How to Have a Healthy Pregnancy if You're Overweight

By Monica Agar, MD, Obstetrics and Gynecology—Virtua

Pregnancy, or trying to get pregnant, often is an incentive for women to take better care of themselves. But, many are increasingly facing obesity, which affects 36 percent of women of childbearing age. Obesity, which is defined as a body mass index (BMI) above 30, is linked to a number of difficulties during pregnancy, labor and delivery.

If you’re overweight or obese, here are some steps you can take to have a healthier pregnancy.

Manage Weight through Healthy Eating and Exercise

Losing even a small amount of weight (10-20 pounds) before you get pregnant can improve your overall health and decrease the risks of obesity-related problems. In many cases, the weight reduction will actually help you get pregnant. 

If you’re overweight when you get pregnant, there’s a lot you can do to have a healthy pregnancy including eating nutritious foods like lean proteins, vegetables, fruits, low-fat dairy and whole grains. If your doctor says it’s safe for you to exercise, try walking or lifting light weights, or take a prenatal exercise or yoga class. Staying fit will also help prepare your body for delivery.

For motivation and guidance, schedule an appointment with a registered dietitian who can help you create a healthy and flexible diet that works for you.

How many pounds should a woman gain during the pregnancy?

• Normal weight (BMI 18.5-24.9): 25-35 pounds
• Overweight (BMI 25-29.9): 15-25 pounds
• Obese (BMI 30 or greater): 11-20 pounds

Is it safe to lose weight during pregnancy?

Whether you started your pregnancy overweight or have gained a little more than expected while pregnant, now is not the time to try to lose weight. When carrying a baby, your body is feeding another life. Any food restrictions you place on yourself are also being placed on the fetus. When you don’t get enough calories and nutrients, you put your baby at risk. This is why it’s important to talk to your doctor before you try to get pregnant for advice on achieving a healthy weight.

Follow Sound Prenatal Care Advice

To have a healthy pregnancy, all women need to follow basic prenatal care and testing recommendations. Before you try to get pregnant, schedule a routine physical and start taking prenatal vitamins with folic acid and DHA. Once pregnant, see your obstetrician for routine prenatal care and screenings like growth and development ultrasounds and blood tests that monitor your health and your baby’s health.

What Risks are Related to Being Overweight and Pregnant

Being overweight or obese places a pregnant woman at increased risk for the following:

• Gestational diabetes
• High blood pressure (pre-eclampsia)
• Sleep apnea
• Pregnancy loss or stillbirth
• Difficulty completing diagnostic tests such as ultrasounds, as well as hearing the baby’s heartbeat
• Difficulty getting an epidural for pain relief during delivery

For the baby, there’s an increased risk of birth defects, such as heart defects and neural tube defects (the structure that develops into the central nervous system). Obesity also increases the risk of fetal macrosomia (the baby being larger than normal) and birth complications. 

Updated March 13, 2017