WHEN Michelle Brown prepared to give birth to her first son River-Forest, she was the largest she had ever been at 19st and a size 26.
Doctors had warned throughout her pregnancy that, at 5ft 6in and with a body mass index of 42, she was morbidly obese.
Not only was she told she was more likely to lose her baby through miscarriage or stillbirth, her weight also put her at risk of life-threatening conditions such as thrombosis, pre-eclampsia and gestational diabetes.
As contractions started, she was terrified something would go wrong.
Michelle is far from alone, as 21 per cent of pregnant women in the UK are now obese and research shows this can put the health of both mother and baby at risk.
According to the Royal College of Obstetricians and Gynaecologists, risk of miscarriage rises from one in four to one in five if your BMI is more than 30.
And babies born to overweight mums are more likely to have problems with the development of their skull and spine.
Michelle, 37, who works as a supervisor in a contact centre, had always struggled with her weight.
And though she knew it put her baby at risk, she struggled to shift the pounds.
She had spent years on diets and in the gym but none of it made a difference.
“Even growing up I was a bigger girl and I’d wear baggy clothes to try and hide my shape,” explains the mum-of-one from Lincoln.
“I lost weight for a bit in my twenties but then piled it on. By the time I got pregnant, I was a size 18.
“Like most women, I did put on weight during pregnancy, and I went up to a size 26.
‘I felt shamed’
“I wasn’t ‘eating for two’ exactly but I struggled to do as much exercise as usual.
“At my first appointment I was told my BMI was too high and that I was obese.
“I was told I was at higher risk of losing my baby, of my baby suffering birth defects, and that I’d get diabetes, suffer back or heart problems and pre-eclampsia.
“I was told I was more likely to need a C-section and suffer high blood pressure.
“You name it, I was warned about it. It was traumatic to hear. Of course, I didn’t want to put myself or my baby at risk but it’s not like I wanted to be overweight.”
Despite the risks, Michelle’s pregnancy progressed well until she was diagnosed with gestational diabetes at 25 weeks.
The condition causes high blood sugar during pregnancy and can be harmful to mother and baby.
She says: “The midwife said I couldn’t go over my due date because of the risks.
“So on the day he was due, in February 2018, I was taken to Birmingham Women’s Hospital for monitoring.
“After two days, they were worried about his heart rate and my high blood pressure and said they had to get him out, so my waters were broken for me.
“I was given an epidural but told it may not work due to my size.
“The labour progressed slowly but just as I was about to start pushing, he turned into the breach position, which can make a natural delivery virtually impossible.
“They used suction cups and forceps to try to turn him.
“Midwives said his heart had gone into a state of panic and they were worried about my diabetes, so they had to get him out. I was taken to the theatre for an emergency C-section.”
River-Forest, now five, was born healthy and well, weighing 8lb 2oz.
Mum and baby were sent home within a few days, fortunately with no lasting issues.
“After the birth, the weight just fell off me and I went down to a size 12 in a few months without really cutting calories,” Michelle says. “I wasn’t breastfeeding but I was busy running around after a newborn.
I’ve since gone up to a size 16 but am very healthy and feel happy with my body.
“I do understand there are risks associated with giving birth when overweight but rather than anyone offering me help, I was just given all the bad news when there was nothing I could do. It made me very scared.
“I felt shamed. I was treated like a whale. Women should be given more support, no matter what their size.”
Research also reveals that overweight women are more likely to have premature babies.
They are more likely, too, to need a Caesarean and suffer compli- cations from the surgery, such as heavy bleeding and wound infection.
A midwife of 12 years, named only as Sarah, says overweight mums put huge pressure on NHS maternity units.
She says: “It’s a big issue, as we have a lot more to do to make sure these women and their babies are safe. On the labour ward, we see all sorts of problems because mum is big, and many of these larger ladies end up needing a Caesarean.
“Sometimes we have a queue of women waiting to go into theatre, and all the time with their blood pressure going up and their babies’ heart rates going through the roof or slowing down. It’s not safe.
“It’s not that we don’t want to care for these women properly, we do.
