance around weight gain in pregnancy is inconsistent, may be influenced by anti-fat bias, and can lead to feelings of shame and stigma for patients when discussed in an insensitive manner. The 5 A's framework has been shown to be a simple and effective framework for conducting weight management discussions and is associated with improved provider-patient interaction and patient satisfaction with this challenging topic. The specific aims of this project were to ask patients for consent before weighing and to use the dot phrase in 85% of all initial prenatal visits.