5 Essentials for a Healthy, Happy Plus-Size Pregnancy

5 tips from experts for a plus-size pregnancy.

Kara Islington weighed 236 pounds when she found out she was expecting her first child. “I was absolutely thrilled to be pregnant, but because of my size, I felt a great deal of anxiety and doubt,” the plus-size mom of two admits. “My brain raced with questions. Was my pregnancy doomed to develop complications? Would my doctor lecture me about my weight? Should I go on a special diet? What about exercise? I wondered whether stores even sold plus-size maternity clothes! I was a basket case.”

These same concerns are echoed among an increasing number of expectant mothers. Leading health organizations strongly advise women to lose excess weight before they conceive or else face an increased risk for such prenatal complications as gestational diabetes, gestational hypertension, and preeclampsia. Despite these warnings, almost half of all pregnant women in the US and Canada are overweight.

If you are a plus-size mom-to-be, can your pregnancy still progress problem-free?

“My weight did not stop me from having a completely normal pregnancy,” says Islington, of Colt’s Neck, New Jersey. “I refused to spend nine months worrying about what could go wrong. Instead, I focused on taking excellent care of my physical health and emotional well-being.”

You too can experience a healthy plus-sized pregnancy. Here are some important bits of advice from both medical experts and plus-sized moms.

Find Size-Friendly Prenatal Care

“Your ability to trust, confide in, and feel comfortable with your obstetrician or midwife is critical,” says Dr. Cornelia van der Ziel, MD, an OB-GYN from Cambridge, Massachusetts, and coauthor of the plus-size pregnancy guide, Big, Beautiful, and Pregnant. Unfortunately, many plus-size women readily admit that, because of their weight, they fear biased or inferior medical treatment.

In your quest for a healthy pregnancy, make it a priority to find a size-friendly midwife or obstetrician. “These are healthcare providers who don’t make negative assumptions about your diet and health, and generally show positive and supportive feelings about your pregnancy,” says Pamela Vireday, a certified childbirth educator in Oregon.

To locate a size-friendly midwife or obstetrician, ask other plus-size women you know for recommendations and then make appointments with a few clinicians just to chat. Vireday advice asking open-ended questions such as, “What are your concerns for me as a larger woman?” and “How will you help me have the best chance at a normal birth?” By listening carefully to the answers, you will gain valuable feedback on how the midwife or obstetrician views plus-size women and be able to pick a care provider whose personality and style best suit your needs.

Gain Weight

“Because I was already 60 pounds above my ideal weight, I wondered whether or not I even needed to gain weight during pregnancy,” confesses Mare Solomon, a recent first-time mom living in Toronto, Canada. “And then I talked to my OB. She explained that changes in a woman’s body—increased blood volume, the placenta, and the weight of a growing baby—make adding extra pounds during pregnancy normal for every woman, no matter how much she weighed prepregnancy.”
The Institute of Medicine (IOM) agrees, recommending overweight women gain between 15 to 25 pounds total during pregnancy (your provider can tell you the amount that’s right for you). The IOM has found that plus-size women who stay within these weight-gain guidelines have the best chance for delivering a healthy birth weight baby and also reduce their risks for delivering by Cesarean section.
“The key to healthy pregnancy weight gain is to gradually add pounds,” Dr. van der Ziel advises. The American Dietetic Association (ADD) calls for plus-size women to gain up to three pounds during the first trimester and then put on between one-half to three-quarters pound per week starting from the twelfth week of pregnancy.

Make Every Bite Count

“Eating a wide variety of nutritious foods can decrease your risk for certain health complications, give you more energy, replenish your body’s supply of key vitamins and minerals, and make it easier to reach weight-gain goals,” says Dr. van der Ziel. Excellent prenatal nutrition also ensures your baby receives the proteins, carbohydrates, fats, vitamins, and minerals necessary for optimal fetal growth and development.
Your challenge for the next nine months is to fill your diet with fruits and vegetables, whole grains, nuts, beans, and certain fats, fish, meats, and dairy products—foods that naturally pack powerful combinations of vital nutrients into every bite. “An occasional treat is OK as long as you make sure you are eating enough quality food,” adds Vireday.

While experts agree that no pregnancy diet can guarantee a perfect outcome, consuming nutritious foods does increase the odds for you and your baby to go through pregnancy problem-free. Be sure to meet with a nutritionist if you need help creating a healthy prenatal menu plan.

Exercise Regularly

Something as simple as walking briskly for 30 minutes a day may dramatically increase your ability to stay healthy throughout pregnancy. Regular physical activity can actually ward off the health problems plus-size women are more likely to encounter.
“Research clearly shows that exercise helps reduce the risks for gestational diabetes and blood pressure issues in pregnancy. In one study, obese women who exercised regularly cut their risk for gestational diabetes in half,” Viraday points out.
Before you lace up your sneakers, check with your care provider to make sure exercise is safe for your pregnancy. If you didn’t exercise prior to pregnancy, start with a leisurely 15-minute walk. Gradually increase your workout intensity and duration. “Aim to exercise every day, or at least five days out the week, for 30 minutes each workout session,” advises Vireday.

Show Your Style

Maybe you have heard horror stories from some plus-size women who, as recently as five years ago, were stuck with mucus and loose T-shirts as their only alternatives in maternity wear. Fortunately, times have changed. Due to popular demand, several department and clothing store chains now stock maternity sizes up to 3X, either in-store or through Internet/catalog sales. Some online-only maternity stores offer sizes up to 6X.
“Your style doesn’t have to change just because you are pregnant,” says Cat Tharp, owner of the Longwood, Florida-based online retailer Pickles and Ice Cream Maternity, about the new direction in plus-size maternity fashions.

Wearing clothes that fit—and flatter—your changing shape can be a much needed self-esteem boost. Mare Solomon remembers feeling depressed after one of her coworkers did a double take when she casually mentioned her due date. “I still fit into some of my non-maternity clothes well into the second trimester. While I could see my belly growing, my loose sweaters and baggy pants hid this fact from the rest of the world.

That all changed when Solomon finally went shopping. “I loved the way I looked in my new maternity clothes, but what shocked me was how much positive attention I received from others just by wearing a fitted maternity top. It was nice to finally get some credit for being pregnant.”
A Note about Plus-Size Bellies…

When will you begin to show? Will you develop a perfect round orb of a belly? Based on what plus-size women report about their own experiences, if you have given birth before or if you are currently pregnant with multiples, you may notice your belly begin to swell as early as the end of the first trimester.
Are you pregnant for the first time? You could see a noticeably rounder pregnant belly starting to show sometime during the fifth month. An apple-shaped woman who carried excess weight in her stomach area prepregnancy may notice this weight shifts downward as her pregnant belly expands. Larger women who gain a minimal amount of weight during pregnancy may find themselves starting to show much later than women with higher weight-gain goals.

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