“But sometimes it takes our attention away from other women who need us.
“At my last clinic, I saw 12 expectant mums, eight of whom had a high BMI.
“All of them had high blood pressure, which is very worrying.”
Babies born to larger women can also experience dystocia, where their shoulders get stuck during delivery.
This can have devastating consequences, including brain damage and even death.
Sarah adds: “Shoulder dystocia can be serious. It can lead to tears for mum and sometimes a blood transfusion is needed.
“You have to get the baby out quickly if this happens, otherwise they are unable to breathe.
“I’ve also seen many larger women have C-sections and then their wounds become infected and they end up back in hospital again, away from their new babies.
University student Jazz Yavus was a size 18 and 17st when she got pregnant with her daughter Sienna-Rose in October 2018.
“I’d always been plus-size,” says Jazz, 28, from Swindon. Before getting pregnant, I was a size 24 and 23st.
“I knew it was risky and, by dieting and exercising, I did manage to get down to a size 18 and 17st.
“Still, though, doctors said I was high risk. I was immediately placed on blood thinners, as they said I was at risk of clots and other complications.
“Every time I saw a doctor I was given the ‘weight talk’ but that caused me stress. They didn’t need to rub it in.
“I wanted a natural birth in a birthing pool but consultants said I couldn’t use these facilities because of my weight.”
Instead, at 39 weeks, Jazz was induced because of her size. She had gone up to nearly 19st while pregnant.
She says: “Things barely got off the ground and I was told I’d probably need to have an emergency C-section unless the labour team could bring down my blood pressure and my baby’s heart rate, which was sky-high.
“It did calm so I had my waters broken and gave birth naturally after over 14 hours of labour.”
Sienna-Rose arrived healthy, and weighing 7lb 3oz, in June 2019.
“I know the complications were due to my size and that my weight put me and the baby at risk,” Jazz admits.
“But plus-size mums are often treated like second-class citizens.
“Rather than helping us cope with complications, we are made to feel bad.”
Nicola Salmon was a size 20 when she got pregnant and says while medics scared her about the risks associated with her weight, she says she had to “fight” to have the birth that she wanted, despite a straightforward pregnancy.
She says: “I started trying for a baby in 2013 and got pregnant quite quickly.
“I didn’t enjoy the pregnancy as much as I should have, as I was convinced I would lose the baby or that something bad was going to happen.
“I was led to believe that gestational diabetes was a dead cert, but it was a totally unremarkable pregnancy.
“I was told I was too big to have a home birth or water birth. But I did a lot of research around it all and eventually went for a terrifying chat with the head of midwifery at my hospital, who agreed I could try for a home birth.”
Before the baby was born in February 2014, Nicola, 29 at the time, was taken to hospital as he had meconium in his waters.
“But this was a very normal complication and nothing to do with my weight,” she says.
Nicola had her second baby in hospital in December 2015, and it was straightforward. Nicola, 38, who lives in Lydney, Gloucs, with husband Paul, 41, an IT consultant, and her sons now seven and nine, works with larger ladies to share her experience.
She says: “The more I looked into it, the more I discovered most bigger women do not experience risks they are repeatedly warned about but they’re convinced it is all going to happen.
“This can cause an awful lot of stress and anxiety. No one should be shamed because of their size.”
Experts say pregnant women should not be counting calories or trying to lose weight, as this can be detrimental to the baby.
Dr Aishah Iqbal, a medical doctor, weight-loss coach and founder of Medic Mums Weight Loss Academy, says: “All mums are at risk of gestational diabetes, pre-eclampsia, raised blood pressure, blood clots and increased risk of C-sections or assisted births.
“But being overweight does put these women at a high risk.
“Don’t try to lose weight during pregnancy. The focus should be around healthy eating and main- taining a moderate level of physical activity.
“Ensure a balanced diet with protein, good fats and fibre, along with 30 minutes of moderate exercise daily.
“It is a common misconception a woman needs to ‘eat for two’ and increase her calorie intake during pregnancy. It is only in the third trimester that an increase of 200 calories is advised.”