How will being overweight affect me during pregnancy?

(RCOG 2018a)

(RCOG 2018b)

(RCOG 2018b)

(RCOG 2018b)

(NHS 2017)

(NCCWCH 2008)

How will being overweight affect my labour and birth?

(Furber et al 2013)

increased or heavy bleeding after birth (postpartum haemorrhage or PPH) (NHS 2017)

an infection, such as a wound or urine infection or an infection in your perineum after a tear (RCOG 2018a)

a blood clot in a deep vein in your leg (deep vein thrombosis or DVT) or in your lung (pulmonary embolism or PE) (RCOG 2018a)

increased time in hospital due to complications (Crane et al 2013)

How will my weight affect my baby during pregnancy and labour?

(RCOG 2018b)

(RCOG 2018a)

(RCOG 2018b)

(RCOG 2018b)

(RCOG 2018b)

(RCOG 2018a)

(RCOG 2018a)

(RCOG 2018a)

(RCOG 2018a)

(RCOG 2018a)

I’m overweight. What can I do to have a healthy pregnancy?

(NICE 2010)

(RCOG 2018b)

(RCOG 2018a)

(BNF nd)

(BNF nd)

(BNF nd)

(RCOG 2018a)

starchy foods such as potatoes, pasta, rice and bread (choose wholegrain when you can)

plenty of fruit and vegetables (try and eat a variety)

lean meat, fish (including one portion of oily fish) and other protein such as eggs and pulses

low-fat dairy products, such as milk, yogurt and cheese

only small amounts of food and drink that contain lots of fat and sugar, such as cakes, chocolate and fried foods

(BNF nd)

(RCOG 2018a)

(RCOG 2018a)

(RCOG 2014)

(RCOG 2014)

(RCOG 2014)

(CMO 2017)

(CMO 2017)

(CMO 2017)

(CMO 2017)

Best exercises for pregnancy From yoga and Pilates to swimming and brisk walking, here are some of the best ways to stay fit and healthy during pregnancy, without harming your baby. More pregnancy videos

(CMO 2017)

(CMO 2017)

(NICE 2010)

Last reviewed: April 2019

References BNF. Nd. Healthy weight in pregnancy. British Nutrition Foundation. www.nutrition.org.uk. [accessed January 2019]



CMO. 2017. Physical activity for pregnant women. Chief Medical Officers. assets.publishing.service.gov.uk [accessed January 2019]



Crane JM, Murpy P, Burrage L, Hutchens D, 2013. Maternal and perinatal outcomes of extreme obesity in pregnancy. J Obstet Gynaecol Can. 35(7):505-11 [accessed January 2019]



Furber CM, McGowan L, Bower P et al. 2013. Antenatal interventions for reducing weight in obese women for improving pregnancy outcome. Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD009334. DOI: 10.1002/14651858.CD009334.pub2. [accessed January 2019]



NCCWCH. 2008. Antenatal care: routine care for the healthy pregnant woman. National Collaborating Centre for Women's and Children's Health, Clinical guideline. London: RCOG Press. www.nice.org.uk [pdf file, accessed January 2019]



NHS. 2017. Overweight and pregnant. Health A-Z. Your pregnancy and baby guide. NHS Choices. www.nhs.uk [accessed April 2019]



NICE. 2010. Weight management before, during and after pregnancy: Dietary interventions and physical activity interventions for weight management before, during and after pregnancy. National Institute for Health and Care Excellence. London: NICE www.nice.org.uk [pdf file, accessed January 2019] [accessed January 2019]



RCOG 2018a. Being overweight during pregnancy and after birth. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk [accessed January 2019]



RCOG. 2018b. Care of Women with Obesity in Pregnancy. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk [accessed January 2019]

