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Obesity during pregnancy can put you and your baby at risk for certain complications. Fortunately, you can take steps to reduce the risks and have a healthy pregnancy with obesity.

Read on to get medical advice for pregnant women with obesity. Learn about how obesity affects pregnancy and the importance of prenatal care before and during pregnancy if you’re overweight.

How Does Body Mass Index Affect My Pregnancy Risk?

Your health care provider calculates your body mass index (BMI) from your height and prepregnancy weight. It tells your doctor whether your weight may increase your risk of pregnancy complications.

• A BMI under 18.5 is underweight. Having a low BMI may put you and your baby at risk for malnutrition.
• A BMI of 18.5 to 24.9 is a healthy weight.
• A BMI of 25.0 to 29.9 before pregnancy is overweight.
• A BMI of 30.0 or higher before pregnancy indicates obesity.

If you’re planning a pregnancy, obstetricians recommend losing weight first because obesity can affect fertility, making it harder to get pregnant. Excess weight also increases the odds that fertility treatments like in vitro fertilization (IVF) won’t work.

If you’re obese, losing even a little bit of weight can benefit you and your baby. A preconception care team can help you establish healthy habits, lose weight, and set the stage for a healthy pregnancy.

How Does Obesity Affect Pregnancy Risks?

Obesity during pregnancy increases your risk of developing complications that can harm you or your baby. The more overweight you are, the greater your risk.

During prenatal visits, excess weight may make it harder for your doctor to check your baby’s heart rate or measure their growth. And excess body fat makes it harder to see your baby’s anatomy on an ultrasound.

Having a high BMI increases your chances of developing these and other serious health problems that can harm you or your baby.

• Birth defects — Obesity in a mother increases the risk of heart and neural tube defects in her baby.
• Gestational diabetes — Excess body fat can make insulin less effective, increasing your risk of gestational diabetes. You may need to take insulin shots to keep your blood sugar in a healthy range.
• Macrosomia (a larger-than-average fetus) — Your baby can grow too large, making vaginal delivery dangerous. You may need a cesarean delivery.
• Obstructive sleep apnea — Obesity can cause you to stop breathing for short periods while asleep. This is dangerous during pregnancy because it raises your blood pressure and leads to heart and lung problems, which can harm your baby.
• Preeclampsia — This is a dangerous type of high blood pressure that can happen during late pregnancy. In rare cases, it can cause kidney or liver failure, seizures, a heart attack, or a stroke. It can also damage your placenta and harm your baby.
• Preterm birth — Your baby may develop health problems if you have gestational diabetes, preeclampsia, or other complications. If this happens, your doctor may need to deliver your baby early, often by cesarean section.
• Stillbirth or miscarriage — Women with obesity are more likely to lose a baby due to miscarriage or stillbirth.

Can Obesity During Pregnancy Affect My Child?

Obesity during pregnancy can have long-term implications for a child, even as they grow into teens and adults. Your child may:

• Develop diabetes as a teen or young adult.
• Have a higher risk of asthma or breathing problems.
• Have developmental issues that affect learning, memory, judgment, or behavior.
• Need surgeries and ongoing medical surveillance if they have a birth defect.
• Struggle with their weight during childhood and beyond, which increases their risk of chronic diseases like heart disease and diabetes.

What Medical Care Do People with Obesity Need During Pregnancy?

What medical care do obese women need during pregnancy?

Proper prenatal care is essential for all women, but even more so if you’re obese. Your weight puts your pregnancy in a high-risk category.

Your doctor may monitor you and your baby more closely to catch any potential problems early and prevent complications. They may recommend:

• Early screening for gestational diabetes — Normally, doctors order this test between 24 and 28 weeks. Your doctor may screen you earlier or more frequently.
• Frequent blood pressure checks — High blood pressure is dangerous during pregnancy and can harm you and your baby. Your doctor may have you check your blood pressure at home in addition to your prenatal visits.
• Frequent ultrasounds — This allows them to monitor your baby’s growth and development.
• Nutrition care — A dietitian can help you meet diet, exercise, and weight goals. If your BMI is in the obese category before pregnancy, doctors recommend limiting pregnancy weight gain to a range of 11 to 20 pounds.
• Screening for sleep apnea — Your health care provider may screen you at one of your first prenatal appointments. They may recommend a continuous positive airway pressure (CPAP) mask, which delivers air while you sleep, or other ways to help with nighttime breathing.

How Can I Have a Healthy Pregnancy with Obesity?

You can do many things to help offset some of the risks of having a high BMI during pregnancy. Start these early — before you become pregnant, if possible, or as soon as you find out you’re pregnant:

• Don’t skip your prenatal care — Make sure you establish care as soon as possible, ideally, before you conceive. Attend all appointments and follow your health care provider’s advice throughout your pregnancy.
• Eat a healthy diet — Nutritious, whole foods nourish you and your baby and promote healthy weight gain. Make sure you’re eating plenty of colorful fruits and vegetables and high-fiber whole grains. Include several servings of protein daily from lean meats like chicken, fish, or beans, and calcium-rich foods like milk or yogurt.
• Eliminate harmful habits — Don’t smoke, drink alcohol, or use recreational drugs. These can harm your unborn baby and pose additional risks to your pregnancy.
• Get regular, moderate exercise — Physical activity promotes healthy blood sugar, blood pressure, and weight. Check with your doctor before starting any new form of exercise.
• Manage your stress — Excess stress affects your sleep, eating habits, blood pressure, and more. Stress management techniques like meditation, yoga, or talk therapy can help if you feel overwhelmed by life or the demands of pregnancy.
• Take your prenatal vitamins — They provide the extra nutrients you and your baby need that you may not get from diet alone.

It’s important to know that women of all sizes can have a healthy pregnancy. But being overweight presents unique challenges and risks. Your health care team can support you to ensure your pregnancy is as healthy as possible.

Editor's Note: This article was originally published on August 11, 2025, and was last reviewed on September 3, 2025.