Good news! You can get pregnant when overweight or obese. Pregnancy is a joyful time. It is also a period that harbors conflicting emotions. Some women experience joy, shock, scary or overwhelming episodes.
For many, it is a period of overwhelming joy and exhilaration. However, for some women, this may not be the case. More often than not, doctors advise overweight and obese women against pregnancy.
Most doctors would advise you to shed weight before a pregnancy. This is because a woman’s weight bears significant implications that complicate the joyous process of pregnancy.
In the United States, more than half of pregnant women are obese. 8% of this statistic is considered to be extremely obese. Although medical practitioners advise against getting pregnant if you’re overweight, there are ways to circumvent it to ensure you have a safe and risk-free delivery. In this article, we’ll cover all the nitty gritty that relates to obese pregnancy.
Can Obese Women Get Pregnant?
Yes, obese women can get pregnant; however, the chances are slim. Obesity makes it harder for women to conceive since it hinders ovulation. If you’re considering getting pregnant, a doctor may advise you to adhere to a healthy diet, exercise and take prenatal vitamins.
Some women may opt for weight loss surgery. However, it’s imperative to consult your doctor on the healing period before you can start your pregnancy journey. Obese women tend to have a longer time getting pregnant, even if their ovulation is regular.
How Does Obesity Affect Pregnancy?
Obesity is linked to various fertility issues. The primary concerns are infertility, frequent miscarriages and ovulatory dysfunction. Research suggests that Polycystic ovary syndrome (PCOS) is the leading cause of infertility.
Nonetheless, recent discoveries link obesity to PCOS. Statistics indicate that 80% of women diagnosed with PCOS are obese.
Obesity means that your body has a higher concentration of fat cells. These fat cells tend to produce high estrogen levels that inhibit ovulation, affecting fertility. In a nutshell, obesity impacts your reproductive health, making it difficult to get pregnant. Notwithstanding, it’s not always the case. While you may not have trouble getting pregnant while obese, it may disrupt your menstrual and ovulation cycles.
Furthermore, obesity may also hinder fertility treatments such as in vitro fertilization (IVF). IVF refers to combining a sperm and an egg in the lab, which is later planted in your uterus. Obese women are less likely to get pregnant with IVF. Furthermore, obese women respond poorly to ovarian stimulation and require higher gonadotropin doses. Also, the rate of miscarriages tends to be high.
Additionally, being obese makes it challenging to have an ultrasound. Since the process uses sound waves to check your baby’s status when pregnant, having excessive fat around your abdomen may impair this process.
However, there is a silver lining. Proportionally obese women have less risk during conception. If your body fat is equally distributed or you carry more fat in your butt, you may quickly get pregnant. On the other hand, the risk tends to be significantly higher for women with a predominantly apple-shaped body, where the weight is concentrated around the abdomen.
How Does Obesity Cause Infertility in Females?
Excessive weight gain affects female fertility. According to the American Society for Reproductive Medicine (ASRM), six per cent of women struggle with fertility issues due to obesity. Moreover, the amount and distribution of fat in your body can affect hormone production, which regulates the menstrual cycle. Obese women have a high concentration of leptin hormone. A high concentration of this hormone in the body reduces fertility.
Obesity impairs fertility in a three-step process. First, the high concentration of fat cells in your body converts androstenedione, the male hormone, to estrone, the female hormone. High levels of estrone then affect the body’s regulation of ovarian and testicular function. This eventually affects your reproductive cycle, making it difficult to conceive.
How Can You Tell If You’re Obese When Trying To Get Pregnant?
According to CDC, an individual is obese if their weight is higher than the health threshold for a given height. The BMI screening tool is popularly used to determine an individual’s weight status.
The tool measures your height and weight and gives you a threshold where your weight should lie. Women with a BMI of 30 or higher have excess body fat and are considered obese. Moreover, they may face higher levels of PCOS, complicating their TTC journey. Similarly, PCOS can also contribute to weight gain, making it challenging for a woman to lose weight.
Women with a BMI of 25 to 29.9 are considered overweight. This means a high concentration of body weight around your bones, muscles, water and fat.
You can calculate your BMI here. Also, you can use the below guide to determine if you’re obese.
