How does one teach compassion? Either you have it or you don’t. A recent article in the Los Angeles Times made me cringe. In South Florida, fifteen ob-gyn practices out of 105 polled said that would not take care of a pregnant woman who weighed more than 200 to 250 pounds. The article goes on to describe two ob-gyn business partners who cited malpractice issues and fear of being sued as a reason for excluding obese women in their practice. So, what’s next? Will pregnant women be denied access to care based on bank accounts or zip codes? Where their children attend school? Whether they own a pet? Where do we draw the proverbial line?
One of my most frustrated moments in clinical practice was dealing with an imaging center who had cancelled my patient’s ultrasound procedure because they were “afraid she was going to break their table.” The patient was excited about her first pregnancy and wanted to do everything in her power to have a healthy baby. The first time I met her, she was almost apologetic about her weight. Most obese patients are. My staff had to locate an imaging center that was not only willing to accept the patient but her Medicaid insurance as well. No one should not have to endure that level of humiliation.
Whether we like it or not, Americans are obese and as physicians, we have done very little to reverse that process. I learned more about nutrition from Weight Watchers® then I did in medical school. Yes, we set up for-profit- weight- loss centers but the motivation is clearly about money. To my South Florida colleagues who exclude obese women from their practice, shame on you. Where did you do your residency training? In a vacuum? The very nature of obstetrics is inherent with risks whether the patient is obese or anorexic. You therefore look for the red flags and proceed accordingly. If a problem exceeds your level of expertise, then refer the patient to the maternal fetal medicine specialists but please don’t discriminate. The unborn babies of obese women are just as important as anyone else’s. If you’re that afraid of challenges, then perhaps it’s time to change your profession.