Significant weight gain is often observed in women, in particular during pregnancy, breastfeeding and menopause. Obesity of the 1st degree during pregnancy is usually considered as a normal phenomenon, which is caused by changes occurring in the mother’s body. However, the situation requires close monitoring, since weight gain cannot be ruled out, which can lead to unwanted complications. Excessive obesity can become a serious obstacle to the birth of a healthy baby.
Obesity and pregnancy
This article will answer many questions about the causes of obesity during pregnancy.
You will learn how obesity affects pregnancy, understand what risks you are exposed to and find recommendations on what actions you can take to ensure a successful pregnancy. Obesity in pregnant women can negatively affect both the well-being of the expectant mother and the health of the child. Arm yourself with knowledge about possible complications and what you, personally, can do to ensure a smooth pregnancy for obese women.
When can you talk about obesity?
Obesity is the presence of excess fat in the body. To determine obesity, as a rule, BMI (body mass index) is used, which is a formula for matching a person’s weight and height. Simply put, body weight is divided by height squared:
BMI = weight (kg) : {height (m)}2 The calculation result is considered to be from 18.5 to 25.
Endocrinologists have identified four degrees of obesity:
- First degree. When excess weight is 10-29% higher than normal;
- Second degree. Body weight exceeds ideal by 30-49%;
- Third degree. Excess fat in the body reaches 50-99%;
- Fourth degree. Normal weight doubles and exceeds 100%.
Obesity and pregnancy
Excess body weight can negatively affect ovulation and impair female fertility, which also applies to in vitro fertilization (IVF). As a woman gains weight, her risk of unsuccessful fertilization increases, both naturally and in the case of IVF.
How does obesity affect pregnancy?
Obesity during pregnancy puts the expectant mother at risk of developing various complications, which include:
The impact of obesity on a child
Excess weight during pregnancy threatens the development of health problems for the child, for example:
Weight gain in an obese pregnant woman
To determine optimal weight gain during pregnancy, indicators such as pre-pregnancy body weight, BMI, the health of the expectant mother and the health of the fetus are taken into account. It is important to be under constant medical supervision, since only a doctor can teach you how to manage your weight and tell you what to do in case of rapid weight gain.
Let's look at the average parameters of weight gain during pregnancy in obese women:
According to some studies, obese women are not afraid of being underweight, based on averages.
The doctor can replace the gain or loss of a certain number of kilograms by maintaining the existing weight or gaining it slightly over the entire period of pregnancy.
Do obese women need specialized care during pregnancy?
The doctor’s task is to pay especially close attention to the development of pregnancy in an overweight woman. Various observation methods are practiced, the choice of which depends on specific circumstances:
Ways to help maintain a healthy pregnancy with obesity
The negative impact of obesity on pregnancy can be significantly reduced. The health of the expectant mother and child largely depends on compliance with certain rules. For example:
Obesity in a pregnant woman is fraught with complications for the woman and the child. Collaboration with your doctor will help you banish anxious thoughts, slow down weight gain, learn to manage illnesses, and control intrauterine development of the fetus.
How to lose excess weight during pregnancy?
What to do to get rid of unwanted fat deposits and bear a healthy baby? First of all, doctors recommend paying attention to your diet. At the same time, we should not forget about the child’s constant need for nutrients that ensure normal development.
Thanks to frequent meals (6-8 times) with low energy value, it will be possible to quickly eliminate the feeling of hunger, while avoiding overeating. The menu should not contain spices, which increase the excitability of the food center, thereby increasing appetite.
During the day the body should receive:
- proteins – 120 g;
- carbohydrates – 200 g;
- fat – 70-80 g.
The energy value of the diet is 2,000-2,200 kcal.
It is useful for pregnant women suffering from obesity to eat:
- soups with vegetable broth (you can cook with fish or meat broth 2-3 times a week);
- lean varieties of meat and fish;
- seafood;
- fresh vegetables and fruits.
The amount of salt should be reduced to the minimum level. It is advisable to drink a glass of water before eating.
