Obesity in Pregnancy: How it Affects Labor and Delivery?

Oversight of Obesity During Pregnancy

The best way to determine if someone is obese or not is to figure out his body mass index (BMI). You might wonder what's BMI. It's a measure of an individuals' body fat based on his height and weight. The World Health Organization (WHO) stated that a person with a BMI of 30 or higher is categorized as obese. And this classification remains the same for expectant or pregnant women. 

Obesity in pregnancy is a growing concern, with 10% to 30% of pregnant women being obese worldwide. Since it can pose multiple health hazards during labour and delivery, obesity management becomes necessary for optimal maternal and foetal health.

How Does Obesity During Pregnancy Affect Labour?

Labour is a complex process influenced by various physiological and mechanical factors. Obesity can affect a number of aspects of labour in expectant mothers:

• Prolonged Labor: Studies have shown that obese women are more likely to experience longer labour durations. It can be caused because of the increased difficulty in monitoring foetal heart rate and uterine contractions through the adipose tissue. Furthermore, an obese pregnant woman might experience difficulties with the descent of the baby through the birth canal and other mechanics of labour.

• Induction of Labor: Obese pregnant women are at a higher risk of requiring labour induction. It’s because obese pregnancies are at a higher risk of contracting conditions such as gestational diabetes and preeclampsia, which often necessitate induction. But for obese women, the chances of successful induction are comparatively lower. Because of this, it can occasionally result in extended labour or even the requirement for a cesarean surgery (C-section).

• Anaesthesia Complications: Healthcare professionals find it more challenging to administer epidural or spinal anaesthesia (commonly used for pain relief during labour) in obese women. Doctors might struggle to recognise anatomical landmarks if there is excess of fatty tissue, which could heighten the risk of failure or consequences like inadvertent dural puncture.

How Does Obesity During Pregnancy Affect Delivery?

Obesity in pregnancy and delivery have a negative relationship, with the former significantly influencing the delivery process and introducing the following complications: 

• Cesarean Section: If you have gained too much weight during your pregnancy, you are more likely to have a C-section, either electively or emergently. Numerous factors, including lengthy labour, foetal distress, or labour failing to progress, might be the culprits. Additionally, obese women who have c-sections are usually on the verge of developing numerous other surgical complications, such as infections, heavy bleeding, and prolonged recovery periods.

• Postpartum Haemorrhage: Obese women are more likely to experience postpartum haemorrhage up to a certain point. It can be the result of uterine atony, a condition in which your uterus fails to contract properly during delivery, causing heavy bleeding. 

• Wound Complications: Surgical deliveries can pose additional risks for women having excess weight, including wound infections and delayed healing. Moreover, surgical sites might become more vulnerable to infection and dehiscence because of increased adipose tissue.

How Can You Manage Weight During Pregnancy?

While pregnancy is not typically a time for weight loss, managing weight gain and maintaining a healthy lifestyle are keys to healthy pregnancy and smooth labour and delivery. Some advice on weight management for expectant women is provided below:

• Pre-Pregnancy Counselling: Are you too overweight to carry a child to term? If yes, you should ideally begin losing weight before conception. Seek pre-pregnancy counselling to understand the importance of a healthy BMI during pregnancy and strategies to achieve it.

• Healthy Eating: Eating healthy is another important area you should concentrate on to keep your weight at an ideal level throughout pregnancy. Have a balanced diet rich in fruits, vegetables, lean proteins, and whole grains. Avoid excessive intake of sugars, saturated fats, and processed foods. You can also work with a nutritionist for a tailored diet plan that meets your and your baby’s nutritional needs without excessive calorie intake.

• Regular Physical Activity: Staying active during pregnancy can help manage weight gain and improve overall health. It’s usually safe and beneficial to indulge in activities such as walking, swimming, and prenatal yoga when carrying a baby in your womb. However, before you start any exercise regimen, it’s advisable to consult a healthcare provider to prevent too much strain on your body and baby. 

• Regular Prenatal Care: You shouldn’t skip regular checkups with your gynaecologists as they are essential to keeping an eye on the health of you and your unborn child. These consultations can help you not only maintain a healthy weight but also reduce the dangers of obesity during pregnancy, including hypertension and gestational diabetes.

• Mental Health Support: Your ability to control your weight is greatly influenced by your mental and emotional health. Pregnancy-related stress, anxiety, and depression can influence unhealthful eating patterns, resulting in weight increase. Seeking support from mental health professionals or joining support groups can provide you with mental and emotional relief, helping promote healthier lifestyle choices.

Final Takeaway

Obesity during pregnancy is a complicated issue that may affect your labour and delivery process. Mothers' and newborns' health can be enhanced by being aware of these consequences and putting weight management tips into practice. 

Gynaecologists at Medanta can guide you through a pre-pregnancy phase, healthy eating habits, exercises, and continuous prenatal care, ultimately navigating your pregnancy with greater confidence and reduced risks.