More than half of all pregnant women are plus-sized. If you’re plus-sized, you’ve probably heard things about how your weight can affect your health. But this doesn’t mean you can’t have a healthy pregnancy and a beautiful, healthy baby if you get the information you need and receive good medical care.
Find a Size-Friendly Caregiver
Find a caregiver who is accepting of you and your body shape, and who will work with you to help you have the healthiest possible pregnancy. Ann Douglas, the author of “The Mother of All Pregnancy Books” and herself a plus-size mother, says, “You want someone who will help you to set weight gain goals for yourself, but who won’t make you feel like an unfit mother if you happen to gain an extra pound or two one month.”
Interview your doctor or midwife at your first appointment and ask specific questions:
• Do you consider yourself to be sensitive to the needs and feelings of larger women?
• What kind of weight gain do you recommend for a large woman during pregnancy?
• Where is the scale located for weigh-ins?
• Does your office have larger-sized gowns and blood pressure cuffs?
If the answers you receive make you uncomfortable, go elsewhere. Remember that part of your caregiver’s job is to talk to you about your risks and health concerns. The news might not always be just what you want to hear, but you want a caregiver who can do so without blaming you or scolding you. Don’t be embarrassed by your weight or shape — doctors and midwives see bodies of all shapes and sizes. Find a caregiver with whom you can be honest, one who will listen to your concerns and questions and treat you with the respect you deserve.
Health Concerns
You might worry that your weight will affect your chances of a healthy pregnancy. The odds are that you will have a healthy pregnancy and deliver a healthy baby. However, plus-size moms are at a higher risk for some conditions.
“Obese women also develop high blood pressure more often than thinner women,” says M. Kelly Shanahan, a practicing OB/GYN and author of “Your Over-35 Week-by-Week Pregnancy Guide.” Plus-size moms-to-be are at increased risk for gestational diabetes, which can lead to a big baby. “Even without diabetes, larger women tend to have larger babies,” notes Shanahan. “Large babies may mean more C-sections and more risk of injury to the baby during a vaginal birth.” There’s an increased risk of shoulder dystocia, where the shoulders get stuck, which can lead to nerve damage in the baby and vaginal tears in the mom. “Women who are obese should be screened for gestational diabetes in the first trimester; if this testing is normal, they should be tested again in the usual 24 to 28-week range.” Controlling weight gain and monitoring the baby’s size can help avoid this.
The March of Dimes reports that overweight women are at a 30-40 percent higher risk of delivering babies with birth defects. Don’t panic — some of the risks can be reduced with folic acid supplements. Talk to your caregiver for more information.
Make sure your care provider discusses these conditions with you and monitors you for them. At the same time, remember that your caregiver monitors all pregnant moms for these conditions, and will do the same for you. Don’t feel you are being singled out because of your weight.
Weight Gain and Pregnancy
One of the biggest misconceptions is that you shouldn’t gain any weight during pregnancy if you are plus-sized. Don’t believe it!
Dr. Robert A. Hadden, professor of clinical obstetrics and gynecology at Columbia University, agrees, “I would never recommend someone diet during pregnancy.” Recommended gains for plus-size moms is between 15 and 20 pounds.
Simply be realistic about your weight gain and try to focus on eating healthy foods. Talk to your caregiver about how much weight he or she recommends for you.
Having a Complication-Free, Plus-Size Pregnancy - Potential Problems and Possible Preventatives.
Diabetes Concerns
Your chances of gestational diabetes are two to eight times greater than women whose BMI is under 25. This condition increases complications like pre-term delivery and the need for C-sections. Your doctor may suggest insulin shots, but if not, you can generally manage it with activity and diet.
Plus Size Pregnancy, Plus Size Babies
Larger moms have babies topping nine pounds about 14 percent more often, and with gestational diabetes, the risk rises to about 20 percent. It turns out that diet changes can even help control baby’s weight, but do it safely! Keep a record of what and how much you’re eating and ask your doctor where to improve.
Blood Pressure Situations
Preeclampsia, a dangerous form of high blood pressure that occurs mostly after 20 weeks of pregnancy, strikes 8 percent of all pregnant women. Obesity quadruples your chances of developing this often-serious condition. Your doctor will keep an eye out for this; symptoms include swollen hands and feet and protein in your urine. If the condition isn’t diagnosed and treated quickly, it can be life-threatening for you and your baby.
Extra Weight Can Be an Extra Pain
Leg cramps, pelvic twinges and back pain are familiar companions to all pregnant women. Larger women can expect more of these problems than those with smaller frames. A good belly-support belt is a must and a heating pad can help with the pain. Check with your doctor or midwife before using popular pain-relievers. Even though you don’t feel like exercising when you already in pain, it can honestly help. Try a prenatal yoga class!
The Delivery Room Marathon!
Many overweight women, though not all, aren’t physically fit. Labor is demanding, and better muscle tone translates into a shorter labor and a lower C-section rate. Get that exercise during pregnancy even if you don’t feel like it! It’s known to help shorten labor as well as recovery time.
Other Plus Size Pregnancy Concerns
Harder-to-hear Heartbeat
The extra padding may come between baby and the doptone or fetoscope, making the treasured heartbeat less audible. Ultrasounds may not be as clear, showing baby’s outlines but missing some finer details. You may not feel the baby move quite as early.
Potential Negative Comments
An OB caring for a larger pregnant woman will definitely want to help her keep her weight down because of the complications mentioned above. He or she may not always be tactful; doctors have varying temperaments and bad days just as we all do. If the doctor or staff seems to be consistently disrespectful, though, rather than caring, it’s time to speak up and ask for constructive advice rather than a stream of criticism. Most medical staff really want to help!
Extra Doctor’s Visits
Between gestational diabetes follow-ups, extra stress tests and blood pressure monitoring, you may be spending extra time at the OB office. While you’re waiting, check out the newest Pinterest offerings on your phone, catch up on those emails or read a good book. Keep the outcome—a healthy mom and baby—in sight!