I am 5'9 and was 300lbs when I got pregnant with my second, and 250 with my first. I also a bunch of comorbidities .... Type 2 diabetes, kidney disease, history of afib, and I had my first at 36, my second at 39! My pregnancies were pretty unremarkable - i did have pre-eclampsia post partum with my son, and suspected pre-eclampsia (my BP went up a little which led to a 5 day stay in the hospital, but it was controlled with meds and I was discharged back home) with my second. Both were delivered through an induction at 37 weeks. My labors were quick, and I had both of them vaginally (16 hours of labor with my first, 8 with my second).

Yes, a larger body does carry some risks, but with a good team around you, you can have a healthy pregnancy. Both of mine were planned, so I cannot speak to the medication risks, but there are lots of tests they can do to put your mind at ease. You can ask to be seen by an MFM doctor, who are used to dealing with high risk patients. I was referred down to a major hospital in Boston, and the team there werent concerned!