DOES OBESITY MAKE CHILDBIRTH MORE DANGEROUS?

The state of California has recently reported that maternal deaths during childbirth have recently INCREASED.  This has shocked doctors and researchers.  Most think this relates to more C-sections being done; also, it’s likely related to more older women having babies, and expectant mothers being more overweight and obese.  Pregnancy-related hypertension (pre-eclampsia), excessive bleeding, and blood clots (well known to be associated with obesity) also seem to be culprits.

As an anesthesiologist, I know very well the difficulties and dangers associated with obesity in women giving birth.  For years, we believed maternal mortality was falling as we got away from doing general anesthesia for C-sections (using spinals and epidurals instead).  Unfortunately, in obese patients,  it’s often harder to place epidurals for pain relief or for C-section.  If that then means we have to do a general anesthetic for a patient having a C-section, it can be harder to place the breathing tube in an obese mom.  Rarely, patients and babies can suffer from a devastating lack of oxygen as a result.

Let’s be clear – maternal death is still rare – in 2006, the national maternal mortality rate was 13.3 deaths per 100,000 live births.  Still, the trend is worrisome; it is 2 women a day in the US!

Drs. Roizen and Oz’s book can give some healthy guideposts to weight gain during pregnancy.



Dr John Ellis MD

Board-certified anesthesiologist, with expertise in cardiovascular anesthesia and the implications of obesity and sleep apnea in anesthesia. See vascularanesthesia.com for professional information. Dr. Ellis has used the strategies in here to: (1) lose 120 lbs over 18 months, (2) stop all antihypertensive medicines, and (3) no longer need CPAP treatment for sleep apnea.

One Comment:

  1. Very recent data confirms this further:
    In this retrospective analysis of US women, bariatric surgery was associated with lower rates of hypertensive disorders in subsequent pregnancy.

    http://www.bmj.com/cgi/content/abstract/340/apr13_1/c1662

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