It is important to limit the consumption of foods containing simple carbohydrates, while including more fiber and carbohydrates in the diet, which are slowly absorbed by the body.
Despite the benefits of eating chocolate, during pregnancy, which is accompanied by weight gain, caution should be exercised with the product. It is not only high in calories, but also contains caffeine, which impairs the absorption of folic acid, calcium and iron. The same goes for strong tea and coffee.
When going on a diet, you should act wisely, without going to extremes. Refusing to eat will not help get rid of obesity, but will only make the situation worse. The results of hunger strikes can be miscarriage, underweight in the baby, abnormalities in fetal development, and metabolic problems.
Even with toxicosis, you cannot refuse food. A common cause of this condition is irregular nutrition. Therefore, you should eat foods that will not cause nausea, and the portions should be small.
Degrees of obesity in pregnant women
During pregnancy, a woman may become obese. As a rule, conception in this case is difficult, but there is still a chance to give birth to a child and there are no natural restrictions. However, conception is only the first stage that needs to be completed, since pregnancy and childbirth may have their own problems.
Degrees of obesity in pregnant women
As in the absence of pregnancy, women have several degrees of the disease. There are 4 degrees of obesity during pregnancy:
All this can be easily determined with an example. If a pregnant woman has a normosthenic constitution, her height is 164 cm, her age is 25 years, and her weight is 98 kg, then the norm for her body will be 63.6 kg. Accordingly, 34.4 kg is overweight. This accounts for 54.6% of the total mass, so grade 3 obesity can be diagnosed
During pregnancy, stage 1 obesity can go completely unnoticed. In this case, any complications are not always observed. But it can develop into a more complex stage and then pregnancy delays, premature births, miscarriages and other problems can occur. After all, during pregnancy you can also gain excess weight and this will be a completely normal phenomenon that will go away after childbirth. If there was initially excess weight, then this can cause complications. Specialists must find out the reason that led to obesity and provide appropriate assistance. Help to make it safe for the unborn child.
Obesity 1st degree during pregnancy
Diagnosis of this condition can occur already during the development of the fetus inside the body, whereas before that the weight was normal. Experts note that stage 1 obesity during pregnancy can be quite normal, since women’s appetite increases and all this depends on the individual characteristics of the body. However, the mother's excess weight may be harmful to the developing baby.
Causes of stage 1 obesity during pregnancy
There are completely objective reasons for weight gain during this period, which allow for a certain increase, but in most cases this does not result in a clinical diagnosis. At the same time, having a certain amount of extra pounds even before pregnancy could lead to the appearance of 1 degree obesity. The main reasons include:
When the fetus develops in the body, the body begins to go into accumulation mode so that the growing embryo has enough of all the necessary substances. The mammary glands also enlarge, and along with them the fat layer. During all months of pregnancy, it is quite possible to gain about 10-12 kg, but for some this figure becomes higher, and determining the degree of obesity in pregnant women depends on it.
Pregnancy and stage 1 obesity: how to get back to normal
During pregnancy, a woman often visits the doctor, which involves monitoring all changes in the body. If you observe a critical increase in excess weight, a specialist can recommend a balanced, proper diet that will help maintain weight and supply the body with the necessary substances. Vitamins, which are taken additionally, will be indispensable here.
Sometimes this does not help and obesity may develop into the next stage, which will be a more serious problem. Higher mobility in this state requires serious responsibility, since everything has to be done in moderation. You should not try to solve this problem on your own, as this requires the supervision of a doctor. If you are obese, getting pregnant is not so easy, but if the disease occurs later, then you need to take measures so that everything goes smoothly.
Physical activity with excess weight
It is a mistake to think that pregnant women should limit themselves in physical activity. Of course, in the 3rd trimester, even simple housework can be difficult, but in other cases, it is useful for pregnant women to train their muscles and try to control their weight.
By walking in the fresh air every day, a woman prepares for the upcoming birth by strengthening her abdominal and leg muscles. In addition, the body receives a lot of oxygen, which has a positive effect on metabolism.
