I nodded my head in recognition as I read the Sunday New York Times article “Growing Obesity Increases Perils of Childbearing.” According to the article, one in five pregnant women are obese and 38-year-old Patricia Garcia was one of them. During her pregnancy, Garcia almost died from a stroke and was forced to deliver her baby eleven weeks early by C. Section. Her baby had stopped growing in her womb and he needed to come out.
Obesity in pregnancy can be a trial by fire, for both the patient and her healthcare provider. I am presently taking care of three obese pregnant women and am keenly aware that they, like Garcia, can have a stroke at any given moment. One of my patients has sleep apnea and I was grateful to find a sleep specialist who accepted Medicaid. Her sleep study showed that her oxygen becomes extremely low when she’s asleep which places her at tremendous risk for anesthesia complications. We will now have to negotiate with Medicaid in an attempt to get her special equipment to minimize complications during her pregnancy. Two months ago an imaging center refused to perform an ultrasound on one of my patients who weighed over 400 pounds because they were afraid that she would break their table. We finally found a hospital that was willing to see her because they had equipment that could accommodate her size and girth. I see a fair amount of obese women in my practice because I am sensitive to their plight. Like the physician mentioned in the article, I too, had obese people in my family.
The statistics in the article were alarming: babies born to obese women are nearly three times more likely to die within the first month of life. They also have twice the risk of having a stillbirth. Five New York hospitals have formed a coalition to determine how best to address the problems associated with obese pregnant women. Wider beds and exam tables, longer instruments and high-definition ultrasound equipment must be purchased. These efforts are commendable and other hospitals should follow suit. Obese pregnant women are at high-risk for death, if mismanaged. Until we, as a nation, do a better job of promoting prevention, the incidence of obesity is not going away. I hope my colleagues are prepared to handle the crisis.