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Healthy pregnancy for women who are overweight

Being overweight can cause complications during pregnancy, labour, birth and after the birth. Pregnancy is a great time to focus on being as healthy as you can be, and there’s plenty you can do to achieve a healthier weight – for your sake and your baby’s.

Weight and pregnancy: why it’s important

Healthy eating, controlled weight gain and regular physical activity during pregnancy can keep you and your baby healthy during pregnancy and birth and after birth too.

In fact, staying healthy in pregnancy is good for your child’s health much later in life. For example, it cuts the risk of your child having diabetes or being obese during childhood and even adulthood. 

If you’re overweight and want to get pregnant
Lower weight and better health can improve your chances of getting pregnant. The best thing you can do is lose some weight before you start trying to get pregnant.

If it’s too hard for you to achieve a healthy weight, even a small weight loss can help a lot. If you can lose 5-10% of your body weight now (for example, 5-10 kg if you weigh 100 kg), you’ll start pregnancy much healthier. For example, you’ll have less sugar and cholesterol in your blood and lower blood pressure.

It’s best to talk with your GP about a healthy weight for your body, and ask about the best weight loss options for you.

If you’re overweight when you get pregnant
Paying attention to what you eat, how active you are, and how much weight you gain during pregnancy can help you and your baby stay healthier.

In the past, ‘eating for two’ was thought of as normal. But we now know that women who are overweight can safely gain less weight in pregnancy. Talk to your doctor or midwife about normal or healthy weight gain during pregnancy.

Practical tips for a healthy pregnancy

Focus on important foods
Rather than concentrating on what you shouldn’t be eating, focus on healthy foods.

Eat:

  • plenty of vegetables, some fruit, wholegrain breads and cereals for a wide range of vitamins, minerals and fibre 
  • low-fat dairy food (or alternatives like soy, rice or oat milk products) for calcium, protein and iodine 
  • lean red meat for iron and protein, and oily fish like sardines for omega-3 fatty acids and protein. 

If you’re filling up on good food, you won’t feel as hungry for less healthy foods. 

Eat lots of small meals and snacks
This can help you with healthy weight control and other pregnancy issues like morning sickness and heartburn. Eating regularly also boosts your metabolism, and stops you from getting too hungry and overeating foods with too much sugar and fat.

Skipping meals won’t help you with healthy weight control. 

Drink plenty of water
Water is the best drink for good health. You need more water when you’re pregnant – aim for at least 6-8 glasses a day.

Flavoured milks, soft drinks and juices can cause extra weight gain. For example, 600 ml of flavoured milk has around 1500 kilojoules – that’s the same as five pieces of bread. This can easily tip the scales towards weight gain. 

Avoid the cravings trap
It can be easy to start eating lots of chocolate, chips, ice-cream, lollies, flavoured milks, biscuits or cakes in pregnancy and write them off as pregnancy cravings. 

Keeping these foods out of your cupboard has health benefits for the whole family, not just you. It’s also a good way to start setting up healthy habits for your children.  

Be organised
Planning what you’re going to eat and preparing meals and snacks in advance is a great way to make healthy food choices. 

Writing a dinner menu for the week makes shopping and cooking easier. And when you stock your cupboard and fridge with grainy crackers, fruit, wholegrain bread and salad ingredients, you’ve always got a healthy snack or lunch ready to pop in your bag.

Reward yourself with non-food treats
Pregnancy isn’t always easy, so it’s normal to want a few rewards. The trick is looking for treats that don’t involve food!

Instead, you could treat yourself to a movie, a catch-up with a friend, or a massage from your partner or another support person.

Be active
It’s recommended that pregnant women do 30 minutes of light to moderate exercise most days of the week, unless you’ve been told something different by your doctor or midwife.

If you weren’t exercising before your pregnancy, that’s OK. It isn’t too late to start if your midwife or doctor says it’s all right. Walking or swimming are both good choices. It doesn’t have to be 30 minutes all at once – you could break it up and do three, 10-minute walks each day. 

You can also add activity to your normal routine by:

  • getting off the bus earlier, walking the long way round, or taking the stairs where possible
  • walking instead of driving to the local shops
  • including physical activity when you catch up with friends. 

Set yourself goals
It’s best to be specific. For example, you could say, ‘I’ll eat vegies with lunch and dinner every day this week’. If you set a goal that you can measure, you’ll know whether you’re achieving it.

Get help
Many health services and maternity hospitals around Australia have dietitians and extra support for women who are overweight. Ask your doctor or midwife what’s available in your area.

You can also get family and friends on board by preparing healthy meals and exercising together. Setting goals with someone who can support you can make it easier for you to reach your goals. 