Most mums-to-be who are overweight can expect to enjoy a healthy pregnancy . Your weight may have no effect at all on your pregnancy or your baby’s birth However, if you’re heavier, with a raised body mass index (BMI) over 30, it does make it more likely you'll be affected by complications . Some of these complications, such as pre-eclampsia and diabetes, can be serious for you and your babyThe higher your BMI is, the greater the greater your risk of having the following complications during your pregnancySadly, your risk of miscarriage also increases if your BMI is 30 or above, from one in five, to one in fourDoctors don't know exactly why weight can make a difference to how well your pregnancy goes. The picture is complicated because there are so many things that can influence your health, such as your age , family history, lifestyle and ethnic backgroundAlthough you may have a healthy pregnancy without any problems, it’s important to know what the complications are, just in case.If you’re overweight, it can affect when you give birth. You’re more likely to go into premature labour There’s also a slightly increased risk that your pregnancy will go past your due date When you do give birth, having a BMI of 30 or above can mean that you’re more likely to have:After you’ve had your baby, you’re also more likely to have certain complications, including:If you’re carrying extra weight around your middle, it can make it more difficult for your midwife to check your baby’s size correctly and to see what position your baby is lying in. You may need to have extra ultrasound scans to check how your baby is growingIt can also be more difficult to monitor your baby’s heartbeat when you’re in labour. If this happens, your midwife or doctor may recommend that you have electronic fetal monitoring. This involves attaching a sensor to your tummy, which feeds through to a cardiotocograph (CTG) where your baby’s heartbeat is recordedYou're slightly more likely to have a large baby (macrosomia), which increases the risk of complications for you and your baby when she’s being born. If your baby is big, she’s more likely to become "stuck" during labour ( shoulder dystocia ), after her head has been born. This may sound alarming, but rest assured your doctor or midwife will act quickly to help your baby be born safely.Being very overweight (BMI of 40 or above) can also increase the chances of a baby having a neural tube defect, although this is rare. A neural tube defect can affect a baby’s brain or spinal cordYou can protect your baby against neural tube defects by taking a larger dose of 5 milligrams (mg) of folic acid daily before you get pregnant and during the first 12 weeks. Your doctor or midwife will be able to prescribe this for you.Sadly, for women with a BMI of 30 or above, the risk of stillbirth also increases, from one in every 200 births, to one in every 100 birthsThe good news is that there are lots of things you can do to help you have a healthy pregnancy and give your baby the best start in life. Eating healthily and being active , are the best ways to reduce the chances of complications developing. You’ll be less likely to put on a lot of extra weight in pregnancy and your chances of developing gestational diabetes will be lowerSet yourself some easy goals that you can follow by downloading a weight management goal plan on the Tommy’s website.It’s not a good idea to go on a diet when you’re pregnant. Having a well-balanced range of foods with enough energy and the right nutrients is important for your health and the development of your babyOn the other hand, you don’t need to eat for two! In your first two trimesters you need the same number of calories as you would do if you weren’t pregnant. It’s only in the last 12 weeks that you need a little more, but only 200 calories , which is about the same as a bowl of wholegrain cereal and milkIf you eat healthily and you’re active during your pregnancy you should be able to control your weight well. Some women may lose a little weight by doing this and that’s okay, it won’t harm your babyIf you're suffering from morning sickness in the early weeks, it can be hard to enjoy a well-balanced diet. Just make sure you drink plenty of water, and try to eat small, nutritious meals often.A balanced diet is the best way to stay healthy and manage your weight and that’s no different when you’re pregnant. Choose the following foods:As well as having a healthy diet, you’ll need to take folic acid . If you have a BMI of more than 30, you should take 5 milligrams (mg) of folic acid every day. This is higher than the usual dose of 400 micrograms (mcg) of folic acid, so you’ll need to get a prescription for it. Ask your doctor or midwife.Taking folic acid for a month before you conceive and for the first three months of pregnancy will help your baby’s nervous system to develop normallyIf you have a BMI of 30 or above, you're also more likely to be low in vitamin D . All pregnant women are asked to take daily vitamin D supplements, but if your BMI is 30 or more, you’ll be asked to take a larger amount each day. You’ll need to take this all the way through your pregnancy and afterwards if you’re breastfeeding. Ask your pharmacist about which supplement is right for you.Being active during your pregnancy can also help you manage your weight and reduce the risk of complications. It’s also a great way of helping your body to cope with pregnancy and prepare for giving birth An active lifestyle can help you sleep better and improve your mood too. There’s no evidence that doing regular moderate activity while you’re pregnant will harm your babyIf you weren't very active before you were pregnant, this isn't the time to start a vigorous new regime. As long as you get the go-ahead from your midwife or doctor, it’s best to start off gradually. Aim to do 150 minutes of moderate activity a week, plus two lots of activity that strengthen your musclesChoose activities, such as brisk walking dancing or swimming . Listen to what your body is telling you, and as you move on in your pregnancy, adapt what you’re doing to fit with your size and shape and how tired you are. Take care to protect your bump too!Everyone is different, so it’s a good idea to talk to your midwife about what’s best for you. If your BMI is over 30, she may recommend that you see a dietitian to help you plan what you’re going to eat and how to stay as well as you can in pregnancy