Increase In Obese Mothers=Increase in Risks

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Specializes in OB.

Obese Mothers a Burden on Hospital Resources - NYTimes.com

I read this yesterday in the New York Times, and found it pretty interesting. As a nurse studying to become a CNM, I expect to be working with mostly low-risk women, and obviously know that the more obese a woman is, the risky labor and birth become, but I was shocked at the numbers presented here. 38% of a hospital's maternity population was obese???? Are you guys seeing such extreme numbers where you work? How does it affect your practice? I think the most discouraging part of the article was the last mention of the costs of caring for these moms and babies, as compared to normal, low-risk patients. To me this goes beyond a problem and qualifies as a health crisis. Thoughts?

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Specializes in med/surg, tele, OB.

I have only been in OB 6 months, but, unfortunately that is the trend that I see. I would say that half of my pts are overweight before pregnancy and close to 1/3 are obese. What is most scary to me is the number of obese, teen mothers I have cared for. I am curious to hear what others are experiencing.

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I don't work in OB, but I know that the majority of staff at the free-standing psychiatric facility in which I work are obese, and we have had several staff members so obese that, even at nine months, you could not tell by looking that they were pregnant! I could not fathom how anyone could think this was a good idea, and shuddered to think of what kind of risks they, their babies, and the providers managing their deliveries were going to face ...

I guess it figures that, if the general rate of obesity in the US population is going up, the rate of obese pregnant women is going to go up, also.

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Specializes in L&D/postpartum.

I've always wondered if obese people even know the risks in the first place, and if providers are comfortable enough with the topic to discuss it.

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I'm wondering whether providers ever just decline to take these cases on (I don't mean when someone arrives at the hospital in labor, but early on in a pregnancy when people are first looking for an GYN provider). Why take the (professional) risk??

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Specializes in School Nursing.

This is just anecdotal from my lifetime of seeing friends and acquaintances have children. I know several obese woman who have had perfectly healthy pregnancies and babies. I've never known any woman that had problems because she was too heavy. I have known a couple of woman have issues due to other factors and none were overweight.

Deny obese woman prenatal care? That is pretty scary.. I don't think anyone she be denied care for their babies.

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Specializes in OB.

I certainly don't think obese women should be denied prenatal care, but I do think that weight is an issue that is often danced around patients by providers who are reluctant to offend or possibly scare them. Or, as others have pointed out, providers may simply be deciding not to take the risks and refusing them as patients. Nutrition during pregnancy is a hugely important factor in both mom and baby's health that is not discussed enough, and I think the risks of obesity need to be really stressed throughout a pregnancy and the moms should get a lot more education, guidance, and support. Our system simply can't support $200,000 worth of care (or other extreme amounts, compared to normal low risk patients) for all obese moms and their babies. However, this article might be exaggerating the problem a bit, or at least presenting from an area with a greater proportion of obese women than normal (although as a New Yorker, I constantly hear how our city has lower rates of obesity). Again, just curious what others are seeing/thinking from their necks of the woods.

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Specializes in LPN, Peds, Public Health.

You also have to remember what is considered "obese". Just because some height/weight chart says you are obese doesn't necessarily mean that you are fat and unhealthy. Im 4'11" and should weigh around 100 pounds according to those things, so yes, I am obese because I sure don't weigh that. My body type would never allow for such a low weight. Granted I could be smaller than what I am... but I would still be labeled as obese. I have no medical problems, I'm not diabetic, I don't have high blood pressure, none of that. I had very healthy pregnancies... so I think we need to look at more than JUST some statistics stating "obesity". I do agree with the fact that it increases risks, but to say that a certain percentage is obese, to me, is unfair... well not unfair, but... ughhhh I dont know how to put into words what I am saying. I guess that just because 38% are obese doesnt mean that all 38% are "morbidly obese" ....

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Specializes in OB.
I do agree with the fact that it increases risks, but to say that a certain percentage is obese, to me, is unfair... well not unfair, but... ughhhh I dont know how to put into words what I am saying. I guess that just because 38% are obese doesnt mean that all 38% are "morbidly obese" ....

Great point. I'm guessing that's where the huge number comes from...I guess I was picturing all morbidly obese women.

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Specializes in LPN, Peds, Public Health.

Thank you, I'm so glad you were able to understand what I was trying to say! I had it in my head but it just wasn't coming out on the key board!

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I've always wondered if obese people even know the risks in the first place, and if providers are comfortable enough with the topic to discuss it.

Unfortunately, by the time an obese woman visits an md for prenatal care, it's already too late....with cooperation on the part of mom weight maintainence might be possible-but the last thing a pregnant woman needs to think of-at the time she is pregenant. In a perfect world, everyone would be at a weight "WNL" at the time they concieve...alas...

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Specializes in OB.

I'm really rather disturbed by the singling out of obese moms because of the costs of their healthcare. There are so many factors that can complicate a pregnancy aside from weight. Should we start questioning the right of anyone to prenatal care because of the cost?

Of course there are potential problems associated with obesity in pregnancy and delivery (especially post c/section) but I educate my patients in ways to deal with the issues just as I do mothers with OTHER pregnancy complicating conditions.

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