Increase In Obese Mothers=Increase in Risks

Specialties Ob/Gyn

Published

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?

Specializes in OB.

I think that because obesity is a health risk factor that is modifiable (generally), it was 'singled out' as a contributor to costs, rather than say, having Type I diabetes, or a heart defect, or something else like one's race or genes that can't be helped. But I wasn't intending to vilify obese women, nor do I think the article was. I'm simply interested in birth and women's health and found the article interesting.

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Specializes in Educator/ICU/OB.

When I became pregnant, I was overweight, but would not consider myself obese at 196#. By the charts, that would be like 30 # too heavy. I know my OB Dr informed me of the risks of weight gain, and that I should shoot for the lower end of the chart for normal pregnancy weight gain. I wanted to do what was best for my baby, as this was my first child/preganacy. I only gained 17# by following an adequate healthy diet and a little exercise. So, with properly informing patients of the risks of obesity, patients can make those decisions and have a healthy pregnancy for their size. I believe they do inform their patients about the risks of obesity, and I am sure they document that, just in case it does affect the pregnancy. It's up to the patients to take that advise and do what is best for the baby.

This is no different than pregnant moms who smoke, drink, use drugs, or have preexisting medical conditions. It takes responsibility on the part of the mom to take care of herself adequately for the safety of the baby. Education on the risks should be discussed at each visit to keep the mom on track.:nurse:

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I think it's fair to say most of our moms are overweight, but I'd have to check all their charts to say if they were overweight before getting pregnant - many women (me included!) gain too much weight while pregnant. Most I would not call morbidly obese. But we do have many problems with these women, GD, PIH, CHTN. AND we have problems with LBW babies, low blood sugar, etc. I think there is a correlation. I would do it differently if I were pregnant today, but luckily my babies were healthy. I was a good weight to start with & gained about 20 lbs more than I should have.

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Specializes in OB.

I agree with a previous poster who talked about the definition of obese. I will admit that at 190 I weigh more than I should but at 5"5 I am considered obese and on the upper end of obese. Yes I am overweight but I don't think obese. As a CNM student I have worked in a clinic with women who are overweight. We always discuss with them at their initial prenatal appointment the risks of their weight on their pregnancy, and the importance of appropriate weight gain during their pregnancy. We also do early GDM testing on these women as many of them are at risk for GDM or even have underlying diabetes that would not be diagnosed unless they were pregnant

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I think that because obesity is a health risk factor that is modifiable (generally), it was 'singled out' as a contributor to costs, rather than say, having Type I diabetes, or a heart defect, or something else like one's race or genes that can't be helped. But I wasn't intending to vilify obese women, nor do I think the article was. I'm simply interested in birth and women's health and found the article interesting.

The article also pointed out that the hospitals have had to buy different beds and delivery tables (capable of carrying heavier weight) and different (longer-handled) instruments to accommodate these clients, which are costs that don't come up with DM, heart defects, substance abuse, etc. (There was a thread not too long ago that discussed the additional costs EMS services incur having to provide specialized equipment for v. heavy clients, and whether or not they should be charged a higher rate to help compensate for the additional costs involved in providing their care. Needless to say, the discussion got quite, um, lively.)

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Deny obese woman prenatal care? That is pretty scary.. I don't think anyone she be denied care for their babies.

Not deny them, but like any other high risk condition, decline to take them as a pt and refer them to a perinatologist.

I'm not sure how I feel on the subject, but I can certainly see the argument for a CNM or OB who only has privileges at a low-risk facility deciding that the mother is too high risk for their practice.

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Specializes in School Nursing.

This is no different than pregnant moms who smoke, drink, use drugs, or have preexisting medical conditions. It takes responsibility on the part of the mom to take care of herself adequately for the safety of the baby. Education on the risks should be discussed at each visit to keep the mom on track.:nurse:

I'm sorry but I disagree with a lot of this statement. Having a weight problem (especially when one gains during pregnancy) and smoking, doing drugs, drinking, etc.. is NOT the same thing. These are things that harm the growing fetus and are not necessary for life. Food and nutrition IS NECESSARY and can't simply be "quit" in order to protect their baby. I think it is offensive to lump addicts who refuse to quit with people who are obese, or may have a true medical issue, when it comes to pregnancy.

I guess in a perfect world only the perfect people should be able to have children.

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Specializes in Educator/ICU/OB.
I'm sorry but I disagree with a lot of this statement. Having a weight problem (especially when one gains during pregnancy) and smoking, doing drugs, drinking, etc.. is NOT the same thing. These are things that harm the growing fetus and are not necessary for life. Food and nutrition IS NECESSARY and can't simply be "quit" in order to protect their baby. I think it is offensive to lump addicts who refuse to quit with people who are obese, or may have a true medical issue, when it comes to pregnancy.

I guess in a perfect world only the perfect people should be able to have children.

That is not at all what I was saying. I was overweight, if you had read my post, and when you become pregnant, whether you are overweight, drink alcohol, use drugs, or whatever, you have to take care of the baby, and do what it takes to do so. For me, being overweight to begin with, I had to watch my diet and exercise. If I used alcohol or drugs, which I did not, I would have to stop. That is what I meant. You have to take care of yourself more when you are pregnant, although in a perfect world, we should all take care of ourselves all the time. That is what I meant by that!!!!~:twocents:

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