The doctor will definitely advise you to perform simple exercises, thanks to which:
- blood circulation improves;
- skin, muscles and ligaments remain elastic;
- metabolism increases;
- the body's energy consumption increases;
- the processes of breaking down excess fat accumulation are activated.
Exercise will not only help you prepare for childbirth, but will also facilitate postpartum recovery. Exercises are selected taking into account the duration of pregnancy and the individual characteristics of the body. Possible contraindications are also taken into account. Sometimes, instead of gymnastics, a specialist recommends half-hour walks.
Pregnancy with 2nd degree obesity
Pregnancy with stage 2 obesity is a more serious problem. It may appear without excess weight before pregnancy, but this will indicate a very rapid increase in body weight, which can harm both the child and the woman herself. Pregnancy with obesity of the 2nd degree most often passes from the first degree, which was before pregnancy. The reasons for the appearance of stage 2 almost completely coincide with the first, but here you can also add diabetes mellitus, which presupposes the presence of excess weight even before conception, albeit not to the same extent.
Complications with the onset of stage 2 obesity during pregnancy
During this stage of the disease, complications such as:
One of the most terrible problems, the occurrence of which many doctors and patients fear, is toxicosis. The likelihood of its occurrence at this stage is almost twice as high as in pregnant women with normal weight, and even in comparison with stage 1 obesity. Toxicosis is a very serious problem for both the woman and the fetus. If pregnancy occurs with grade 2 obesity, then a complex of supporting vitamins is needed, which will reduce the risk of toxicosis.
There remains a risk of miscarriage and miscarriage. The gestational process in obesity is complicated in 45-85% of cases. Toxicosis most often manifests itself in the later stages. The course of this disorder occurs over a long period of time and is most often severe. Here there is a direct dependence of the degree of obesity on the complexity of the diseases that may accompany it.
Another problem for high obesity is post-term pregnancy. Childbirth may not occur on time. With all the problems with pregnancy, if a woman has already reached the 9th month, then there is a high probability that the child will be born late. Obesity of the 2nd degree during pregnancy creates a lot of problems, but there are many cases that show that it is quite possible to carry and give birth to a healthy child. Naturally, this requires the help of doctors. In most cases, if there is a second degree of obesity before pregnancy, then the likelihood of conceiving becomes very small.
Diabetes
Obese pregnant women are more likely than others to suffer from gestational diabetes, when there is an excess of glucose and damage to almost all body systems.
The danger is that diabetes may not go away after childbirth, but may develop into a chronic form.
This also causes overweight children to be born, which leads to:
- birth injuries;
- fetal death;
- infections.
Pregnancy with stage 3 obesity
Pregnancy with grade 3 obesity is practically impossible, since there are many complications in the body that affect hormonal levels and other areas. But it may happen that the third degree occurs already during pregnancy. Almost all problems of past stages manifest themselves in a more serious form. The probability of toxicosis becoming more than 80%. Late labor also occurs three times more often than in normal conditions. Pregnancy with grade 3 obesity often ends in miscarriage before reaching the last trimester.
Risks for the expectant mother
Excess weight increases the risk of complications for pregnant women and their children.
- The overall risk of miscarriage before 12 weeks is 20%; if you have a BMI over 30, the risk is 25%.
- If your BMI is 30 or higher, you are three times more likely to develop gestational diabetes than women with a lower BMI.
- If you have a BMI of 35 or higher at the start of pregnancy, your risk of preeclampsia is twice as high as that of women with a BMI of up to 25.
- All pregnant women have a higher risk of developing blood clots compared to non-pregnant women, and if your BMI is 30 or more, your risk increases further.
- Shoulder dystocia (the baby's shoulder becomes stuck during labor) may occur.
- Postpartum hemorrhage (heavier bleeding than usual after birth).
- The baby weighs more than 4 kg - the overall risk of this for women with a BMI between 20 and 30 is 7%. If your BMI is over 30, the risk doubles to 14%.
- It is more likely that instruments (surgical forceps or a vacuum extractor) will be needed to deliver the baby or an emergency caesarean section.
