Obesity increases probability of c-section and birth defects

Over the years I have worked with high risk pregnancies, women going through or coming out of IVF, women with poly cystic ovarian syndrome (PCOS), women who develop pre-eclampsia and women who try to fend off repeated gestational diabetes.

I see many women post c-section and women who start pregnancies at a BMI of over 25 or more. Generally, I've found women do better during pregnancies regardless of BMI starting out if they exercise and keep doing SOMETHING even if it's just a little movement for as long as possible right up until birth. I've had clients who are overweight and have vaginal births and healthy babes. And they did whatever was possible to stay conditioned and eat well before and during their pregnancy. And my prenatal clients that came to me with a BMI over 25 ensured they gained on the low end of the suggested weight gain scale.

IN NO WAY WOULD I EVER WANT TO ADD TO ANYONE'S NEGATIVE FEELINGS ABOUT HAVING NEEDED A C-SECTION. C-sections save many lives.

Many of you might be up to date on the fact that Canada's infant mortality rate does not compare very well with other industrialized nations. (5.7 out of 1000). We now sit 25th lowest in the world. Much of this can be attributed to poor health care in rural areas particularly for First Nations peoples.

During my pregnancy I researched birth statistics and grew to understand the medicalization of the birthing process in Western culture. We all know that the rate of c-sections has been steadily increasing. We also know that women are having babies later in life and that over time our waistlines as a population have been expanding.

When I came across this info about a new study, I had to post it. I found it very interesting and kind of surprising. This excerpt is taken from the New York Times Well Blog:

"About one in five women are obese when they become pregnant, meaning they have a body mass index of at least 30, as would a 5-foot-5 woman weighing 180 pounds, according to researchers with the federal Centers for Disease Control and Prevention. And medical evidence suggests that obesity might be contributing to record-high rates of Caesarean sections and leading to more birth defects and deaths for mothers and babies.

Hospitals, especially in poor neighborhoods, have been forced to adjust. They are buying longer surgical instruments, more sophisticated fetal testing machines and bigger beds. They are holding sensitivity training for staff members and counseling women about losing weight, or even having bariatric surgery, before they become pregnant."

Some key points of interest:
11% of women with a BMI of 20-25 get C-Sections
25% of women with a BMI 30-35 get C-Sections
43% of women with a BMI over 40 get C-Sections

This study comes out of the US but much could be extrapolated into our current infant mortality statistics in Canada. Many impoverished people don't have access to proper nutrition in addition to other poverty related issues that put some people at higher risk for obesity. If you're not sure about your food security, or even having a reliable roof over your head then weight loss becomes a trivial concern.

Here's some more from the blog:

"About two out of three maternal deaths in New York State from 2003 to 2005 were associated with maternal obesity, according to the state-sponsored Safe Motherhood Initiative, which is analyzing more recent data.
Obese women are also more likely to have high blood pressure, diabetes, anesthesia complications, hemorrhage, blood clots and strokes during pregnancy and childbirth, data shows.

While doctors are often on the defensive about whether Caesarean sections, which carry all the risks of surgery, are justified, Dr. Howard L. Minkoff, the chairman of obstetrics at Maimonides, said doctors must weigh those concerns against the potential complications from vaginal delivery in obese women. Typically, these include failing to progress in labor; diabetes in the mother, which can lead to birth complications; and difficulty monitoring fetal distress. “With obese women we are stuck between Scylla and Charybdis,” Dr. Minkoff said."

The solution to all of the above? I don't know big picture. The women who come to see me before and during their pregnancies are privileged to have access to a personal trainer. I've seen some people more motivated than ever to get healthy in order to have a healthy pregnancy, almost like a preconception boot camp. If you're thinking about getting pregnant maybe the potential health of your child will be a strong motivator for taking care of yourself in a way you aren't currently.

There's just something wrong with the direction we're heading in as a society and no single person is to blame.

Why is Canada slipping in it's ranking as compared to the rest of industrialized nations? I'm way over my head in having any ideas for solving that sad state of affairs.

But here's a good explanation of what is happening to us as a country:

"Factors affecting infant mortality include the growing gap between rich and poor and the child poverty rate, he said. The article also pegs Canada's child poverty rate well below average.

Canada has 15 per cent of its children living in households with less than 50 per cent of the Canadian median income. Denmark, Finland, Sweden and Norway all come in at five per cent or less."

taken from "Canada's highest infant mortality rate highest in Saskatchewan"