Weight in pregnancy
In an ideal world we would all eat less and exercise more and, as someone who is overweight, I know it’s not good to be obese but being overweight and pregnant is now a cause of concern as it can have an affect on your options as well as how you are treated.
- If you have a BMI over 30 you tick the obese box which means that you may need closer attention throughout your pregnancy.
- If your BMI is over 35, your options for place of birth change – a birthing centre is no longer possible and you may have a fight on your hands for a homebirth. Chances are you will also be placed under Consultant Care, rather than just seeing your community midwife, and you may also be offered an appointment with an anaesthetist to discuss management of labour – some maternity units recommend citing an epidural earlier in labour ‘just in case’.
The complaints I receive from some of my antenatal clients is that they feel like, because they are overweight, they are automatically treated as a risk to be managed. Some women are handled sensitively and others are terrified with the potential risks of being overweight and pregnant.
Risks do exist but women need to be informed and supported – common sense and individualised care and preparation can help women to manage these risks.
According to the Royal College of Obstetricians and Gynaecologists the risks include:
- Gestational diabetes (3x as likely than if a BMI is below 30)
- High blood pressure
- Pre-eclampsia (doubled if BMI is over 35)
- Bigger baby weighing more than 8lb 14oz if BMI is 30+ (14% compared to 7% in women 20-30 BMI) which can increase the risk of Shoulder Dystocia
- Emergency Caesarean
- Issues with any anaesthetic – the greater a woman’s BMI, the longer it can take to site an epidural. This can lead to suggestions that an epidural is sited earlier in labour.
- Induced labour – with signs of
- Invasive baby monitoring – the greater a woman’s BMI, it can be harder to monitor baby’s heartbeat with a sonicaid, which can increase the need for fetal scalp monitoring.
Managing the risks
Take control, arm yourself in information and practical skills for labour. If you are pregnant with a high BMI, you can work to reduce the potential risks…
Take control with food:
Eating well with plenty of fresh fruit and veg (more than your 5 a day), cut down on sugar and processed foods can make a huge difference. But don’t diet, just eating sensibly will prevent you from gaining excess weight, it may also mean that you lose some weight. It can also reduce the risk of developing diabetes and making a bigger baby.
I have battled with my weight and my attitude to food for my entire adult life, so I write this as someone who understands the problems and pitfalls. Although not pregnant, I am currently making changes to my diet to be healthier. I am not on a diet but I have stopped making excuses, I have identified my food/exercises weaknesses and I have cut out much of the crap. A huge part of eating better is getting your head in a better place so, if you are reading this and you are pregnant, this is not a time for dieting and restricting calories but it is a time for making the calories count – make them fuel your body with good stuff, chances are it’ll help you feel better and a bit more energised too. You only need more calories in the third trimester and it’s only 200 a day, so you don’t need to eat for two.
Taking control with food can mean being more organised but it’s the little things that can make a huge difference:
- Without sounding like a patronising cow, to help you cut down on sugary snacks and processed food – if you don’t buy it you can’t eat it! I worked out that my weak spot was in the evening, when I would snack more but if it’s not in the house, I can’t eat it. Think about your eating habits and identify your weak spots and make a plan from there.
- Buy fruit, veg and healthy snacks that you like, so you have plenty on hand for those days when you are never full or you are too tired to cook a meal.
- Fill your freezer with good food – if you or your partner cook, make more and freeze it so you can have a good meal in minutes when you are knackered.
- Don’t deprive yourself and don’t feel guilty if you eat some treats but do balance it out with the good stuff
Continue with any exercise/walking/swimming or you can start bringing some gentle exercise into your life. Through the Network you can contact Debbie at Pushy Mothers and we also have pregnancy yoga and pilates, along with aquanatal. It’s not the time to have a regime but regular gentle exercise can help your energy levels, make you feel better and improve your strength and stamina.
Get ready for birth:
Go to some good antenatal classes because it is worth the investment to be empowered, to find out what your options are and to prepare for how you can manage your contractions, how to use positions to stay comfortable and supported and how to use your breathing to ease anxiety, to stay calm and in control.