Obesity and Pregnancy


Obesity, defined as an excessive accumulation of body fat, increases the risk of serious complications during pregnancy that could threaten the health of mother and baby.

Texas Children’s Pavilion for Women offers specialized care to help women who are obese achieve the safest, healthiest pregnancy possible. Our providers are highly trained and experienced in the evaluation and management of these pregnancies.

What is Considered Obese?

Obesity is measured by your body mass index (BMI). BMI is calculated by dividing your weight (in kilograms) by the square of your height (in meters).

A BMI of 30 or higher is considered obese; 40 or higher is considered severe obesity.

Potential Pregnancy Complications

The higher your BMI during pregnancy, the greater the risk of complications. Obesity-related pregnancy complications may include:

  • High blood pressure (hypertension)
  • Gestational diabetes
  • Preeclampsia
  • Preterm birth
  • Birth defects, including heart defects and neural tube defects such as spina bifida
  • Macrosomia (abnormally large baby), increasing the baby’s risk of injury at birth
  • Labor and delivery problems, including anesthesia complications
  • Difficulty monitoring the baby’s heart rate during labor
  • Risk of cesarean delivery
  • Infections, including urinary tract infections, wound infections and postpartum infection
  • Increased risk to mother and baby of future health conditions, including diabetes, heart disease and obesity
  • Pregnancy loss, including miscarriage and stillbirth
  • Excessive weight gain during pregnancy and retention of that weight gain

Plan Ahead to Improve Outcomes

Proper planning and health care before becoming pregnant can help women who are obese minimize their risks of complications and improve pregnancy outcomes.

The healthier you are at conception, the healthier the environment for your baby’s growth and development.

It’s optimal to visit with your health care provider before you get pregnant to:

  • Assess your personal risks
  • Develop a safe weight loss program that includes good nutrition and regular physical activity and may include weight loss surgery
  • Evaluate and manage co-existing medical conditions
  • Assess your medications and make adjustments, as needed
  • Begin taking prenatal vitamins
  • Discuss any prior weight loss surgery and time your pregnancy accordingly

Treatment during Pregnancy

Your treatment during pregnancy will depend on your weight, your BMI, your overall health and the health of your unborn baby.

In general, your prenatal care may include: 

Frequent prenatal visits for close monitoring

  • BMI calculation at your first prenatal visit and a recommended weight gain plan; the recommended weight gain for obese women during pregnancy is typically 11 to 20 pounds
  • Nutrition and exercise counseling
  • Early screening for gestational diabetes
  • Later or more frequent fetal ultrasound for more detailed imaging
  • Fetal echocardiography to screen for congenital heart defects
  • Management of existing health conditions and medications
  • A carefully planned delivery, including an anesthesiology consultation
  • Blood clot prevention during delivery, if a C-section is needed
  • A multidisciplinary health care team

The Benefits of Specialized Care

At Texas Children’s Pavilion for Women, we offer the following benefits and services for mothers-to-be with weight-related concerns:

  • Preconception risk assessment and counseling
  • Prenatal evaluation and a recommended plan of care
  • Advanced fetal imaging for early detection and treatment of complications
  • A personalized nutrition assessment and diet plan to avoid excessive weight gain
  • Delivery at our state-of-the-art facility with 24/7 access to critical support resources, if needed
  • Immediate access to Texas Children’s Hospitalfor babies who need extra care and monitoring, including Texas Children’s Fetal Center™ and Texas Children’s Newborn Center, home to our level IV neonatal intensive care unit (NICU)
  • A multidisciplinary medical and surgical team experienced in the care and treatment of pregnancies involving obesity, including maternal-fetal medicine specialists, fetal specialists, anesthesiologists, neonatologists, pediatricians and registered dieticians
  • Close collaboration with your current health care providers
  • Proven experience coordinating the multidisciplinary care required for the best possible outcomes