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Pregnancy can be one of the most joyous, annoying, stressful, cumbersome and enjoyable periods in your lifetime. It can also be a time when you worry about complications and health risks, and this is even more true for women who are overweight. While women of any size and shape can experience complications during their pregnancy, there are certain complications that overweight women are at a much higher risk for. If you or someone you know is plus size and pregnant, you’ll want to pay close attention to the complications discussed in this article.

First, we’ll need to discuss what qualifies a woman to be overweight or obese. If a woman’s BMI is 25.0 to 29.9 before her pregnancy, she is considered overweight. You might be surprised to learn that 2 out of 3 women in the United States fit in this category; that is about 66% of female population (between the ages of 15 and 44). Women are considered obese when their BMI reaches 30.0 or higher before becoming pregnant. About 1 in 4 women in the same age range as mentioned above fall into this category; that is about 25% of the women in that age group.

>> What are the most common pregnancy complications? Find out here.

Women who fall into either category are at heightened risk for the following complications: miscarriage, pre-eclampsia, gestational diabetes, birth requiring c-section, or shoulder dystocia. Dr. Laura E. Riley, obstetrician at Massachusetts General Hospital who sees about two dozen pregnant patients a day, says ”Obesity and being overweight is the toughest topic to discuss with patients. Patients think of weight as a cosmetic issue, not a health issue.”

Women who are overweight or obese are more likely to have a miscarriage or a still birth than a woman who is of a healthy weight. Some studies have even found that overweight or obese women double their chances of having a miscarriage. One theory for this is that overweight women have higher insulin levels in their blood, which can alter or damage the lining of the womb.

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Pre-eclampsia is a condition in which the mother’s blood pressure rises sharply, which can cause harm and even fatalities to the mother and/or baby. Research has linked certain chemicals that are found in body fat to be the cause of the heightened risk. So the more body fat a woman has before becoming pregnant, the more at risk for this condition she will be. Preeclampsia.Org shares that 5-8% of all pregnancies will see preeclampsia, which most commonly occurs after the 20th week of pregnancy.

While 7 out of 100 women develop gestational diabetes during pregnancy, overweight and obese women are much more likely to develop it. Gestational diabetes is a temporary form of diabetes that generally goes away after pregnancy, however, many women who have the condition go on to develop Type 2 diabetes later in life. One of the risks involved with this condition is that the baby will grow too big to deliver normally. In these cases, the birth is generally induced early, which can lead to its own set of complications for the baby or a C-section must be performed. To learn more about how gestational diabetes is treated and how to reduce complications from it, visit National Diabetes Information Clearinghouse.

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Babies that are born to overweight women are much more at risk for shoulder dystocia, because they are generally larger than those born to women of healthy weights. Shoulder dystocia is a medical emergency in which a baby’s shoulder gets stuck during a vaginal delivery. The risks for the baby in this case can include injury to the nerves of the shoulder, arms and hands (which can lead to shaking or paralysis for up to a year), broken arm or collarbone, and lack of oxygen, which in several cases can cause severe brain damage or death. According to Dr. Irina Burd, overweight babies have a higher risk of complications later in life, like high blood sugar, obesity and even a higher risk for cancer. Complications the mother would be at risk for include heavy bleeding, tears in the uterus, cervix, vagina or rectum and bruising of the bladder.

If you’re worried that you could be at risk, consider changing your eating habits and talk to your doctor about introducing an exercise routine. For healthy meal options, check out our recipes index!