- BMI below 18.5 – Underweight
- BMI 18.5-25.9 – Standard Range
- BMI 25.0 to 29.9 – Overweight
- BMI 30.0 and higher – Obesity
What is the Maximum Weight to Get Pregnant?
A good indication of your weight range when trying to conceive is your BMI. As previously discussed, your BMI is a play of your height and weight. Doctors advise that the best BMI to have when getting pregnant is below 25. Howbeit, this varies with individuals.
Moreover, your BMI alone is not enough to determine your fertility status. You may have a BMI that falls within range but experience irregular ovulation from hormonal imbalance. Another individual may be obese but experience regular ovulation hence having a higher chance of conceiving.
Overweight and No Period: Can I get Pregnant?
Having irregular periods doesn’t necessarily mean you can’t get pregnant. There is still a chance of getting pregnant; however, you may need some help.
Women with periods that vary by a day or two have a higher probability of getting pregnant than those whose periods vary by six days. The important thing is to find out why you’re experiencing irregular periods.
If you have irregular periods, your doctor may advise on fertility treatments. Additionally, lifestyle adjustments may trigger the onset of regular periods.
Conversely, obesity can result in irregular periods. Research shows that obese women may experience irregular periods with episodes of amenorrhea and oligomenorrhea With irregular periods, your ability to conceive will depend on the following:
- Frequency of your irregular periods
- The reason behind your irregular periods
- The possibility of having timed sex
How Do I Know if My Period is Irregular?
If your menstrual cycle is shorter than 21 days or longer than 36 days, you are likely experiencing irregular periods. Also, if the period between your cycle varies significantly, that is, from 24 days to 34 days between months, your periods are irregular.
Typically, your menstrual cycle may vary by a day or two. If your cycle consistently becomes longer or shorter than what you’re used to, you don’t need to worry.
Being stressed or sick can trigger irregular ovulation leading to a variation in your cycle. Anyway, be that as it may, it’s essential to consult your doctor on irregular periods before pregnancy.
Getting Pregnant When Overweight or Obese: What Are the Risks?
Getting pregnant when overweight is possible. Notwithstanding, it is much more difficult, takes longer and has significant risks. As mentioned, a woman’s reproductive function is regulated through hormonal balance. Excessive fat cells in the body can inhibit the process resulting in infertility. Aside from this, obese or overweight pregnancy can lead to health complications such as:
High Blood Pressure or Preeclampsia
High blood pressure can result in preeclampsia. This is a condition that ensues during your second trimester. If your blood pressure is high, it may cause some of your vital organs, kidney and liver to stop working correctly.
Additionally, it can contribute to blood clots in your body’s vessels, hindering blood flow. Consequently, poor blood flow affects the delivery of nutrients, oxygen and blood to your baby. Furthermore, it can retard your baby’s growth resulting in a condition known as foetal growth restriction.
Preeclampsia can also cause preterm birth. This is where you deliver your baby before 37 weeks, also known as premature birth. A premature baby has a high risk of developing breathing and hearing complications.
Also, women with preeclampsia can suffer from placental abruption. This is a condition where the placenta moves from the uterus’s inner wall before delivery. This separation can result in heavy bleeding that may be fatal for the baby and mother.
Obesity increases the chances of diabetes. Excessive weight can lead to the development of type 2 diabetes. The same can occur in pregnant women who end up developing gestational diabetes. Having too much sugar in your body heightens the risk of diabetes for you and your baby. Additionally, it raises the risk of delivering a large baby, which may prompt doctors to carry out a caesarean birth.
Gestational hypertension is a condition caused by high blood pressure during pregnancy. It is also caused by insufficient protein in your urine, kidney, or heart complications.
Women experience this condition in their second trimester (20 weeks after pregnancy). Usually, gestational hypertension goes away after delivery. However, for some women, it may lead to chronic hypertension.
Obstructive Sleep Apnea
Obesity can affect your breathing and result in sleep apnea. Sleep apnea is when you stop breathing for intermittent periods while asleep. This can lead to fatigue, preeclampsia, high blood pressure or lung and heart problems.
Miscarriage or Stillbirth
Obesity increases your risk of facing a stillbirth or miscarriage. Stillbirth refers to a baby dying in the womb before birth, after 20 weeks of pregnancy. On the other hand, miscarriage refers to a baby not making it to 20 weeks of pregnancy.
