What to expect as a larger pregnant woman?

[Shahhhh]

Hi guys!!

I'm 28 years old, I'm a size 18-20 and I'm currently 13 weeks pregnant. We had a miscarriage in April so we're thrilled to be here 💛

I had my meeting with my midwife the other week, and although I expected to have some extra things to check on due to me being overweight, she only really told me that I'd meet with someone at the hospital who deals with larger ladies and pregnancy. I was wondering if anyone has any experience in what that might look like?

I know there are extra risks involved due to being overweight, however my midwife said she's not concerned as that is my only issue really. I don't have any health issues, not on any medication, no asthma or ill health at all.

I just kind of want to know what to expect as a first time mum with a bit of extra weight!! Thanks ladies xxx

Congratulations on your pregnancy

I had no health issues at all being pregnant at a larger size. Had test for gestational diabetes but it was fine. I was past the BMi cut off for midwife led care so delivered on the normal Labour ward but it was uncomplicated and all fine both times

Just had test for GD, nothing else different.. I was about 20 stone at the time

They should test you for gestational diabetes, and if they forget, ask (they somehow missed mine and I had it). You're generally a slightly higher risk pregnancy so they shouldn't be offering you a home birth. Otherwise, not much really.

Im currently size 20 and wasnt told id need any extra care to be honest. I did ask about it but was told not to worry!

The only thing i think its affected is scans can be trickier (they keep writing 'view restricted due to high bmi' on the report!). Oh and obviously due to the extra weight it puts more pressure on things like your back and pelvis, which if you suffer from spd isnt fun. So maybe read up on that a little to see what you can do ro prevent it?

They add up overall risk. Your youth is in your favour. Risk is at a certain BMI - 31 I think, might have been 35.

They weigh everyone but might talk to you about limiting weight gain, refer you to optional classes.

In terms of birth options, water birth is sometimes out as they worry they wouldn't be able to lift you out in an emergency. Midwife led units might also say it's better you're in a delivery suite.

Post birth they might want you to wear pressure socks to help with thrombosis risk. You might be at slightly higher risk of birth complications.

Don't worry though, everyone can have risk factors and you're definitely nothing out of the ordinary for them.

Thanks so much ladies! They did mention the GD test, said that would be at my 20 week appointment, is that right?

She also mentioned I might have more growth scans just to check in 🤷‍♀️ and I didn't want a home birth anyway but they don't do them in my area due to staffing so that's fine!

My fat friend was given a GD test and declined a home birth. That was the only difference.

I was about a size 16 when I got pregnant, now 38+2. I was prescribed 75mg of aspirin until 37 weeks as this reduces the risk of preeclampsia. I had a gestational diabetes test too and all came back fine.

Thankfully, I'm still midwife led as I have no other risk factors so able to have a water birth if there is a pool available, but I did have to have 3 extra growth scans due to my BMI (all fine so far, have my final one tomorrow)

I've had no issues at all so far, fingers crossed you won't either! Nobody has ever mentioned my weight, I've not been weighed again and my midwife/sonographed haven't mentioned anything at all x

You can decline gd test if you want. I looked up symptoms and as I had none of them, I declined second time.

I’d really recommend reading Sara Wickhams writing about BMI in pregnancy www.sarawickham.com/research-updates/women-with-higher-bmi/

There is a group on Facebook and insta called ' the heavy weight midwife' it's excellent support and advice so I'd highly recommend joining.

I had my son 5 months ago and had risks because my bmi was 39, and I'm 36. I had to see the consultant and had a GD test. I did have GD so was monitored every 4 weeks with growth scans.

I had my baby naturally, in the pool at 39 +1 so please don't just agree with what they tell you (ie not allowed waterbirth) gather all the information and make your own judgement based on the risks (I've had a baby before - straight forward water birth so I had that on my side)

WHY? Why would you do this?

OP - please please please, do not decline the GD test.

I didn't have any symptoms that I saw. But I had GD. And it was HARD to get it under control. Thank god I was diagnosed as if I'd carried on as I was, who knows what would have happened.

You might need to take baby aspirin no big deal…

you will get extra scans 👍

you would be insane to turn down GD testing

Separately I would also REALLY recommend following a GD based diet /lifestyle from the get go. Both for you to control and limit weight gain and for your baby

Focus on protein veg and fats
sweet potato and wholewheat pasta in controlled portions…
when I needed sweet treats I had homemade frozen banana dipped in dark chocolate or oppo/ halo ice cream (lower GI)a short walk after meals like 5-15 mins does wonders for blood sugar. I did this in 2nd pregnancy …

I wish I had known this/done this from the outset of my 1st not when they finally confirmed GD at 34weeks.

i feel they don’t impress the risks to your baby / first weeks with newborn enough.
they certainly didn’t with me…

if your baby is born with hypoglycaemia…

• if they pick it up and it resolves no biggie
• if they pick it up and it doesn’t resolve quickly your baby will be in NICU for anywhere from a few days to weeks/ a month
• if they don’t pick it up or take it seriously it’s plain dangerous and your baby could be brain damaged (I had to fight to actually see a dr when my first baby had a 0.2mg glucose read… they kept saying just give more milk 😒 despite the fact no glucose = brain damage)

we spent 2 weeks in Nicu it was hell and potentially avoidable

Ignoring back pain from relaxin messing with my ligaments my pregnancy was otherwise textbook

I was a size 18-20 before pregnancy too. My BMI was 34.17 with my first pregnancy, which unfortunately we had to terminate due to a not compatible with life diagnosis. I fell pregnant again and was 3 weeks further along at my booking appt, and my BMI worked out at 35.1. I mention this because they do consider the thresholds at 30-35 and 35+.

