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Written by Caroline Meyer

For most women who are overweight, there may be no effect on their pregnancy at all. They may experience a normal, healthy pregnancy and a normal delivery. Women who have a BMI (body mass index) over higher than 30 are however, more likely to suffer from diabetes, pre-eclampsia and other conditions during pregnancy. Women who are heavier are also more likely to have a miscarriage. Other conditions such as your general health and lifestyle, age, family history and ethnic background can also have an effect on your pregnancy and increase the risk of complications. 

What complication risks are increased due to weight? 

Women who are overweight have a lower chance of falling pregnant than women of lower weight. IVF is also a lot less likely to be effective in heavy-set women.  

High blood pressure, clotting problems and pre-eclampsia are more likely for women who are overweight. These are life-threatening conditions for both the baby and the mother.  Gestational diabetes is a form of diabetes that women can get during pregnancy. This results in high levels of sugar in the body. Excess weight can also cause you to carry your baby for longer and experience complications during the birth. You may also have issues with pain medication and anaesthesia. There may be difficult in administering an epidural if you are having one. Your hospital stay may also be prolonger especially is you have experienced any issues. There is a greater chance of having to undergo a Caesarian section, which can also lead to other complications such as blood loss and infection. There is also a higher risk of having to have an assisted birth (forceps delivery).There is also a greater chance of a stillbirth in obese women. 

Other issues you may experience during pregnancy if you are overweight include venous thromboembolism which is caused when a blood clot travels to a major organ due to clotting problems and can cause a stroke or heart attack. Sleep apnoea is also more likely. This is when you actually stop breathing for periods of time while sleeping. There is a higher risk of UTIs (urinary tract infections) as well as other infections during pregnancy. You may have to have your labour induced especially if you go over term. You may also experience problems with breastfeeding once your baby is born. 

Are there any risks to the baby? 

Some of the risks are increased such as neural tube defects which effect the spine and brain. There is also a higher risk of premature birth (before 37 weeks) which can have long lasting effects on your baby. You may end up with a baby that is much larger than normal which can also cause problems during labour and birth and increases the chances of a c-section being required. Your baby is also more at risk of being obese and having diabetes or heart disease later in life. 

How can you improve your chances of a healthy pregnancy? 

If possible, go for a full health screen prior to falling pregnant. Your doctor will check you for any current health issues as well as help you find ways to improve your health through diet and exercise. It is preferable to lose weight before you fall pregnant if you are overweight. During your pregnancy make sure you get regular check ups, even if you are feeling okay. Ensure checks such as glucose screening and ultrasounds are done to check your health and that of your baby. If you are overweight, you should not put on more than 10kg during pregnancy. This does not mean you should diet  or starve yourself during pregnancy. You should attempt to eat healthy foods and avoid snacking and foods high in sugar and unhealthy fats. Drink plenty of water and avoid fizzy drinks and other fluids full of sugar. Stay active. Even if it just means a short walk every day, ensure that you do some activity every day. Speak to your doctor about safe options for you. 

Remember, while it is very important to eat a healthy nutritious meal three times a day while you are pregnant, you do not need to eat for two. For the first 6 months you need to eat the same amount of food you usually would to sustain yourself. It is only in the last 3 months that you need to increase your intake by around 200 calories (this is equal to a small bowl of cereal with milk). If you suffer from morning sickness at the start, make sure you drink plenty of water and try and eat smaller meals during the day, made up of nutritious foods. Avoid snacks, sweets and commercially prepared foods. 

Foods to eat while pregnant will include your basic carbohydrates such as pasta, rice, potatoes and whole-grain bread. Lean meat and fish (at least one portion of oily fish per week), eggs, legumes and pulses to make up the proteins. Dairy such as yoghurt, cheese and milk in their low-fat versions or vegetable based milks if you are lactose intolerant. A variety of vegetables and fruit in as natural state as you can (raw over steamed and steamed over boiled / fried). You can enjoy a sugary treat once in a while such as a small chocolate or cake, but limit the amount of calories consumed from these sorts of foods. 

As well as ensuring a diet that is as healthy as possible you will need to make sure you are taking folic acid to help your baby’s nervous system develop properly. You may also need to take a multi-vitamin or a vitamin D supplement if it is recommended by your doctor.  

There is an added risk to having a baby when you are overweight. Discuss your decision with your doctor before falling pregnant if possible so you can reduce the risks. Make sure you get adequate medical attention all the way through your pregnancy to try and pick up any issues as they occur. Other than that, eat healthy and stay as active as you can to improve your chances of a healthy pregnancy, safer childbirth and a healthy baby. 

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