'Lose weight' - it's a prescription you may hear from your doctor or midwife to improve your chances of fertility. They dispense it so easily but is it really that important? Can you afford to ignore it?
The effect of maternal nutritional status prior to pregnancy is extremely important. The body mass index (BMI) is used as a marker of nutritional status.
If your BMI is greater than 24.9 kg.m2, you are overweight but you have an exciting challenge in front of you. You are in a very fortunate position because you have one of the greatest motivators to lose weight: to have a healthy baby.
An increasing BMI has an effect on many aspects of fertility, successful and safe pregnancies and, very importantly, healthy babies. It is a linear relationship; as your weight increases so do the risks.
Being overweight is associated with:
...you have one of the greatest motivators to lose weight: to have a healthy baby
- a decreased rate of conception.
- an increased risk of miscarriage.
- a greater chance of having a complication during pregnancy (having high blood pressure, gestational diabetes, developing blood clots or the baby having an abnormality such as neural tube or cardiac defects).
- less accurate ultrasounds. Ultrasounds in overweight women may not be as accurate because the ultrasound quality is poorer. Therefore, it can be more difficult to detect any problems.
- a higher rate of induction of labour.
- a higher rate of failed induction (where labour is unable to be induced, necessitating a caesarean delivery).
- more problems with caesarean sections, as they can be more technically difficult in overweight women and anaesthetic risks are higher. After a caesarean section overweight women, (compared to normal weight women), are more likely to experience complications including wound infection and blood clots.
- a greater chance of a macrosomic (large) baby. It can be a cause of obstructed labour, resulting in a higher rate of operative delivery (forceps, vacuum or caesarean section)..
If you are overweight and planning a pregnancy, here is your challenge: to decrease the risk of everything stated above. Every kilogram helps. The best study to date that has proven this, found that even a small weight loss (an average of 6.3 kg) in a group setting over a six month period, resulted in an improvement in ovulation, pregnancy rate and pregnancy outcomes.
The way to weight loss success is to make healthy lifestyle changes that you can sustain. Here are a few tips to get you started:
- Get organised. Devise an action plan. This will involve planning what you are going to eat for the week, creating a grocery list and making sure you are organised each day. Ensure you are including at least five serves of vegetables, two serves of fruit and two litres of water each day. If you have healthy food options available, it makes it easier to stick to your plan.
- Be aware. Keeping a Food and Activity Diary helps you not only become aware of what you are eating but has also been found to decrease weight. It might take a bit of time each day but - good things take time!
- Watch your portion sizes. There is no such thing as a 'good' or 'bad' food, it is the quantity in which we enjoy them. Losing and maintaining your weight does not mean that you have to abstain from certain foods, it just means you have to abstain from the quantity you were once consuming them in. Tools like the TEMplate System make this simple and easy to do.
- Have breakfast. Skipping breakfast impairs memory, concentration and problem-solving skills, meaning you are less productive at work. People who skip breakfast can slow their metabolism and they tend to weigh more than breakfast eaters. Breakfast skippers are also more likely to binge-eat later in the day.
- Enjoy exercise. Find an activity you enjoy and just do it. Wearing a pedometer has been proven to help lose weight, if you set yourself a daily step goal. Start gradually, then aim for a minimum of 10,000 steps a day.
The weight is over. This is your challenge - and you can do it!
For more information on how you can maintain a healthy weight, visit www.healthyweightforlife.com.au
Chat about diet and fitness with other members on Essential Baby.
Kyra Sim is an Accredited Practising Dietician with a Bachelor of Science and a Masters of Nutrition and Dietetics. As part of her ongoing PhD she is conducting a randomised controlled trial into the effects of weight loss on overweight women prior to commencing IVF at the Royal Prince Alfred Hospital fertility unit.