How do you deal with obesity before pregnancy? Starting life off with the correct weight for you and your baby is important and if you do need help, then knowing your weight guidelines will help educate yourself and Â in the future your children.
Before getting pregnant
Before you get pregnant, you can use the NHS BMI (body mass index)healthy weight calculatorÂ to work out if you are overweight.
A BMI of 25 to 29.9 means you’re overweight, and a BMI of 30Â or aboveÂ means you’re very overweight, or obese.
If you are overweight, the best way to protect your health and your baby’s is to lose weight before you become pregnant.
By reaching a healthy weight, you increase your chances of conceiving naturally and reduce your risk of the problems associated withÂ being overweightÂ in pregnancy.
If you get pregnant before losing weight, try not to worryÂ â€“ most women who are overweight have a straightforward pregnancy and birth, and have healthy babies.
But remember that being overweight does increase the risk of complications for both you andÂ your baby.
Dealing with obesity before pregnancy
If you areÂ very overweight and pregnant,Â don’t try to lose weight during your pregnancy, as this may not be safe. There is no evidence that losing weight while you’re pregnant will reduce the risks.
The best way to protect your health and your baby’s health is to go to all your antenatal appointments so that the midwife, doctor and any other health professionals can keep an eye on you both. They can manage the risks that you might face due to your weight, and act to preventÂ â€“ or deal withÂ â€“ any problems.
It’s also important to eat aÂ healthy, balanced dietÂ and get some physical activity every day.
EatingÂ and exercise
Eating healthily and doing activities such as walking and swimming is good for all pregnant women.
If you weren’t active before pregnancy,Â it’s a good idea toÂ consult your midwife or doctor before starting a new exercise regime when you’re pregnant.
If you start an aerobic exercise programme (such as swimming, walking, running or aerobics classes), tell the instructor that you’re pregnant. Begin with no more than 15 minutes of continuous exercise, three times a week. Increase this gradually to daily 30-minute sessions.
Remember that exercise doesn’t have to be strenuous to be beneficial. As a general rule, you should be able to hold a conversation as you exercise when pregnant. If you become breathless as you talk, you’re probably exercising too strenuously.
Don’t lose weight in pregnancy
If you become pregnant before losing weight, you’ll be tested forÂ gestational diabetes.
You may also be referred to an anaesthetist to discuss issues such as pain relief in labour. You’re more likely to need anÂ epidural, becauseÂ very overweightÂ women are more likely to have an instrumental delivery (ventouse or forcepsÂ orÂ caesarean), and it can be difficult for the epidural to be given.
If you’re overweight, discuss your birth options with your midwife or doctor. Ask if there are any particular safety concerns for youÂ around giving birth at home or in a birthing pool.
BecauseÂ overweight women are more likely to need forceps, ventouse or caesareanÂ to giveÂ birth, it’s usually safer to opt for a hospital birth, where there’s faster access to medical care and pain relief options, if needed.
Being overweight in pregnancy
Being overweight increases the risk of complicationsÂ for pregnant women and their babies. The higher a woman’s BMI, the higher the risks. The increasing risks are in relation to:
- miscarriageÂ â€“Â the overall risk of miscarriage under 12 weeks isÂ one in fiveÂ (20%); if you have a BMI over 30, the risk isÂ one in fourÂ (25%)
- gestational diabetesÂ â€“Â if your BMI is 30 or above, you are three times more likely to develop gestational diabetes than women whose BMI is below 30
- high blood pressure andÂ pre-eclampsiaÂ â€“Â if you have a BMI of 35 or above at the beginning of your pregnancy, your risk of pre-eclampsia is twice that of women who have a BMI under 25
- blood clotsÂ â€“Â all pregnant women have a higher risk of blood clots compared to women who are not pregnant, and if your BMI is 30 or more the risk is additionally increased
- the baby’s shoulder becoming “stuck” during labour (sometimes calledÂ shoulder dystocia)
- post-partum haemorrhage (heavier bleeding than normalÂ after the birth)
- having a baby weighing more than 4kg (8lb 14oz)Â â€“Â the overall risk of thisÂ for women with a BMI between 20 and 30 is 7 in 100 (7%); if your BMI is over 30, your risk is doubled to 14 in 100 (14%)
You are also more likely to needÂ anÂ instrumental (ventouse or forceps) delivery, and an emergencyÂ caesarean section.
Risks to theÂ babyÂ if you’re overweight in pregnancy
Problems for your baby can includeÂ being born early (before 37 weeks), and an increased risk of stillbirth (from an overall risk ofÂ 1 in 200 in the UK to 1 in 100 if you have a BMI of 30 or more).
There is also a higher risk of foetal abnormality, such as neural tube defects like spina bifida.Â Overall, around 1 in 1,000 babies are born with neural tube defects in the UK. If your BMI is over 40, the risk is three times the risk of a woman with a BMI below 30.
These problems can also happen to any pregnant woman, whether she is overweight or not.
Bear in mind that although these risks are increased if your BMI is 30 or over, most women who are overweight will have a healthy baby.
You can find out more in a leaflet from the Royal College of Obstetricians and Gynaecologists, calledÂ Why your weight matters during pregnancy and after birth.