Mums-to-be with a BMI over 25 will be warned of risks they face in pregnancy in new guidelines

Overweight women will be warned by health officials about the additional risks they face during pregnancy.

For the first time, women with a BMI of 25 and above are being told that they are more likely to have an emergency C-section and that their babies will need specialist care when deciding where to give birth.

Doctors and midwives should warn patients that being overweight increases the risk of stillbirth and neonatal death, according to NICE’s draft proposals.

Regulators said the guidelines update is needed to address growing levels of maternal obesity, with less than half of pregnant women now considered to be at a healthy weight.

Last night, charities welcomed advice to improve pregnancy safety and urged health care providers to “support rather than stigmatize” pregnant women.

But obesity campaigners said its need is more evidence of the “ever-growing obesity epidemic” and called for more to be done to tackle the causes.

Experts found that there were increased risks in all childbirth situations – from home births to midwife-led wards and delivery suites.

It meant the guidelines stopped suggesting where overweight women should have their babies, as it’s not yet fully understood how the environment affects the risks.

Instead, women should be given the information to “make an informed, personal choice about where they were born” after weighing the risks, they argue.

According to the latest estimates, about 59 percent of women and nearly 69 percent of men are now overweight or obese.

This includes a growing number of expectant mothers, leading to the revised advice for health professionals.

Research has previously shown that obesity during pregnancy significantly increases the risk of maternal complications, such as gestational diabetes, preeclampsia, miscarriage, and postpartum bleeding.

Meanwhile, babies born to overweight parents are much more likely to become overweight children and suffer from lifelong conditions such as type 2 diabetes.

Tam Fry, chair of the National Obesity Forum, said more needs to be done to reduce pre-pregnancy obesity.

He said: ‘It is quite right that Nice revised the guidelines, but it is a sad reflection of the ever-increasing obesity epidemic.

“It is vital that women of childbearing age are healthy before becoming pregnant – for their own health as well as that of their babies. More needs to be done to stem the tide of this national disgrace.”

The Nice watchdog committee found that women with a BMI of 25 and above had several increased risks compared to women with a lower BMI.

Some dangers depended on whether the woman had given birth before, they noted.

Risks include a higher number of transfers to an obstetric ward, a higher number of deliveries during labor or emergency caesarean section, and a higher rate of neonatal admissions, stillbirth, or neonatal death.

It recommends that women be given information – such as how the average number of stillbirths, neonatal deaths or the baby requiring neonatal care differs depending on BMI – where evidence is available.

Previous advice for obese mothers, such as recommending it to mothers with a BMI of 35 and above who have a planned birth in a maternity ward, remain.

This includes recommendations that women with a BMI over 30 be individually assessed before being advised on the most appropriate childbirth options.

The British Pregnancy Advisory Service (BPAS) welcomed the efforts to improve pregnancy safety.

Chief executive, Clare Murphy, said: ‘We support the recommendation that women receive personalized information about the risks associated with different delivery methods, but ultimately these are decisions every pregnant woman must make.

“It is critical in our efforts to improve motherhood safety that we ensure that the risks are properly contextualized when communicated to women, and that they are supported – not stigmatized – when they engage in maternity care. ‘

Amina Hatia, midwifery manager at pregnancy organization Tommy’s, said: ‘We know this information can be cause for concern, but it is important for expectant mothers with a higher BMI to understand that they will receive extra care during their pregnancy, including additional care. ultrasounds and tests and support from a hospital dietician if your BMI is over 30.

“There are also many things you can do to minimize the risks and have a healthier pregnancy, such as making sure you go to all appointments and take the tests offered, stay active, and take the recommended supplements.” Healthy eating is very important, but actively trying to lose weight during pregnancy is not recommended.’

The updated draft guideline is in public consultation until 6 June 2023.