Studies show that overweight women experience more extended hours of active labor. Women with normal BMIs have an average of 6.2 hours of labor—however, women with BMIs above 40 experience close to two hours longer than usual. Eventually, women with more prolonged active labor undergo c-section delivery.
It is essential to discuss with your doctor the complications of labor when obese and pregnant. The discussion should also consider labor progressions corresponding to your weight and any health issues a c-section delivery may have for you or your baby.
Does Being Overweight or Obese During Pregnancy Affect the Baby’s Health?
Yes, being overweight or obese can cause complications for your baby, such as:
Congenital Disabilities: Also known as birth defects, they alter the function and shape of the baby at birth. Such defects include Neural Tube Defects (NTDs) or heart defects. NTDs affect the baby’s spine and breath, leading to neurodegenerative conditions. The most common NTDs are spina bifida and anencephaly.
Macrosomia: This is where a baby is born with a weight exceeding 13 ounces or 8 pounds at birth. It’s also known as Large for Gestational Age (LGA). Much more common, women who have large babies when pregnant have to undergo c-sections. The baby may also be at risk of developing heart disease, asthma, and diabetes in future.
Can I Have a Successful Obese Pregnancy?
If you’re reading this, you’re probably thinking of the risks that obesity has with pregnancy. While it may complicate your TTC journey, the good news is that most obese women have successful pregnancies. However, this doesn’t mean you shouldn’t worry about your health and your baby. It is vital to have a preconception check-up before getting pregnant.
What is a Preconception Check-up?
This check-up assesses your body’s preparedness and health state for pregnancy. During the check-up, your doctor will ask several questions which you must gather before your appointment. This includes;
Birth Control Type: If you’re on birth control, your doctor will advise when to stop and how long you should wait before trying to get pregnant.
Lifestyle Habits: Being honest with your doctor about your diet and lifestyle is vital. This includes diet, exercise routines, and whether you smoke or drink.
Menstrual Cycles: Your menstrual cycle is a definitive indication of your reproductive health. Your doctor will ask about your cycle length and your last period date.
Medications: Your doctor will need to know if you’re on any medications, whether prescription or over-the-counter. They may advise you to discontinue the medication or swap them with pregnancy-safe ones.
Medical Conditions: If you have any medical or chronic conditions, it’s prudent to alert your doctor during the preconception check-up. Such conditions need to be monitored during pregnancy. The good news is some conditions may not affect your pregnancy; however, it’s critical to let your doctor know about them. This also includes your mental health.
Family History: You may need to dig deep for this. You’ll need to provide details of any family-related diagnosis, including cancer or diabetes. You will also need to provide your partner’s family history.
How to Have A Successful Obese Pregnancy?
Your best chance at having a successful pregnancy while obese is losing weight. Losing 10 to 20 pounds can improve your chances of getting pregnant while obese. Studies suggest that a 5 to 7 percent body weight loss by obese women enhances fertility.
Some of the ways you can achieve this include:
Set Healthy Goals
If you’re on a fitness journey, the first step is to set the goals you want to achieve. For instance, you can have a goal of eating vegetables twice a day. Besides, it helps when you get support from family and friends by having frequent healthy meals together.
Some hospitals provide extra support in goal setting, such as a diet plan or nutritional recommendations. You can consult your doctor on what you need to do and set it as your weight loss journey.
Eat a Healthy Diet
Let’s face it dieting isn’t easy. The minute you set your mind on not eating junk, your body develops an insane craving for it. Most people quit their dieting journey as soon as it starts.
A healthy diet can help you shed enough pounds to get pregnant. Consistently feeding on a low-fat diet significantly contributes to weight loss. If you’re having trouble switching, it’s best to focus on what you need to eat rather than what you need to avoid. Once you set your mind to healthy foods, choosing a nutritious diet over unhealthy meals becomes easier.
Examples of healthy foods include; low-fat dairy (alternatively, you can switch to rice, soya or oatmeal), plenty of fruits and vegetables, whole grain bread, cereals and lean red meat.
