Want to have a baby? Do this first

The government has a tough message for some women who want to get pregnant: Shed some pounds first.

Before becoming pregnant, only 45 percent of women were of normal weight in 2015, according to a report released on Jan. 5 by the U.S. Department of Health and Human Services/Centers for Disease Control and Prevention. Some of the women were underweight, but many more were overweight, meaning they had a body mass index above 24.9.

The government has a goal of increasing the proportion of women entering pregnancy with a normal weight from 52.5 percent in 2007 to 57.8 percent by 2020. But instead of improving, the number is declining, and that has some health care experts concerned.

“It is important for a woman who is planning to become pregnant to be at a healthy weight prior to conception because of the increased risks that obesity confers to a pregnancy,” says Dr. Kelli M. Kilgore, an obstetrician and gynecologist at Advocate Good Shepherd Hospital in Barrington, Ill. “Obesity confers increased risk at all stages of a pregnancy.”

“In the first trimester, it increases a woman’ risk of spontaneous miscarriage as well as increases the risk of neural tube defects, hydrocephaly and cardiovascular or orofacial anomalies. Obesity also increases a woman’s risk of certain antepartum complications later on in pregnancy, including cardiac dysfunction, gestational diabetes, preeclampsia, sleep apnea and nonalcoholic fatty liver disease. There is even a slightly increased risk of stillbirth in overweight and obese women. When it comes time for labor and delivery, obesity puts a mom at increased risk for cesarean section, failed trial of labor, endometritis and blood clots.”

The report found the prevalence of prepregnancy normal weight in 2015 ranged from 37.7 percent in Mississippi to 52.2 percent in Washington, D.C. The prevalence in Illinois was 42.8 percent, a decline of about 3 percent compared with 2011.

Of the Illinois women, 3.1 percent were underweight before they became pregnant, 42.8 percent were normal weight, 26.8 percent were overweight and 27.3 percent were obese, meaning they had a body mass index above 29.9 percent.

Dr. Kilgore says that when a woman is interested in becoming pregnant and would like to reach a healthier weight prior to conceiving, she recommends incorporating lifestyle changes rather than “going on a diet.”

“Start slow,” she advises. “You don’t have to run to the gym, open a membership and start lifting weights or doing all-out cardio every day. Start by incorporating small changes into your daily routine.”

Here are some of her suggestions:

1. Replace your daily soda with more water.
2. Swap some air-popped popcorn for those greasy chips.
3. Aim to get your daily servings of fruits and veggies before you allow yourself that reward.
4. Track calories to see how much you’re really taking in.
5. Get a FitBit or other fitness tracker and set goals on the number of steps you take each day.
6. Find a cardiovascular routine that you enjoy; there are endless videos on YouTube. And get your partner to join in your quest for a healthier lifestyle.

“Finally, it is important to understand that there will likely be setbacks in your weight-loss journey, but don’t let them throw you completely off the track,” Dr. Kilgore says. “Get right back on and keep going!”