We have compiled what you need to know for an easier plus-size pregnancy. Read the article to have a healthy pregnancy and a healthy baby.
As the obesity rate in America continues to climb, so does the rate of obesity among pregnant women and those hoping to conceive. While excess pounds are not necessarily a roadblock to conception and a healthy pregnancy and delivery, no one knows exactly how many pregnancies are complicated by obesity. A released guidelines from the American College of Obstetrics and Gynecology recommend frank weight discussions even before a woman conceives, so it would seem that along with average weights, concern is on the rise. Should you be concerned? Read on for the latest on obesity and conception.
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Some obese women have trouble conceiving. When this happens, some of those women blame their weight, but the root of their infertility may actually be causing them to pack on the pounds. Katie R., a Chicago-area fertility expert, says obese women who have trouble getting pregnant frequently suffer from the hormonal imbalance polycystic ovarian syndrome (PCOS), a condition that causes the ovaries to secrete androgens. Among other effects, the androgens cause abnormal ovulation and make it difficult to lose weight. Women with PCOS who do manage to conceive also face a greater risk of miscarriage. In such cases, pregnancy loss is due to low levels of progesterone and not the additional pounds these women carry.
To learn more about miscarriage and its symptoms : What are the Symptoms of Miscarriage?
“Obesity itself doesn’t make it more difficult to get pregnant,” Katie says. “Realistically, the chance of getting pregnant is not any lower in obese or overweight women.”
Still, fertility specialists often recommend weight loss before getting pregnant. Some fertility centers may have weight requirements before performing in-vitro fertilization, since it requires a minor surgical procedure that includes anesthesia, possible intubations and trans-vaginal ultrasounds through a larger amount of body mass. For women well into their 30s who are trying to conceive, this can amount to a race between the scale and their biological clocks. “It’s not as if I’m not concerned about weight issues, but it’s a Catch-22 if the woman is 37 years old, 40 years old,” Katie says. “Years could go by before she lost the weight safely. I don’t put those kinds of restrictions on my clients.”
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Is It Too Much?
Bonnie C., a nurse midwife in Portland, Ore., says focusing solely on a woman’s weight can be misleading in terms of her overall health. “There isn’t any clear evidence supporting that all women who are plus-size face all the risk factors,” she says. “Plus-size women can be healthy, while some thin women do not eat well and are unhealthy. All pregnant women have to be looked at individually.”
Rather than starting prenatal discussions at the scale, Snell starts with a review of her general eating and exercise habits. “It’s not unusual to find overweight women eat less, which is also not ideal,” she says. She then looks at the blood chemistry, determines whether the mom is hypertensive or anemic and whether she’s exercising.
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Instead of telling clients how much weight they can gain, she talks about food choices and exercises that even inactive women can do comfortably as their bodies change throughout pregnancy. “I tell them not to worry too much about the scale,” she says. “Some bigger moms may not gain any weight, or they might gain more than 25 pounds. Whatever it is, they should be feeling good.”
Bonnie, a plus-size mother of four, said she understands that talking about weight can be an emotional issue for any woman. “It’s something we talk about at the first visit,” she says. “A lot of women don’t want to know their weight. That’s fine with me.”
Though extra pounds put moms at a greater risk for developing gestational diabetes, “that can be controlled with diet and exercise,” Bonnie says.
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Right Things To Do
Molly W., a plus-size mother of four in Oregon and vocal advocate for women who have a plus-size pregnancy, says big moms-to-be should make finding a supportive doctor or midwife their first priority. “Some doctors are not size-friendly, and this is obvious from the very beginning,” she says. “Others disguise it better but secretly harbor a lot of prejudice. Still others truly want to be size-friendly but suffer some of the typical assumptions about large women that lead to unnecessary interventions.”
Molly suggests asking open-ended questions during initial visits, letting doctors reveal their attitudes. “For example, you might ask, ‘What are your concerns for me as a pregnant large woman?’ or ‘As a large-size woman, how would you treat my pregnancy differently than if I were average-size?'” she says. “Then just nod sweetly and let them ramble while you listen for underlying assumptions and attitudes.”
Molly also says it is appropriate for caregivers to speak neutrally about complications that could occur and what women can do to lower the risk, “but if they act like problems will happen or if they schedule you for lots of extra interventions simply because of your size, that’s a red flag,” she says. Other red flags, according to Molly, include overemphasis on weight gain, restrictive food plans, strong fears about a big baby, negative assumptions about health habits and an automatic assumption that obese women will need an induction or a Cesarean because of their size.
If you are wondering how to prepare to postpartum life : Preparing for Postpartum Life The Joys and Challenges of Life After Delivery
Aside from being supportive and open-minded in regards to weight, caregivers should be equipped to give optimal care to large women. Molly says heavier women should always have their blood pressure taken with large or super-sized cuffs to avoid over- or under-treatment due to an inaccurate reading. Most big women will fit in a large cuff. Super-size women and those who have very heavy arms may need a bigger cuff, sometimes called a “thigh” cuff. Women should measure their upper arms in centimeters and check that against the appropriate size ranges listed on the large or super-size cuffs. “Don’t hesitate to insist on changing to the correct-sized cuff if necessary,” Molly says. “It really can make a difference.”
Excess weight can have health consequences, but as with anything, there are two sides to every story. Perhaps the most important thing to keep in mind is that weight is not the sole indicator to good health. “It is absolutely possible to have a healthy pregnancy and a healthy baby, even if you are plus-size,” Molly says.
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