I’m a plus-size girl. This is a statement I rarely say out loud. In fact, this is a subject that makes me completely uncomfortable. Why? It’s 60% shame and 40% denial. Obviously, if I’m a plus-size woman, I was also a plus-size pregnant woman. Twice; the second was a plus-size twin pregnancy.
In my opinion, the size of a pregnant woman’s body shouldn’t warrant mentioning, but here we are. What’s that old saying about size? “The size doesn’t matter, it’s what you do with it that matters.” Well, this plus-size girl made a litter of babies with this body and I’m calling that a win!
Let’s talk about what it means to be plus-size and pregnant with twins.
Is it bad to be plus-size and pregnant?
Have you ever Googled “plus-size and pregnant” or “plus-size pregnancy”? If you have, you may have been convinced that no matter what, you will have a high-risk pregnancy.
With all the warnings out there about how dangerous it is to be overweight and pregnant, it’s no wonder that most plus-size pregnant women worry about their health and the health of their babies. However, the truth is, you can have a healthy plus-size twin pregnancy! Being overweight and pregnant does raise your risk for a number of complications, but many of these are manageable and even preventable. Plus size pregnant women give birth to healthy babies all the time!
If you just heard that second heartbeat for the first time, or you know it’s been two for a while, you need to read our twin pregnancy week by week timeline to help you learn what happens week by week with twins. Click here to learn more… and while you’re at it, check out our expecting twins classes and twin parent coaching services.
What should I know about having a plus-size twin pregnancy?
A plus-size twin pregnancy often comes with a lot of challenges, but so can any pregnancy. According to the American College of Obstetricians and Gynecologists (ACOG) having a plus-size twin pregnancy puts you at a higher risk for miscarriage, preeclampsia, gestational diabetes, sleep apnea, and hypertension. What does this mean?
Possibly the most well-known risk in a plus-size twin pregnancy is developing gestational diabetes. According to the American College of Obstetricians and Gynecologists (ACOG) nearly half of all gestational diabetes cases are attributed to being overweight and pregnant. They also say that having gestational diabetes increases your risk of cesarean delivery.
Twin pregnancy makes you twice as likely to develop high blood pressure (hypertension). It usually develops after 20 weeks of pregnancy and increases your chances of developing preeclampsia and placental abruption.
Preeclampsia is a condition that occurs only during pregnancy. Symptoms may include high blood pressure and protein in the urine. Preeclampsia can prevent the placenta from getting enough blood, causing the fetus to get less oxygen and food and possibly low birth weight. Most women can still deliver a healthy baby if preeclampsia is detected early and treated with regular prenatal care.
Sleep Apnea causes your breathing to start and stop repeatedly during sleep. Since apnea deprives your body of oxygen, it can be very serious for both you and your baby. Continuous positive airway pressure (CPAP) therapy is a safe and effective way to reduce the risks of sleep apnea during and after pregnancy (if needed).
While there are some increased risks with plus-size pregnancy, there is no guarantee that you will have any of these complications. People of all sizes can have healthy pregnancies!
Now let’s talk about how to ease the stress if you actually need to deal with one of these “what if’s”.
Hire a size-friendly health professional
First, hire a plus-size-friendly OB-GYN! This is an absurd suggestion. You shouldn’t need to be advised to do this because all doctors should be size tolerant, right? WRONG!
I had the unfortunate experience of having a weight bias doctor throughout my entire first pregnancy. Every appointment, I left in tears, feeling like I was so much less of a person, because of the number on the scale. I did develop gestational diabetes. And at every appointment, I would bring my glucose tracker, and she would interrogate me as if I was falsifying the numbers. I controlled my gestational diabetes with diet and exercise alone (no medication) and due to this, I actually lost weight during my pregnancy. When she would see this in my chart, she would give me a high five! I was not able to enjoy my pregnancy, nor the changes in my body, and the miraculous things it was doing and creating.
I learned my lesson and found myself a new provider when I was pregnant with twins.
This was the best decision I made for myself, my babies, and my weight! Working with a compassionate care provider is one of the greatest gifts you can give yourself!
Dealing with Insensitive Comments
People are rude, have no tact, and DO NOT understand personal boundaries. You will have someone (might even be a loved one) comment on your appearance in the most insensitive way.
For me, it was from a stranger on a hospital elevator.
While on my way to a non-stress test I was alone on the elevator with this gentleman (jerk). When I chose the Labor and Delivery floor, he informed me that he was happy to see that I was headed to the maternity ward. “You’re HUGE, and look like you are going to explode right here,” he said. By that point in my pregnancy (28 weeks) I was beyond the cordial smile and giggle like what he said was funny. So I informed the man (jerk) that I was pregnant with twins and that I was 28 weeks along. And in true jacka$$ fashion, he replied with, “So you’ll actually get bigger?” He then shared with me that he himself was a twin. As I exited the elevator, I made sure to inform him what a lucky lady his mother was for having a son like him!
In my experience, handling insensitive comments during pregnancy has three phases. In the first phase, you just ignore the people and comments. When you move on to the second phase, you pretend the comment is a joke and just smile like it was funny. In the third phase (much like the third trimester) you are officially done and over the comments so you give it right back via sarcastic comment or even insult if necessary. Mean comments are never easy to hear and are often hurtful, but try to remember what your body is doing and praise yourself, not everyone can build two babies at once!
Is there a medical bias against plus-size pregnancy?
There is a social stigma around being overweight, and there is an evident bias in the medical field against plus-size pregnancy. Many plus-size pregnant women experience disdain over their weight from OB-GYNs, midwives, nurses, and hospital staff. Doctors sometimes can’t, or won’t see beyond the size of the woman.
There are lots of health care professionals that would consider having a plus size twin pregnancy (or any plus size pregnancy actually) unhealthy and will actually recommend that you lose weight before getting pregnant or even during pregnancy.
According to a study published in the journal BMC Pregnancy & Childbirth, weight bias experienced by pregnant and postpartum women is associated with more gestational weight gain and postpartum weight retention. Therefore, not only are weight-based comments unkind, they are not productive either.
If you feel you are not receiving the best care due to a bias against your weight, do not hesitate to switch doctors. Pregnancy is very much about doing what is best for the baby, but also doing what is best for you too!
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When will you see your baby bump?
Every pregnant woman, plus size or not, wants to look pregnant when they are pregnant. The “baby bump” is the most obvious visual indicator of pregnancy. But for us plus-size gals, the bump takes a bit longer to show. On average, a plus-size woman starts to show around 22 weeks. Plus size twin pregnancies will start to show earlier than single pregnancies, but it will still be later than the slender twin pregnancy.
I used to ask my husband daily if I looked pregnant or just fat. I can remember wanting to yell “I’m pregnant” with every side glance I’d get from a stranger. It’s easy to say this when you’ve come out on the other side of trauma, but try to remember, whether you look like you are due any day or you look like you’re having a food baby, your body is doing amazing things!
You can search “plus-size pregnancy” and be flooded with a whole lot of scary information and statistics. But the truth is, ANYONE can have a high-risk pregnancy and ANYONE can have a risk-free pregnancy. Vow to do what is best for your babies and yourself, no matter the cost. Be your own advocate. Focus on overall health vs. what size you are. You can be thin and unhealthy or overweight and healthy.