How Extra Weight Influences Your Pregnancy
The "Big Girl" Bias
Finding a doctor who is "size friendly" can be a challenge, says Bruce D. Rodgers, MD, coauthor of Your Plus-Size Pregnancy and director of maternal-fetal medicine at Women & Children's Hospital of Buffalo. "Although your doctor will probably want to discuss medical issues regarding your weight, if he (or the office staff) makes you feel guilty about your size or discourages you from trying to conceive, it's time to find a more sensitive, educated healthcare provider."
Gestational diabetes, a temporary form of high blood sugar during pregnancy, affects up to 15 percent of obese women -- triple the rate of average-size women. Uncontrolled, it increases the risk of fetal birth defects and congenital heart problems. Babies born to moms with gestational diabetes tend to be large, which can pose problems in the delivery room. "Big babies can mean bigger episiotomies, vaginal lacerations, and an increased chance of a cesarean section," says Dr. Rodgers. Typically, expectant moms are tested for diabetes toward the end of their second trimester, but because extra weight also increases your risk of type 2 diabetes, you should be tested within the first six weeks after delivery and yearly after that. If you're diagnosed with diabetes (gestational or type 2), you may need to take insulin medication and will definitely need to make healthy food choices to keep the condition in check.
Bad Blood Pressure
Eight percent of all pregnant women develop preeclampsia, a form of high blood pressure that usually occurs after the 20th week of pregnancy (though most cases are mild and occur at the end of pregnancy). Your odds quadruple if you're obese. The disease increases urine protein levels and causes fluid retention in the hands and feet. Bed rest and medications usually help, but if the condition isn't treated properly, it can be life-threatening for both mom and baby.