A majority of plus-sized women who are pregnant will experience a healthy pregnancy, but they are at risk of having a more bumpy ride than someone who is not overweight.

Women who are overweight, or have a body mass index (BMI) of 25 or more, are at a greater risk of certain pregnancy complications like gestational diabetes and preeclampsia. No knows for sure why weight matters so much, as far as most doctors are concerned it is just one piece of the puzzle. The truth is most plus size women have completely uneventful pregnancies and deliver perfectly healthy babies as long as they eat well, exercise and watch their weight throughout pregnancy.

The biggest problem with being plus sized and pregnant is that you are at a greater for some of the following:

Studies have shown that overweight women have a higher rate of neural tube defects – problems with how your baby’s brain and spinal cord develop. These studies are unable to pinpoint exactly why overweight women are at a higher risk and have a higher rate. Some studies have shown that overweight women have lower blood folate levels than a woman who is of normal weight. Folate is needed especially in the early stages of pregnancy to help avoid neural tube defects. Because of this, if you are overweight your doctor may prescribe you a prenatal vitamin with 1000 micrograms of folic acid. In fact, if you are overweight and planning on becoming pregnant, you may want to start taking folic acid before you even conceive.

Gestational diabetes is another complication that overweight women are at a greater risk of developing. Gestational diabetes is elevated blood-sugar level during pregnancy. The National Institute of Child Health and Human Development estimate that women with normal BMI which is between 19 and 24 have a 2% chance of developing gestational diabetes. Overweight women have a 6% chance of developing this condition and obese women or women who have a BMI of 30 or more have a 9% chance of being diagnosed with gestational diabetes. Remember though that if you are diagnosed with this, you can still go on and have a healthy pregnancy with a modified eating plan.

Almost 10% of obese and overweight women develop a condition called gestational hypertension. This is when your blood pressure becomes high with a reading of 140 over 90 or higher after your 20th week of pregnancy but you don’t have any protein in your urine.

Gestational hypertension is usually a small concern but it can put you at a higher risk for preeclampsia (which is indicated by high blood pressure AND protein in your urine), intrauterine growth restriction, preterm birth, placental abruption and stillbirth.  If you do go on to develop preeclampsia, your weight is probably not that big of a factor. In fact, if you are under 35 and overweight you have LESS of a chance of developing preeclampsia that a woman over 35 and a healthy weight.

Perhaps the most common complication for overweight women is a longer time in labor and the possible risk of a cesarean section. Nearly 26-35% of deliveries are cesarean delivery. You are at a bigger risk if you have been diagnosed with preeclampsia or gestational hypertension or have a large baby.

Eating healthy throughout your pregnancy and working with your doctor to manage your weight will help reduce these risks and increase your already high chances of having a healthy pregnancy and a healthy baby.