Too Heavy for Baby? Covering Pregnancy and Obesity in Your Community

Last month, I was reading a story about maternal mortality by the Los Angeles Times' Shari Roan. The story was largely about the impact of c-sections on the recent rise in maternal death rates, but this statement stuck with me:

The upswing in the number of women who enter pregnancy overweight is now considered a major public health problem across the country.

Then came this Sun Sentinel story by Bob LaMendola: some Florida ob-gyns have started turning away overweight  women from their practices – even before they become pregnant – hoping to avoid complications and added liability:

Fifteen obstetrics-gynecology practices out of 105 polled by the Sun Sentinel said they have set weight cut-offs for new patients starting at 200 pounds or based on measures of obesity - and turn down women who are heavier.

Some of the doctors said the main reason was their exam tables or other equipment can't handle people over a certain weight. But at least six said they were trying to avoid obese patients because they have a higher risk of complications.

If this is happening in Florida, it's likely happening elsewhere, perhaps even in your community. Sounds like a great local story to me. The stakes are high: entering pregnancy overweight or obese has been linked to higher rates of gestational diabetes, high blood pressure, birth complications including premature delivery, and overweight babies.  And the issue potentially affects many women: Nearly two-thirds of U.S. women of childbearing age are overweight or obese, according to the Institutes of Medicine, which issued updated guidelines for how much weight to gain during pregnancy in 2009.

One way to start your reporting is to determine what percent of women in your state start pregnancy overweight, which is a statistic your state or local health department might track. In Oregon, health officials estimate that 40 percent of women enter their first pregnancy overweight. An even higher percentage of women enter their second and subsequent pregnancies overweight (no surprise to any woman who's struggled to lose her baby weight).

Then, talk to local ob-gyns. What are they seeing in their practices? If they haven't turned away a patient for being overweight, have they wanted to? What stopped them? Are they concerned about pregnant patients who are overweight or obese but otherwise healthy?

Check with medical malpractice insurers: are they raising their rates for ob-gyns because more patients may be at higher risk for complications?

Finally, talk with the women themselves. Are they trying to lose weight before getting pregnant? Limit their weight gain during pregnancy? Check out this presentation on maternal weight gain for some historical background on how much weight doctors have advised women to gain during their pregnancies – the recommended amount has doubled since the 1930s.   

Any other ideas or angles you're interested in? Please share them in the comments below.

Photo credit: Crystal_1979 via Flickr