Anyway, I haven't found it a problem at all. I'm now 33 weeks and have never been weighed again since - I'm actually really amazed I've only put on 12lb so far. I was offered extra scans at 32 and 36 weeks, but no one has really said whether it was because of our previous history or purely down to weight and age (I'm 39).

I'm Consultant-led, but again, I've only had 2 appointments with her and she's been so lovely. It's been more about reassuring me about potential abnormalities than anything else, and if I'm still doing well at 36 weeks I can be downgraded to midwife led care for birth. I don't think this would have been offered if I hadn't asked, so don't be afraid to. It would have opened up the midwife led unit and pool etc to me.

I was given the GD test at 28 weeks and didn't have it.

I'm having a good pregnancy this time, I've not had any weight related problems and I've got a lovely round bump - I was sad at the thought about just looking chubbier but it's very obviously a baby!

Only thing I've found hard is getting maternity clothes in bigger sizes, I really need a 22 now and not much is available. I can recommend

George at Asda - pants, long vests, swimsuit, PJs, oversized shirts
Next - twin packs of leggings
Lovall - just got my first order from them, joggers, jeggings and tights in bigger sizes, wish I'd ordered sooner
Beyond Nine - Love my Poppy jumpsuits

Seraphine - have a few bits in bigger sizes in their Curve range (look on Vinted too)
Tu at Sainburys have a few bits too
New Look - I've got a few jumpers
H&M - ok but their clothes aren't my style, would be good for holiday clothing

I have a BMI 35+ and am having a home birth in a pool (which contradicts what others have said, so don't assume it's not possible for you.)

I had aspirin as someone above mentioned, GD test and growth scans every 4 weeks from 32 weeks.

Although technically 'high risk' all my test have come back fine and I've had a healthy pregnancy with midwife led care.

I had a bmi of 41 at booking with DS.

Had asprin, two consultant appointments and extra scans. GD test (negative). Everyone I saw in my pregnancy was lovely and non judgemental.

I was active throughout my pregnancy and I was still working on the allotment digging at 39 weeks. I didn't feel physically limited or get SPD.

However I did have hypertension towards the end of my pregnancy and needed beta blockers. Also I had a failed induction due to the hypertension and a EMCS with a then hypoglycemic baby (he is completely fine now). I don't know if these complications were weight related or not but it was quite stressful.

Then really struggled to shift the weight post partum and put more weight on. Then had fertility issues so really tried and struggled to lose weight for ttc. Then got pregnant and can't stop eating to stop feeling sick! So at my booking for this second pregnancy I was bmi 42 which I'm a bit annoyed with myself about.

But I did have great care last time and this time they will be on it with my blood pressure and I'm also having a ELCS. I am very happy to have a very medicalised pregnancy as long as baby well. I am glad that I get extra monitoring and tests.

Congratulations on your pregnancy! I have lots of friends who are lower bmi who also had issues so I don't think it's always a correlation at all.

Thank you all so much for your lovely comments and advice! My midwife did say I may need aspirin but I haven't heard anything else (she hasn't really been proactive this far, I've had to chase up a few things)

At what point did you start aspirin? So I know if I need to chase that up now or if that's something I don't start until I'm like 20 weeks for example

From 12 weeks for asprin. I think you will meet criteria as it is first baby and high bmi but I could be wrong.

I have a perscription to pick up at my dating scan.

I came to recommend this book!!

Be prepared for the lovely "maternal habitus" or high BMI being written on every single scan notes, even when they were able to perform the scan perfectly well, they will always include it regardless 🙃

Sorry, forgot to mention the aspirin. I was told to take it from 12 weeks but I dragged my heels and started at 14 weeks. Silly really, I should have taken it. I just never take medication so was reluctant! I think they said it had to be started by 16 weeks for best results

Chase for your aspirin. They forgot mine and I started it late. They also told me I had to take higher dose of folic acid so worth checking that too. I had a scan and meeting with a consultant once a month. I had to start injecting to avoid blood cloths during the last months.

I recommend anything written by Dr Sara Wickham

My lovely DH tried to convince me “suboptimal view due to maternal habitus” wasn’t code for fat 😂 Again, they managed to do the scan perfectly fine!

This is a test that everyone gets where I live, regardless of the size