The Royal College of Physicians (RCP) has published a new view on obesity and maternal health calling urgent action across the whole system to support women’s health before, during and after pregnancy, highlighting that one in four pregnant women in England is now living with obesity.
Obesity in pregnancy is linked to far higher rates of gestational diabetes, pre-eclampsia, caesarean birth and postpartum haemorrhage. Rates of maternal obesity are highest in the most deprived communities, reinforcing existing health inequalities.
These risks can be fatal: the 2021–24 MBRRACE-UK Confidential Enquiry into Maternal Deaths reported that 64% of women who died during pregnancy or within six weeks of birth were living with overweight or obesity.
The RCP has warned that rising rates of maternal obesity are increasing pressure on maternity services and contributing to avoidable harm. Emerging evidence shows an association between maternal obesity and the increased risk to their children of cardiometabolic disease and other adverse health outcomes later in life, compounding inequalities across generations.
The College’s new view on obesity and maternal health calls for coordinated, system-wide action across seven areas:
- tackling the wider determinants: transforming food systems and strengthening prevention to prevent obesity in the first place
- improving pre-pregnancy education, considering the impact of obesity on reproductive health
- embedding compassionate and inclusive obesity care into healthcare training
- improved interconnection between maternity services, weight management services and primary care
- tackling inequalities through targeted local action
- strengthening data and surveillance to monitor maternal and infant outcomes related to obesity
- investing in research on the safety and long-term impacts of obesity treatments in pregnancy.
The RCP recognises obesity as a chronic, systemic illness, shaped by health inequalities, genetic influences, ethnicity, social and commercial factors, stigma, mental health and the environments people live in. The RCP view on obesity and maternal health was underpinned by its existing approach to obesity more broadly, which was set out in July 2025 in its policy statement on obesity.
The RCP view on obesity and maternal health was developed with expertise from physicians, obstetricians, the Royal College of Paediatrics and Child Health (RCPCH), the Royal College of Midwives (RCM), the Royal College of Obstetricians and Gynaecologists (RCOG), the Royal College of General Practitioners (RCGP) and others – sets out the impact of the rapid rise in maternal obesity and overweight before examining seven key areas for action. It seeks to review the evidence available to best determine key recommendations for policy makers and the NHS.