Plus-Size & Pregnant

Carrying some extra weight? Pay close attention to these four issues.
Pregnant woman looking in mirror

Alexandra Grablewski

When Sue Thomas, of Rochester, New York, learned she was pregnant, she first worried about finding cute maternity clothes to fit her size 20 curves. Then in her third trimester, she had more serious concerns: Her blood pressure skyrocketed, causing her face and lips to occasionally go numb, and upping her risk for preeclampsia, a condition that is triggered by high blood pressure in pregnancy. It can be life-threatening for both Mom and Baby, and can result in premature birth.

Because of her high blood pressure, Thomas spent a scary evening in the ER at seven months pregnant and nearly required an emergency cesarean section. "I was terrified my baby would pay a price because of my weight," she recalls.

Thomas's experience during her pregnancy isn't uncommon. One out of five women are obese at the time they conceive, according to the Centers for Disease Control and Prevention. And even more are overweight. (A person with a body mass index of 25 to 29 is considered overweight; with a BMI of more than 29.9, obese.) Those extra pounds can increase the risk of pregnancy complications, says Justin Lappen, M.D., an assistant professor of ob-gyn at Case Western Reserve University School of Medicine in Cleveland.

If you were concerned about your weight before you got pregnant, don't panic. "Most women still have healthy pregnancies and deliveries," Dr. Lappen says. "What's crucial is that you and your doctor discuss any potential complications."

Weighty Concern: Gestational Diabetes (GD)

Why it happens

During the second trimester, pregnancy hormones block insulin from helping your body to properly use or store glucose, causing glucose levels to build up in your blood. This condition can occur in healthy-weight pregnant women, too, but overweight women are up to four times more likely to develop GD because they are already more insulin-resistant. And GD leaves its mark long after you deliver: Your lifetime risk of developing diabetes is higher after having the condition, research shows. Plus, "because excess nutrients cross the placenta wall, your baby makes more insulin to compensate, which could predispose her to obesity, heart disease, and diabetes too," says Debra Krummel, Ph.D., R.D., a nutrition researcher at the University of Cincinnati.

What to do

No skipping breakfast! Your glucose levels will remain more stable if you eat a meal or snack every few hours -- and what you eat is as important as when. Stick with lean protein (chicken, soy products, beans), high-fiber foods (fruits, veggies, whole grains) and healthy fats (avocados, almonds, walnuts). "Keep in mind that excessive weight gain, even if you began pregnancy at a healthy size, will increase your chances of GD," says Diane M. Ashton, M.D., M.P.H., deputy medical director at the March of Dimes.

To better protect yourself if you are overweight at conception (or have a family history of diabetes), ask your ob-gyn whether you can be tested for GD twice: once in your first trimester and again at the midway point, when pregnant women usually are screened. Moderate exercise can also reduce your risk.

Weighty Concern: High Blood Pressure

Why it happens

The higher your BMI at conception, the greater your risk for hypertension in pregnancy. If left unchecked, high blood pressure can result in preeclampsia, putting both you and your baby at risk.

What to do

Begin an exercise routine, even if you weren't physically active before pregnancy. Talk with your doctor first, but you should be able to manage moderate activities, such as brisk walking, swimming, or yoga, about three times a week, says Sean Blackwell, M.D., an ob-gyn at The University of Texas Medical Center in Houston. Reducing stress is also key. Many moms-to-be find meditation and breathing exercises helpful. If your numbers remain high, your doctor may have you take readings with a home blood-pressure monitor, so you can immediately alert her if you notice your blood pressure beginning to spike.

That's what Thomas did, and her doctor prescribed hypertension medication. Thomas also added more salads and fruit to her diet, and tried to get more sleep, which can help lower blood pressure. When she delivered at 41 weeks, her baby was healthy, and in the last year Thomas has shed the baby weight. "I run or work out four times a week and I hope to finish my first 5K soon," she says. Thanks to these efforts, her blood pressure is down and she no longer takes medication.

"I'm making better decisions about my health and diet now because of my daughter," notes Thomas. "I want to be around to watch her grow up."

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