With over half of all pregnant women falling in the plus-size category, plus-size pregnancy is something that can no longer be ignored. If you're plus-sized, you've probably heard things about how your weight can affect your health. But being plus-sized doesn't mean you can't have a wonderful, healthy pregnancy and a beautiful, healthy baby if you get the information you need and receive good medical care.
Find a Size-Friendly Caregiver
Find a caregiver who is accepting of you and your body shape, and will work with you to help you have the healthiest possible pregnancy. Ann Douglas, author of The Mother of All Pregnancy Books and herself a plus-size mother of four, says, "You want someone who will help you to set weight gain goals for yourself, but who won't make you feel like an unfit mother if you happen to gain an extra pound or two one month."
Interview your doctor or midwife at your first appointment and ask specific questions:
- Do you consider yourself to be sensitive to the needs and feelings of larger women?
- What kind of weight gain do you recommend for a large woman during pregnancy?
- Where is the scale located for weigh-ins?
- Does your office have larger-sized gowns and blood pressure cuffs?
If the answers you receive make you uncomfortable, go elsewhere. Remember that part of your caregiver's job is to talk to you about your risks and health concerns. The news might not always be just what you want to hear, but you want a caregiver who can do so without blaming you or scolding you. Don't be embarrassed by your weight or shape - doctors and midwives see bodies of all shapes and sizes all the time. It is important that you find a caregiver with whom you can be honest, one who will listen to your concerns and questions and treat you with the respect you deserve.
You may worry that your weight will affect your chances for a healthy pregnancy. Remember that the odds are that you will have a healthy pregnancy and deliver a healthy baby. However, plus-size moms are at a higher risk for some conditions.
"Obese women also develop high blood pressure more often than thinner women," says M. Kelly Shanahan, MD, FACOG, a practicing Ob/Gyn and author of Your Over-35 Week-by-Week Pregnancy Guide. Plus-size moms-to-be are at increased risk for gestational diabetes, which can lead to a big baby. "Even without diabetes, larger women tend to have larger babies," notes Dr. Shanahan. "Large babies may mean more cesarean sections and more risk of injury to the baby during a vaginal birth." There's an increased risk of shoulder dystocia, where the shoulders get stuck, which can lead to nerve damage in the baby and vaginal tears in the mom. "Women who are obese should be screened for gestational diabetes in the first trimester; if this testing is normal, they should be tested again in the usual 24 to 28 week range." Controlling weight gain and monitoring the baby's size can help avoid this.
The March of Dimes in its February 2002 report "Nutrition Today Matters Tomorrow", reports that overweight women are at a 30% to 40% higher risk of delivering babies with birth defects. Don't panic - some of the risk can be reduced with folic acid supplements. Talk to your caregiver for more information
Make sure your care provider discusses these conditions with you and monitors you for them. At the same time, remember that your caregiver monitors all pregnant moms for these conditions, and will do the same for you. Don't feel you are being singled out because of your weight.
Weight Gain and Pregnancy
One of the biggest misconceptions is that you shouldn't gain any weight during pregnancy if you are larger than average size. Don't believe it!
Dr. Robert A. Hadden, assistant professor of clinical obstetrics and gynecology at Columbia University, agrees, "I would never recommend someone to diet during pregnancy." Recommended gains for plus-size moms is between 15 and 20 pounds.
In fact, a 1996 study reported in the medical journal Obstetrics & Gynecology found that gaining little or no weight won't necessarily make you or your baby any healthier. "It's not healthy for a woman to aim for zero weight gain during pregnancy," agrees Douglas. "Try not to beat yourself up if you exceed it, but, at the same time, don't give yourself carte blanche to gain 50 pounds during your pregnancy."
Simply be realistic about your weight gain and try to focus on eating healthy foods. Talk to your caregiver about how much weight he or she recommends for you.