Staying healthy after birth

It’s important to keep eating well and doing moderate physical activity after the birth. This will give you more energy to care for your new baby. 

There are a couple of other ways to get to a healthy weight.

Breastfeed
Breastmilk is all your baby needs up until around six months. Babies can have solids from six months on, but experts say it’s best to also keep breastfeeding until at least 12 months.

Breastfed babies are less likely to be obese in their childhood, adolescence and early adulthood.

Breastfeeding can sometimes help with weight loss after the birth because it burns extra calories.

Plan for weight loss
After the birth you’ll have your hands full looking after your baby, so it’s a good idea to plan ahead for losing weight when you’ve recovered from birth.

In the early weeks after birth, you can begin by just walking with your baby in a pram, baby carrier or sling. You could also join a community-run or private weight loss group or use a gym with a crèche. Many early childhood centres run free walking or exercise groups for new mothers.

Your GP, dietitian or child and family health nurse could help with ideas and contacts, or you could look online for weight loss or exercise groups near you.

What is overweight?

The Body Mass Index (BMI) identifies healthy, overweight and obese weight ranges. Your BMI is based on your weight and height.

You can use a simple BMI calculator to find out which weight category you fall into. It’s best to use your pre-pregnancy weight. 

Weight gain during pregnancy
The recommended weight gain for pregnancy will depend on what your BMI was before you became pregnant.

The Australian Dietary Guidelines recommend that:

  • normal-weight women (BMI 18.5-24.9) gain 11.5-16 kg
  • overweight women (BMI 25-29.9) gain 7-11.5 kg
  • obese women (BMI over 30) gain 5-9 kg.

For women whose BMI is very high (over 40), many doctors say they should gain less than 5 kg in pregnancy. 

Some overweight and obese women will lose weight in pregnancy too. This can be safe, as long as you’re eating well and being closely checked by your doctor or midwife at your antenatal appointments.  

Checking your weight during pregnancy
If you start pregnancy above a healthy weight, your weight should be checked at each antenatal appointment. If it isn’t, it’s a good idea to ask to be weighed or create a simple chart to track it yourself.

At your appointments, you can also ask about:

  • why you’ve gained a certain amount of weight
  • how to reduce weight gain in pregnancy
  • what you can do to stick to your recommended weight gain – for example, healthy food alternatives
  • how other things in your life might be affecting your weight.

Risks of being very overweight during pregnancy

Many overweight women have healthy pregnancies and babies. But there are health risks linked with being very overweight or obese in pregnancy.

These risks increase if you gain too much weight while you’re pregnant. The higher your pre-pregnancy BMI and/or the more weight you put on while pregnant, the higher your risk of health problems or complications.

These are some of the risks linked with being very overweight or obese and/or gaining too much weight during pregnancy: 

  • Gestational diabetes: this is raised blood sugar levels in pregnancy, which can be bad for your short-term and long-term health and your baby’s. Most women are offered a test for gestational diabetes at 24-28 weeks of pregnancy or earlier. If you have a family history of diabetes or if you have a high BMI, you have a higher risk of getting gestational diabetes.
  • Labour and birth complications: women who are obese are more likely to have induction of labour and a long labour. They have a higher chance of needing birth intervention , including caesarean, and a higher chance of shoulder dystocia
  • Medical complications: these complications include problems with managing pain during and after the birth – for example, it can be harder to get women’s bodies and medical equipment into the right position, and harder to keep pain relief going. There’s also an increased risk of bleeding straight after the birth, pre-eclampsia, sleep apnoea, longer wound healing time after caesarean, and postnatal depression

If you do what you can to stay healthy and avoid too much weight gain by sticking to the recommended weight gain guidelines for pregnancy, you’re less likely to have these health complications.

Weight control: other things to consider

Weight control is a complex issue.

Your mood and emotions can affect your ability to eat healthy food and be active. If you’re not getting enough sleep, it can be harder to eat well too. Physical symptoms like back pain can also get in the way of exercise.

Talking to your health professional about these issues and getting support can help you work out what’s affecting your eating habits and lifestyle. Your health professional might raise some of these issues in your antenatal appointments. But if the issues don’t come up, it’s a good idea for you to ask.

Your body image might also change in pregnancy. You can talk to your doctor or midwife about changes in your body and how you feel about these changes. 

Where to get support

You can get help with and motivation for healthy living and weight loss from:

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Last updated or reviewed
10-03-2017

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Raising Children Network is supported by the Australian Government. Member organisations are the Parenting Research Centre and the Murdoch Childrens Research Institute with The Royal Children’s Hospital Centre for Community Child Health.

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