Dear Dr Murage,
I am overweight and planning to get pregnant. Is it safe to get pregnant now, or should I wait till I attain a healthier weight?
Rita
Dear Rita,
You have a very important concern. Being overweight has many health implications, not least in pregnancy. Your ideal weight depends on your height. The most quoted measure of weight is what is referred to as Body Mass Index (BMI).
A BMI of between 19 and 25 is regarded as normal, and is associated with many health benefits. You can easily calculate your BMI by inputting your height and weight in freely available apps.
Being overweight is associated with many negative effects in women’s health. For starters, you may have irregular periods, implying an irregular ovulation pattern and a potential delay in getting pregnant. Overweight women have a higher risk of requiring fertility treatment compared to women of normal weight.
Once you get pregnant, your risk of a miscarriage is higher. All other pregnancy complications tend to be more common in overweight women, and so are complications during labor and delivery. Once you deliver, your recovery is likely to take longer, especially if you end up with a Cesarean Section.
Outside pregnancy, you are also more predisposed to other diseases if overweight. The risk of certain cancers is higher, and these are not necessarily just gynecological cancers.
You are also at a higher risk of cardiovascular disease and Type 2 Diabetes. If you coincidentally already have any of these diseases, you would end up worse off if you got pregnant.
You have plenty of reasons to want an optimal BMI prior to getting pregnant. Get yourself to a pre-pregnancy clinic as soon as you start considering getting pregnant. You will get a chance to engage in a full discussion about the necessary precautions.
You will also get advised about pre-pregnancy supplements. Overweight women may require higher doses of the recommended supplements to prevent some developmental abnormalities in babies.
There are many strategies for BMI optimisation. True, you may have a genetic predisposition to easy weight gain, but you can still do a lot to control how much you gain. Watch what, and how much you eat. Processed foods will leave you worse off with weight gain.
Aim for the good old whole meal foods, complex carbohydrates and, lots of fruits and vegetables. Wash these down with lots of water or freshly pressed juices. You are better off avoiding all those caloric-laden fizzy drinks.
Build in physical activities. This will help break down what you imbibe, rather than store it as fat. Any physical activities that you enjoy will do, just make it consistent.
If struggling to lose weight, get help from a dietician or a physical therapist. Once you get to the target BMI, go on and get pregnant. Your chances of a healthier pregnancy will be much higher with an optimised pre-pregnancy weight.
- Dr Alfred Murage is a consultant obstetrician and gynaecologist