You can have a happy and healthy plus-size pregnancy

Prioritize taking prenatal vitamins, drinking enough water, and eating for nutrition

pregnant standing on scale

“I am thrilled to be pregnant so why am I not happier? Because I know I am going to gain more weight. And I worry that my weight might negatively affect my pregnancy or my baby’s health.”

OR

“I should make an appointment with my doctor before getting pregnant. But I know, the doctor will tell me I should lose weight first. So I just don’t make the appointment.”

Whatever the pregnancy-related thoughts whirling in your head, worries about weight are an additional burden if you’re a plus-size woman. Weight – or overweight – is kind of an obsession in America. Every woman’s magazine has some article relative to losing weight. Obesity is even being referred to as an “epidemic” in the United States. And how often do you have lunch with your girlfriends without having at least one conversation about dieting, losing weight, etc.? Or has your mother or sister or husband – or whoever doesn’t struggle with weight – encouraged you to lose weight before getting pregnant?

Whether you are thinking about getting pregnant or you already are, the fact that you are reading this indicates you want to know more. You are looking to make decisions that will help you and your baby do well in spite of your extra pounds.

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More than one-half of American women are considered overweight or obese. Stressing about your weight will make your pregnancy and your excitement about having a baby less enjoyable. And frankly, stress isn’t good for pregnancy either. So let yourself off the hook a bit. Take comfort in the fact that the majority of plus-size women have normal pregnancies and healthy babies.

That’s not to say you shouldn’t do what you can to take care of yourself and your baby. The American College of Obstetricians and Gynecologists (ACOG) urges plus-size women to lose weight before pregnancy, limit weight gain during pregnancy and lose baby weight quickly after pregnancy. And the Centers for Disease Control and Prevention (CDC) ranks being overweight or obese during pregnancy at nearly the same risk level as uncontrolled high blood pressure, diabetes, smoking or drinking.

Starting with weight gain

Pregnancy has probably got you thinking more about the effects of being overweight. Do you actually know how overweight you are? Facing the reality can help you make realistic choices. It’s not just the number on the scale. You should also know your Body Mass Index (BMI). BMI takes into account your height and weight, and is an estimate of body fat. If your BMI is between 25 and 29.9, you are overweight. If it is 30 or more, you are obese. If you don’t know, here is a BMI calculator. Strive to limit your weight gain during pregnancy.

BMI 25 to 29.9: 15 to 25 pounds

BMI 30 or higher: 11 to 20 pounds

You may lose some weight naturally. The first trimester, women can lose weight as a result of morning sickness. Your baby will still get necessary nutrients because overweight women have a reserve of calories in stored fat. So losing a little weight naturally will not hurt your baby. Also, your body uses more calories during pregnancy, so if you don’t increase your consumption, you’ll probably lose some weight. Your body’s priority is to provide your baby nutrition. As the calories you consume go toward baby’s growth, your body may resort to using fat stores to keep you going – leading to weight loss.

Dieting during pregnancy is not recommended. Eat foods that your baby needs to grow and you need to stay healthy. In other words, eat wisely. Restrict or eliminate foods with no nutritional value, but do not restrict your overall food intake or go hungry. By eating healthy and exercising wisely, you can positively impact your pregnancy and reduce risks of health conditions. Gestational diabetes, preeclampsia and C-section deliveries are among possible complications more common in overweight women and in pregnant women who gain excessive weight.

Controlling your intake

“I’m going to gain weight anyway so I may as well enjoy eating what I want whenever I want.” That mentality can lead to excessive weight gain for any pregnant woman, overweight or not. You don’t want to go there.

Mood swings, morning sickness and other pregnancy-related side effects can also impact your eating patterns. Be prepared. Here are three things you put in your mouth that can make a big difference in helping you feel better physically throughout pregnancy. At the same time, they will contribute to better outcomes for your and baby.

1. Remember to take your prenatal vitamin every day.

This is the easiest way to make sure both you and baby get nutrients you both need. If you are one of those people who has trouble swallowing pills, you will be glad to know that prenatal vitamins are available now in chewable, gummy and miniature forms.

  • Pregnant women are advised to get 600 micrograms (mcg) of folic acid daily to help prevent neural tube defects. Some studies have found that plus-size women have lower blood folate levels than smaller women. (You do get some folate from food, but your body doesn’t absorb it as well as the synthetic kind.)
  • Many prenatal vitamins contain 600 or more mcg as well as other vitamins and minerals that your body may need. Check with your doctor to see if you might need more than 600 mcg of folic acid during your pregnancy.

2. Drink plenty of water.

The Institute of Medicine recommends that pregnant women drink 10 8-ounce glasses of water or other beverages each day. Plus-size women need more hydration than smaller women because you have more body mass. Water is your best source of hydration! Unfortunately, many physicians say their patients tell them they drink soda, juice or coffee when they are thirsty.