Furthermore, the recommended calorie intake for a healthy pregnancy is as follows:
- 1st trimester – 1, 800 calories per day
- 2nd trimester – 2,200 calories daily
- 3rd trimester – 2,400 calories daily.
Drinking plenty of water throughout the day holds a plethora of benefits. For starters, water is calories-free. Also, consuming it before meals can suppress your appetite, leading to less food consumption.
Additionally, water helps you cut down on sugary beverages that impede your weight loss journey. Most health practitioners advise drinking eight glasses of water a day. This equates to 2 litres a day. However, this amount varies with individuals. For example, you may need more water if you engage in strenuous activities that results into sweating.
Eat Small Meals Frequently
Instead of having three large meals daily, why not swap them for small regular meals? The typical meal times for any individual are breakfast, lunch and dinner. Instead, it would be best to have five to six small meals.
Further, eating small calorie-free meals boost your metabolism and regulate your blood sugar levels. It also reduces your craving, often leading to overeating sugary and fatty foods.
Take note. Skipping meals won’t help you reduce weight. It’ll only prolong the craving, which often results in overindulging that causes more harm than good.
Staying active doesn’t mean hitting the gym all week. Although this can significantly help, there are other ways to help you lose weight during pregnancy. For starters, light exercises such as walking are ideal if you’re not an active person.
Doctors recommend at least two and a half hours of walking for pregnant women. You can start with short but frequent exercises if this is a hard-to-hit target. For instance, you can have a 15 to 30-minute session of yoga or aerobics every day of the week.
The safest exercise to do is walking. Not only is it less tiring, but also can be easily integrated into your daily routine. You can simply set a step-count target using your phone or watch. You can also try out pilates or yoga. However, it’s advisable to do so with a qualified instructor. Overall, depending on your weight and stage of pregnancy, your doctor can recommend the ideal physical activities.
It is advisable to avoid exercises that strain your joints, such as sudden direction changes or high jumping. Additionally, activities that put your stomach at risk of getting hit, such as football, basketball or boxing should be avoided. Heavy weight lifting is an excellent way to shed weight, but it’s not ideal for pregnant women.
Suppose you notice signs of vaginal bleeding, painful and regular contractions, balance loss, blurred vision, vomiting, headache, dizziness, pain or swelling in your calf. In that case, it’s important to stop exercising and consult your doctor.
Control Your Cravings
Pregnancy comes with a lot of cravings. It’s no surprise that you’ll want to eat again right after finishing a meal. In such cases, it helps to stock up your house and fridge with healthy snacks. Fruits, grainy crackers and salads are a great way of beating the craving.
Gain Weight the Right Way
As you work towards losing weight, keep in mind you’ll still gain weight during pregnancy. The proper weight gain for overweight women is 15 to 25 pounds. For obese women, the gain is 11 to 20 pounds.
If you’re having a single pregnancy with a BMI of 30 or higher, you need to gain 11 to 20 pounds. On the other hand, a multiple pregnancy calls for a weight gain of 25 to 42 pounds. Nonetheless, your doctor is more likely to advise you to avoid excessive weight gain during pregnancy.
Understand Conditions That May Affect Your Pregnancy
Gestations hypertension and diabetes are common conditions to experience during pregnancy. By understanding these conditions, you’re jumping at the forefront of managing them. It is essential to consult a doctor once you start experiencing vision changes, face swelling, severe and persistent headaches and intense pain in your upper abdomen.
Schedule a Preconception Assessment
As mentioned, a preconception assessment helps your doctor understand any existing conditions that may complicate your TTC journey. By having the assessment done beforehand, your doctor can advise or direct you to a diet specialist to help you reduce your weight. What’s more, the doctor may also prescribe nutritional supplements such as folic acid or vitamins.
Managing Your Weight After Delivery
Congratulations, you’ve just had a successful delivery and are home with your bundle of joy. Sticking to your diet and exercise routine is key to reaching a suitable weight. One way to achieve this is regular breastfeeding of your baby. Breastfeeding helps you shed some of the postpartum weight.
It may be challenging to lose the weight you gain during pregnancy. It is, therefore, advisable to delay another pregnancy until your body fully recovers after losing the excess weight.
Can High Doses of Folic Acid Help With My Obese Pregnancy?