Childbirth with obesity
Much depends on the degree of obesity during pregnancy, since women who are simply overweight, or with stage 1, can give birth on their own. They do not require additional help and everything happens as naturally as possible, if there were no complications during pregnancy. Grade 1 obesity during pregnancy and subsequent childbirth, with a normal fetal size and fairly wide pelvic bones, occurs without the use of a cesarean section. This stage of the disease does not yet greatly complicate labor. All this is greatly facilitated if special balanced diets were used during pregnancy that did not contribute to weight gain.
Pregnancy and childbirth in women with grade 2 and 3 obesity
During childbirth, overweight women often undergo a cesarean section. If you are obese, it becomes more difficult to give birth to children, since the functioning of the part of the brain that should be responsible for labor is disrupted in the body. It is for this reason that at higher stages of the disease, postmaturity often occurs, since the brain does not send the appropriate signals to the body for labor to begin. If the situation does not change and, due to obesity, it is not possible to give birth to a child on time, then he may begin to suffer from oxygen starvation. If you do not take any action, a miscarriage may occur. Doctors consider a caesarean section to be one of the best ways to resolve this issue, as it helps the baby to be born in a timely manner.
Another complication with a large amount of excess weight is the problem of severe bleeding. With normal weight, bleeding also occurs, but in relatively small quantities and is completely controllable. If, with 2 and 3 degrees of obesity, a woman gives birth herself, then, according to statistics, the bleeding may be more profuse and more difficult to stop.
Health problems can arise not only before and during childbirth, but also after it. Excess weight can lead to hormonal imbalance. This can trigger the onset of diabetes. After childbirth, a young mother may develop this disease. Before and after childbirth, you should donate blood to analyze the sugar in it in order to prevent it in a timely manner.
Childbirth takes place under the supervision of several specialists, as there is a serious risk of complications. Before birth, a fetal activity test is performed to determine whether it is ready for birth. If everything is normal, but the body does not begin labor on time, then a decision is made to perform a cesarean section. Otherwise, there is a risk of complications for both the child and the woman. To avoid all these complications, a thorough examination is required throughout the entire pregnancy and determination of the due date.
Why can an obese woman give birth only by caesarean section?
In medical practice, this is the most common and safest way to remove the baby from the mother's body if any complications may arise. As a rule, the problems with women's health that arise without a cesarean section are more serious than with its use. During obesity, giving birth to a child becomes much more difficult, since many natural functions of the body are disrupted. When using this operation, the woman in labor does not have such a high responsibility. Here, most often, problems may arise with the healing of tissue at the incision site, since an excess amount of adipose tissue leads to inflammation. But even in this case, the child’s life will not be threatened.
Contraindications to pregnancy in stages 2 and 3 of obesity are due to all these problems that can arise during childbirth. Naturally, having an abortion if conception is successful is also not recommended, since there are many cases of healthy children being born, but during pregnancy, and especially during childbirth, constant medical supervision is required. In the first degree of obesity, there are no contraindications to pregnancy and childbirth, since special diets will help maintain normal weight before childbirth. There is also almost no danger of bleeding here, therefore, cesarean section is used only during complications.
Obesity and childbirth
Each case may have its own characteristics of childbirth with obesity. Almost everyone has imperfect development of the generic system. The generic dominant is practically absent in most obese women, and the higher the degree of the disease, the higher the percentage of its absence. The focus of excitation in the brain does not arise, as happens with normal weight, and labor does not occur naturally.
In the first degree of obesity, everything is often resolved through the use of medications. In any case, in the last month full medical supervision is required, since it is often necessary to resort to surgical delivery. In addition to cesarean section, forceps are also used, but most often drug correction is used, applied in a timely manner to initiate labor naturally. All this helps to avoid the risk of oxygen starvation.
Another feature may be the completely natural danger of giving birth to a massive fetus. If the baby is post-term, it increases in size, which complicates natural birth. In each situation, the correct decision of a specialist is required so that there are no complications.
