Helping overweight and obese women lose weight before or after pregnancy
Obese and overweight mums-to-be face a range of potential problems during pregnancy and childbirth. Those who are obese, for example, are more likely to have a blood clot or get diabetes. They are also more likely to have a longer labour.
The chances of having an instrumental or caesarean delivery are also higher - and they are less likely to have a choice about where and how they give birth and the types of pain relief they can have.
Babies born to overweight and obese women are also more likely to have medical problems and, in the future, are more likely to become overweight or obese themselves.
Yet health professionals do not, as a matter of course, tell women about these risks and the importance of keeping to a healthy weight before - and after - pregnancy. (The first few years after pregnancy and childbirth are also a time when women are likely to gain weight - particularly if they get pregnant again, without losing any weight gained from the previous pregnancy.)
It's not that professionals don't recognise the risks. Rather, they are often unsure what advice to give. In some cases, they lack the training, skills or confidence to provide this support.
Now new NICE guidance ‘Weight management before, during and after pregnancy' aims to change all this.
Health and fitness advisers working in the NHS and local authority leisure services should be trained to provide information about the health benefits of losing weight before getting pregnant, it says.
Where necessary, they should also offer women of childbearing age the opportunity to join a proven weight-loss programme.
Local authority leisure and community services should also offer women with babies and children the opportunity to take part in a range of physical activities. This could include swimming, organised walks, cycling or dancing. Where possible, NICE says, affordable childcare should be provided.
Pregnant women should never diet - because it could affect the unborn baby.
Rather, health professionals should measure pregnant women's weight and height - ideally, the first time they see them, says NICE. They should also, give them advice on a healthy diet and how much physical activity they should do. If necessary, they should offer them further help.
"Having recently had a baby myself, this guidance was pertinent to my experiences both during and after pregnancy,” said Dr Tracey Sach, a member of the Public Health Interventions Advisory Committee at NICE which developed the guidance.
“During pregnancy, it was not uncommon to hear I should be ‘eating for two' and that I should stop cycling. However, neither is necessary and this guidance aims to dispel these common myths.”
Professor Mike Kelly, Director of the Centre for Public Health Excellence at NICE, added: "This new guidance is about helping health professionals to help women have a healthy pregnancy - it's not about preaching to women.”
"It's also important that women do not feel pressurised into rapid weight-loss or crash diets after pregnancy.
“They should understand that weight loss after birth takes time and that physical activity and gradual weight loss will not affect their ability to breastfeed. Losing weight gradually can actually help women maintain a healthy weight in the long term."
In adults, a body mass index (BMI) measurement of 25 to 29.9 means that someone is considered to be overweight. Someone with a BMI of 30 or above is considered to be obese. (The BMI is calculated by dividing weight [kg] by the square of height [m2].)
This page was last updated: 16 August 2010