CHENNAI: Khushboo Sharma, a city-based bank employee, tried to conceive in 2015. But, she had to cross many hurdles. The main one being obesity. After not being able to get pregnant for almost a year, she consulted a doctor who had just one advice for her: “Lose some weight and adopt a healthy lifestyle.”
Getting pregnant is not always a smooth ride. In most cases, women have no control over factors that contribute to infertility, but there are some modifiable factors that can play a role in helping one get pregnant and prepare you for a relatively easier pregnancy term and delivery. The most important factor is weight.
Khushboo weighed over 90 kg at that time. With her doctor’s advice, she began exercising regularly and included more fruits and vegetables in her diet. Now, she is a mother of a two-year-old daughter.
Heavy risk
“Obese women have a lot of adipose tissue or fat cells in their body. These fat cells, like ovaries, produce some estrogen. The estrogen and progesterone stored in the body act as contraceptive pills, preventing ovulation. On the flip side, when you’re underweight, your ovaries make less estrogen, which can also impact ovulation,” says fertility specialist Dr Loganayaki.
Concurring, Dr Shanthi Balachandran, a gynaecologist says, “Risk increases as the weight of the person increases. Body shape matters too. Abdominal fat has a bigger impact on ovulation than fat stored elsewhere in the body. If women can bring their Body Mass Index below 30, they’re more likely to get pregnant, less likely to miscarry and their baby is more likely to be born at term and healthy.”
The risk of embolism begins once an overweight woman gets pregnant. “They can develop two types of blood clotting problems — deep vein thrombosis (DVT) and pulmonary embolism. In DVT, a blood clot forms in a deep vein. In pulmonary embolism, a blood clot breaks loose from a vein and travels to the lungs where it can be fatal. According to studies, obese patients are 2.5 times as likely to have DVT and 2.2 times as likely to have pulmonary embolism,” says Dr Loganayaki.
What can be done?
Even a small amount of weight loss can improve fertility and pregnancy health. Also, some dietary and lifestyle changes that limit weight gain during pregnancy can improve the health of both mother and baby.
“Various researches suggest that a low carbohydrate diet can increase the chances of conception by five times. Processed meats, canned products and frozen foods can affect the reproductive system in women and reduce the quality of eggs. Eat whole eggs (with the yolk) as they are a good source of protein. Couple it with lots of vegetables and greens. High-quality fats like ghee, gingelly oil and coconut oil are crucial for the development of a baby’s brain. Eat a lot of fruits; they help you lose weight,” says dietician Raghavi Balachandran.
One of the most important exercises to do is to walk, suggests Dr Shanthi. “Walk at least 6,000 steps a day. Walk to the shops and take the stairs. Opt for healthy snacks like nuts and ask your doctor to suggest some exercises that are pregnancy-friendly,” she says. It is crucial to have frequent fetal ultrasound and screen for obstructive sleep apnea (sleeping disorder) for the mother, explains Loganayaki.
Diabetes and pregnancy
“Obesity is known to increase the risk of developing diabetes during pregnancy. Obesity is associated with insulin resistance and once that happens, women are more prone to diabetes. During pregnancy, the placenta makes hormones that can lead to a build-up of glucose in your blood. Usually, your pancreas can make enough insulin to handle that. If not, your blood sugar levels will rise. This can cause gestational diabetes,” says Dr Loganayaki.
But, it is still possible to deliver a healthy baby with the condition, and for that, one must go for regular follow-up tests.
Weight management postpartum
“Women hold on to a couple of kilograms postpartum, and it is crucial to shed that weight. Going into a future pregnancy with higher weight can put both the mother and the developing baby at risk. Medical complications such as gestational diabetes and hypertension can occur,” says Dr R Vimala, a gynaecologist.
Raghavi says that shedding even half-a-kilogram per week after pregnancy helps a lot. “You can follow the same Low Carbohydrate and High Fat (LCHF) diet post-pregnancy, too. Including the right nutrition in your diet and engaging in physical activities are the best ways to shed weight. Drink lots of water and eat at least five portions of fruits and vegetables per day. Occasional cheat eats are allowed,” she says.