What To Know About How Obesity Can Affect Pregnancy

It’s not about a number on the scale or how your jeans fit. Obesity is a medical condition that can affect your fertility and overall well-being.

And once you’re pregnant, obesity can make things more complicated.

The good news is that there are steps you can take to have the healthiest pregnancy possible.

Ob/Gyn Deidre McIntosh, MD, shares the risks of obesity and pregnancy and offers advice on how to stay healthy.

How does obesity impact your pregnancy?

Having obesity (a BMI greater than 30) during your pregnancy can come with a higher risk for a number of complications. That includes issues like:

• Gestational diabetes
• High blood pressure (gestational hypertension)
• Preeclampsia
• Sleep apnea
• C-section birth
• Preterm labor
• Miscarriage

You may also find that your pregnancy can take a bigger toll on your day-to-day, like more joint pain and fatigue.

But again, it’s more than a matter of weight. Obesity is a medical condition that can affect your body systemically. It puts stress on your heart, kidneys, lungs, liver and more.

Pregnancy can further strain your system. Your body is putting in extra work behind the scenes to support healthy fetal development — from increasing blood volume to developing teeny-tiny organs.

Put them together, and it adds up to a lot of work for your body to keep everything running smoothly. And when it’s working overtime, troubles may arise.

But before we move on, let’s remember that you are human first and foremost. Your BMI doesn’t tell the full story of your health and well-being. You’re more than the sum total of your risk factors. And your risk isn’t your destiny. You can have a healthy pregnancy. But it may take some extra effort.

Managing obesity during pregnancy

Even when you’re living with obesity, pregnancy isn’t the time to attempt to lose weight. Some weight gain during pregnancy is normal and healthy.

The American Academy of Obstetrics and Gynecology recommends that pregnant women with obesity should gain about 11 and 20 pounds during the course of a healthy pregnancy. But if you gain less and it’s not impacting proper fetal growth and development, you don’t have to aim to gain more to reach those goals.

“During pregnancy, the goal shouldn’t be to restrict yourself or to lose weight,” Dr. McIntosh emphasizes. “But it is the time to make healthy choices and build healthy habits.”

How? Dr. McIntosh shares a four-step strategy to manage obesity during pregnancy.

Don’t drink your calories

Of course, you should avoid drinking alcohol during pregnancy. That can save you some liquid calories, while also avoiding a host of alcohol-related dangers to a developing fetus.

But drinks like juice and soda (yes, even diet soda) contain calories and sweeteners that you don’t need. Same goes for those fancy coffee drinks.

“Cutting out drinks that are sources of empty calories and sweeteners is a relatively simple swap that can make a difference for your health,” Dr. McIntosh advises.

Opt for water instead. And if you need a little flavor, add some fresh fruit or a squeeze of lemon. Or if you’re craving something bubbly, try some unsweetened sparkling water.

Need your morning coffee? Black coffee is typically OK, just keep your caffeine to less than 200 milligrams a day. That’s one to two mugs a day.

Eat more protein

Protein helps fill your belly and keep you fuller longer. It can also help your body build muscle and give you energy to go about your day.

During pregnancy, upping your protein intake can help support healthy fetal development, too.

Good sources of protein during pregnancy include:

• Beans
• Lentils
• Lean meat and poultry
• Soy
• Pregnancy-safe fish (make sure it’s cooked and low in mercury)
• Nuts and seeds (choose unsalted varieties)
• Fully cooked eggs (no runny yolks during pregnancy)

Eat fewer processed foods

The healthiest foods are the ones that have the fewest ingredients and are closest to what’s found in nature. And a healthy pregnancy diet should include a wide variety of whole foods.

Eat veggies rather than veggie chips. Eat a slice of whole-grain bread rather than cereal.

The goal is to aim for a balanced diet that includes foods from all the major food groups, including:

• Whole grains
• Protein
• Fruits
• Vegetables
• Dairy

Check out the MyPlate calculator for more personalized recommendations.

Move more

If you’re not already an avid exerciser, pregnancy isn’t the time to drastically change up your routine.

But it is a good time to make sure you’re getting more movement into your day. Start with a walk around the block after lunch. Or a prenatal yoga class.

“Any little bit of extra movement in your day can help to support a healthy pregnancy and help you feel your best,” Dr. McIntosh shares.

Pregnancy-safe exercise can help prepare your body for labor and delivery. It can also help with reducing pregnancy aches and pains and things like bloating and constipation.

A pregnancy healthcare provider, like an Ob/Gyn or certified nurse midwife, can help you develop an exercise plan that works for you.

You got this

Yes, it can be scary to learn that living with obesity can put your pregnancy at risk for complications. But knowledge is power. And you can use that understanding to fuel your commitment to developing healthy pregnancy habits.

You’ll see a pregnancy care provider often over the course of your pregnancy. Use your prenatal appointments to check in on how things are progressing. Ask for advice. And know that taking even small steps to care for your health can make a big difference throughout your pregnancy — and beyond.