  • Take a water bottle with you wherever you go. Sip it throughout the day. When you urinate, your urine should be clear or pale yellow in color. That\’s a sign of good hydration.
  • If it’s hot outside or you are exercising or physically active, drink even more water.
  • If morning sickness or nausea is interfering with your ability to drink water, experiment with ways to make it more appealing. Try sparkling water with flavors. Add your own flavor, like lemons or strawberries.
  • Keep caffeine and sugar to a minimum. Anything with refined sugar (juice drinks, lattes and sodas) can make your blood sugar levels fluctuate and contribute to hunger and headaches. (If you do drink juice, drink only pasteurized juices. Unpasteurized juices aren’t safe during pregnancy.)
  • Did you know that even sugar-free soda can lead to weight gain? American Diabetes Association studies have shown this to be true although it isn’t yet understood why.

3. Plan what you eat and eat for nutrition.

Planning can help you avoid the trap of grabbing whatever is handy when you have a craving or feel famished.

  • Keeping a daily food diary helps you track whether you are getting enough of the right nutrients and drinking enough water each day. Start with a good breakfast.
  • A breakfast with protein, fat, carbohydrates and fiber will help you feel better all day.
  • Eat small meals throughout the day. That keeps your blood sugars more even and helps curb food cravings and hunger attacks.
  • Include protein at every meal and snack. Avoid foods with refined sugar or processed white flour. This helps stabilize your blood sugar levels and keeps hunger at bay.
  • Have “good-for-you” snacks easily accessible and ready in appropriate portion-size containers. Examples include: cleaned fresh fruit, trail mix and nuts, string cheese or cheese slices with whole grain crackers, smoothies (add flaxseed for fiber) in individual jars that you can take from the freezer, an apple with a handful of walnuts or almonds, 1/2 cup of plain yogurt with fresh fruit, a slice of whole grain toast with 1 tablespoon of almond or peanut butter, sliced cucumber or banana on whole grain bread, a hard boiled egg with raw veggies, raw veggies with low fat cheese or dressing.

Moving your body

Every pregnant woman should discuss exercise with her doctor before beginning a program, but as a plus-size woman, it’s even more important that you communicate with your doctor before beginning an exercise program. Extra weight increases the likelihood of back pain and falling. During pregnancy, the extra weight in the front of your body shifts your center of gravity. This makes you more likely to lose your balance, which increases your risk of falling. As your pregnancy gets farther along, you become short of breath more easily because there is increased pressure on your diaphragm. Women who are overweight or obese have more trouble exercising as their pregnancy progresses because of these physical changes.

But don’t let the added weight give you an excuse to quit moving! Exercise can decrease the risk of gestational diabetes, preeclampsia and C-sections – all more common among plus-size women. Exercising after your baby is born helps you take off pregnancy weight and also decreases the risk of deep vein thrombosis (also more common in plus-size women).

Other advantages of regular exercise during pregnancy include reduced back pain, less constipation, improved overall general fitness, and stronger heart and blood vessels. So it’s even more important now to be physically active.

ACOG says almost all pregnant women can safely do at least 20 to 30 minutes of moderate exercise on most or all days of the week. The CDC recommends that pregnant women get at least 150 minutes of moderate-intensity aerobic activity every week. Some women prefer to do longer workouts once a day or 30-minute exercises five days a week, while others may choose smaller 10-minute workouts throughout a day. Do what works for you.

One of the best ways to stick to a workout routine is to line up an exercise buddy. It will help you with motivation and accountability!

Understanding complications

All pregnant women are screened for gestational diabetes. Being overweight puts you at higher risk for this type of diabetes. Gestational diabetes usually disappears after childbirth but once you’ve had it, you are at higher risk of being diagnosed later in life with diabetes. Babies born to mothers with gestational diabetes may have problems with breathing, low glucose levels and jaundice. High blood pressure and preeclampsia  are among conditions also more common in pregnant women who are overweight or obese.

If you need a C-section, you also have an increased risk of a common problem, which is infection at the incision site. In that case, be sure to change the dressing on your incision often to keep the wound as dry as possible. Also, after you bathe, make sure to dry the incision site completely.

Getting support

One of the things plus-size women sometimes worry about is whether or not people will know they are pregnant or think they are just gaining more weight. If that’s going to bother you, share your news first! There’s no reason you have to wait any given amount of time to tell the world you are pregnant. Of course, wearing maternity clothes is a pretty good indicator too.

Sharing your pregnancy with family and friends is also a good means of emotional support. Be selective: don’t share with negative naysayers or women who love to tell horrifying stories about their pregnancy or labor and delivery. If the conversation starts to drift that direction, intervene and change the subject to a positive one.

Talk to your health care provider openly and honestly. Your provider can help you with struggles to eat right, exercise optimally and just stay on track. If you’re having problems modifying your diet or are gaining weight faster than recommended, ask for a referral to a dietitian or nutritionist.

Most importantly, help your partner understand the importance of supporting you during your pregnancy. Did you know that women who have an involved and supportive partner during pregnancy are more likely to give up harmful behaviors (such as overeating)? These women tend to be less anxious and less stressed after childbirth too. A Partner’s Guide to Pregnancy is a good resource for helping your partner understand the importance of helping you.

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Posted In Health Information, Pregnancy, Women's