By Kecia Gaither, MD
One-third of Americans today are classified as obese, and another one-third considered overweight. And according to the U.S. Centers for Disease Control and Prevention (CDC), nearly one-quarter of women giving birth are obese (for example, 175+ pounds for a 5-foot-4 woman) before becoming pregnant. Gaining weight during pregnancy is anticipated and necessary for a healthy mother and baby. However, according to double board-certified OB/GYN and Maternal Fetal Medicine Physician Dr. Kecia Gaither, “for obese women—defined as a body mass index (BMI) of 30 or higher—starting a pregnancy can present a wide range of complications and possible health challenges for them and their babies.”
Dr. Gaither adds that “beginning a pregnancy already obese makes it harder to lose weight after the baby is born, and commences the nine-month term with well-defined health disadvantages to both the mother and baby.
Knowing the Potential Complications
“The list is long of potential health complications for an obese pregnant woman and her baby,” notes Dr. Gaither. Following are six common concerns for obese pregnant women and their physicians:
Preeclampsia: This occurs when a pregnant woman develops high blood pressure, often in the 2nd or 3rd trimester of their pregnancy. Preeclampsia takes place at a higher rate in obese women and frequently requires premature delivery, placing the baby at risk.
Gestational Diabetes: This occurs when a woman without diabetes develops high blood sugar levels during her pregnancy and it happens more frequently in obese pregnant women. This can lead to the baby growing larger than normal and increasing the risks of a stillbirth.
C-Sections: Otherwise known as surgical births, both emergency and elective, are more common in obese women. Complications from a C-section can include wound related infections, excess blood loss and blood clots.
UTI Infection: Obese pregnant women suffer more urinary tract infections (UTIs) than women of normal weight. Moreover, the babies of obese moms also have higher risks of infection after birth.
Labor Challenges: Obesity can interfere with the use of certain pain medications commonly offered during labor, such as an epidural. Labor is also more likely to be induced – brought on with the use of drugs – in obese expectant women.
Overdue Deliveries: Typical full-term pregnancies range from 37 to 40 weeks, but obese mothers often deliver later. This can make the delivery more difficult and put more stress on both the mother and the baby.
Obesity is also an issue for fertility
“The realities of dangers associated with obesity in pregnancy make it obvious why starting pregnancy at a normal weight is advisable,” notes Dr. Gaither. But the research points to even more fertility related challenges for obese women, suggesting that it is more difficult to become pregnant in the first place if you’re overweight or obese. Dr. Gaither adds that “extra weight can inhibit normal ovulation. Obesity is also thought to influence the outcome of infertility treatments such as IVF (in vitro fertilization), reducing the chances that an implanted embryo will “take.” Lastly, obesity also increases the risk of miscarriage once a pregnancy is established.”
Tips for Obese Women
“In a perfect world it would be advisable for obese women to lose weight prior to pregnancy. Regrettably this doesn’t usually happen,” adds Dr. Gaither. In such instances early prenatal care is particularly important, especially if co-morbid health issues (e.g., hypertension or diabetes) are present.
Dr. Gaither also counsels overweight and already pregnant patients to talk with their physicians about how much weight they should aim to gain while expecting. It is not healthy to stay the same weight or lose weight during a pregnancy. “As a general rule of thumb, overweight women should aim to gain about 15 to 25 pounds, while obese women should target an 11- to 20-pound gain,” adds Dr. Gaither. It is also recommended that all patients, obese and normal weight, remain physically active every day while pregnant. For patients that have not been active prior to their pregnancy, small steps, such as a daily walk, can help keep blood sugar in check, burn calories and tone muscles. And lastly, Dr. Gaither recommends a healthy diet of lots of vegetables and fruits, lean proteins, 6-8 glasses of water a day and avoidance of processed or fried foods.
Kecia Gaither, MD is a double board-certified physician in OB/GYN and Maternal Fetal Medicine and holds a Masters’ degree in Public Health. Dr. Gaither has particular expertise in caring for women with diabetes, HIV and obesity in pregnancy. For more information: www.keciagaither.com