Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Thursday, July 22, 2010

Reality Brief: Obesity and Pregnancy Don't Mix Well

Doesn't take a genius to understand that when a woman decides to undergo a pregnancy she should be in good physical shape. The hormonal changes that alter her body, the adjustments required to ensure a healthy pregnancy to produce a healthy baby are paramount to the process.

If a woman is severely overweight, she stands a risk to her own health, one that includes a likelihood of hypertension, of gestational diabetes, delivery problems, pre-eclampsia, and of course, neo-natal complications. The entire enterprise can be placed in dire jeopardy.

That, related to the growing incidence of obesity among the general population, including young people, and certainly including young women aspiring to motherhood, leads to a dangerous situation. The greater weight the woman carries, the greater the risk to her health and that of her fetus. Including the heightened risk of premature delivery.

Premature babies are at increased risk of breathing problems, infection, feeding problems and a plethora of other significant health-averse problems. Data from Statistics Canada indicate that fully 29% of women living in the country are overweight. That's a staggering statistic. Obesity rates are rising to the extent that babies born prematurely has doubled in 25 years.

With that risk comes a higher percentage of cesarean sections, a procedure which itself can lead to high rates of mortality, both mother and child. Yet cesarean sections are becoming increasingly common as a mode of delivery. Babies born to obese mothers (23% of Canadian pregnancies) are more likely to be at increased risk of obesity and diabetes themselves.

A sudden rise in blood pressure in obese expectant woman can be life-threatening to both mother and baby. Obesity can lead to blood clots and diabetes. Overweight women, more likely to undergo a C-section, are also at higher risk of uncontrollable bleeding and destabilizing infections.

The higher costs associated with tending to the needs of obese, pregnant women and their babies over-burdens an already-overstrained health care system. Add to that the fact that new equipment is required, given the new demographics of overweight women in their childbearing years. Maternity wards having to be entirely retro-fitted to care for these women.

Operating rooms outfitted with stronger tables capable of bearing the weight of obese women, wider wheelchairs, and sturdy lift devices to cope with the increase in obese expectant women. Representing yet another cost to hospitals and to taxpayers, taking funding away from other needed areas, simply to be able to cope with the needs of the obese.

The long-term prognosis for a continuation of the rising tide of obese mothers and at-risk babies is nothing to celebrate. But there is more, newer research that appears to demonstrate the higher risk of spontaneous pre-term births where date-averse contractions begin, bringing labour to a conclusion, or where doctors intervene by performing a C-section to prevent complications.

The risk of induced preterm births (before 37 weeks) rises to 30% for obese women with a BMI of 35 or over. For the extremely obese the risk of spontaneous preterm delivery rises to 70%. These women also share a 25% higher risk of delivering before 32 or 33 weeks' gestation. Placing their babies at high risk for complications related to premature birth.

Where's the sense in that? When women are desperate to conceive, turning to IVF procedures, and those failures leave them bereft of hope, when in many instances they might be exercising restraint in their food intake, why seek sympathy and financial support from the health care system?

It's past time that people take responsibility for their choices, and becoming morbidly overweight, then deciding to proceed with a pregnancy is not a responsible decision.

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