Yes, if you have a BMI above 30, taking a 5mg dosage of folic acid is advisable. The usual folic acid dosage is 400mcg. Therefore, you will need a prescription for the high dosage.
Folic acid is instrumental in preventing the baby’s NTD development (Neural Tube Defects). The high dosage increases the level of folic acid in your body, which prevents your baby from developing conditions such as spina bifida.
Is Specialized Care Necessary for Obese Pregnancy?
Having a BMI of 30 or higher calls for close monitoring of your pregnancy. A doctor will recommend the necessary steps and tests to take while pregnant. Some of the tests include:
Sleep Apnea Tests
Sleep apnea is a common condition that arises with obesity during pregnancy. It is a severe condition that increases your risk of preeclampsia—as such, getting an evaluation and treatment from a specialist is vital once you display the signs. It would be best to watch out for signs of loud snoring, gasping for air while asleep, hypersomnia, insomnia or frequent morning headaches.
Blood sugar monitoring is crucial for obese pregnancies. Your doctor will check your glucose levels between 24 and 28 weeks of pregnancy. If your BMI is 30 or higher, you are likely to have the first test during your prenatal visit. Another test will be conducted during your second trimester to ensure your glucose levels are still within range. If you have high glucose levels, a maternal-fetal medicine specialist can advise on the best precautions to take.
Special Fetal Ultrasound
Usually, a pregnant woman gets a fetal ultrasound at 18 to 20 weeks. However, with a high BMI, it becomes challenging to have an ultrasound. This is because the fat concentration around your abdomen prevents sound waves from penetrating the fat tissue. As such, you may need a different type of ultrasound that correctly monitors your baby’s health.
Does PCOS Cause Weight Gain?
Yes, PCOS can contribute to substantial weight gain. Out of ten women, one suffers from polycystic ovary syndrome (PCOS). PCOS causes hormonal imbalances in the body, which can lead to weight gain.
Furthermore, women with PCOS are at a high risk of developing hypertension, high cholesterol, fatty liver, and high insulin levels.
The good news is that a healthy diet can help you control weight gain due to PCOS.
Is Weight Loss Surgery Suitable for When Preparing for Pregnancy?
A majority of obese women are turning to weight loss surgery to prepare for pregnancy. Examples of these procedures include gastric banding, gastric bypass and sleeve gastrectomy. Bariatric surgery is advisable for women with a BMI of 40 or higher. It is also suitable for people with heart complications to having a BMI of 35 and 39.
While weight loss surgery can help you lose the weight you need, it creates a higher risk for complications when pregnant.
However, worry not; you can still have a successful pregnancy. Doctors advise women who undergo weight loss surgery to delay pregnancy by12 to 24 months. Moreover, some surgeries may affect your food intake, affecting your baby’s nutrition during pregnancy.
Women who undergo such surgeries end up having underweight or small babies. Therefore, it is essential to understand the type of surgery you’ll be undergoing. You can consult your doctor about whether weight loss surgery suits you and which type you should have.
Can I take Nutritional Supplements If I Want to Get Pregnant?
Folic acid is an excellent nutritional supplement during the first three months of pregnancy. Doctors can also advise on taking it a month prior to conception. Additionally, Vitamin D supplements are also advisable. Obese women tend to have a deficiency of this vitamin. Taking vitamin D nutritional supplements helps regulate your body’s phosphate and calcium amounts.
Are there Medications that Can Increase Fertility?
Obese women with diabetes are advised to take metformin. This medication regulates blood sugar and insulin utilization by your body. However, taking it alone is not effective in achieving a successful pregnancy. It is best to combine it with a healthy diet and frequent exercise.
What is the Difference Between Obesity and being Overweight?
An obese individual has a BMI of 30 or higher, whereas an overweight person has a BMI of 25 to 29. Obese women have an increased risk of complications during pregnancy compared to overweight women. However, both weight states require proper nutrition and exercise to curtail possible health defects. The proposed methods can help obese and overweight women prepare for pregnancy.
So there you have it, your ultimate guide to getting pregnant while obese. Contrary to popular opinion, an obese pregnancy is possible. However, you will require close monitoring, weight and diet changes, as well as specialized care and tests.
It is prudent to consult your doctor before or after getting pregnant on the proper steps to take to achieve a successful obese pregnancy.