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Does Prenatal Obesity Matter?

I gave a talk last month about obesity and pregnancy. I had an inkling it wouldn’t be a well accepted topic.  I have this image in my head that very few people are as interested in obesity as I am; and that probably for the most part American’s are sick of hearing that they should maintain a healthy weight.

I didn’t get booed off the podium.  I actually had a few women ask questions when I was done, and a few who felt inspired that they really needed to take their own health more seriously.

I had three main points:

1. If at least 1 in 5 women will enter pregnancy obese, it is not an issue midwives can ignore.

2. We think about obesity as just having extra weight?  As if the problem is that there is the extra stuff hanging on your body that slows you down because you have to go through the day essentially wearing a full backpack. And if you could just drop that backpack your life would go back to “normal.” The problem with this type of thinking is that it ignores the fact that adipose tissue is active tissue with a metabolic function – and that function is not to just store and release extra fat based on how many slices of pie I ate this week.

3. When I read popular literature about obesity and pregnancy, I read about a very limited set of problems.  These problems begin with the labeling of obesity as a risk category for pregnancy, which allows the mother fewer options and results in unnecessarily high cesarean rate for obese women. My concern with this line of reasoning is not that it is necessarily wrong, but that it is dreadfully incomplete and gives the false impression that obesity adds no REAL risks to the health of mother or baby.

I have to rush off this morning – Statistics exam tomorrow and I’m having a dreadful time trying to stay focused and review.  Over the next couple weeks I’ll fill you in on the details of the main points, and we can explore some ways to help women achieve their optimum health.

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Jennifer Vanderlaan CNM MPH is the author of the BirthingNaturally.net website. She has been working with expectant families since 2000, training doulas, childbirth educators, and midwives. She has worked with midwives in Central America and Sub-Saharan Africa. Her interest in public health grew in 2010, and she is now a PhD student learning to become a producer of knowledge.

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