Taking obesity seriously

When I first entered the world of natural birth I was educated to believe body weight had no effect on maternal or infant outcomes.  The organization I trained with was equally adamant that gestational weight gain was a useless measure that predicted nothing. I believed them. I made this belief a part of my life and looked the other way when I was obese for the first time in my life after my second pregnancy.  I spread this belief to other mothers, believing I was protecting them from fat shaming, from a non-evidence based health system, from the poorly researched advice they would get from other sources.

Learning to un-believe this lie was a slow and painful process. It involved learning to think critically about the available research instead of dismissing anything that disagreed with the belief I had been taught. It involved understanding the risks of obesity in non-pregnant women, and learning how those risks remained or increased with pregnancy.  It came with the challenge of accepting that BMI has never been a measure of attractiveness, it is only an estimate of health risk.

Today I accept obesity as the risk it is. Instead of ignoring papers like this one recently published in Obstetrics & Gynecology, I read the study. If you are still skeptical let me share something which might help bust your concerns about “conspiracy.” The lead author on this paper is one of my research heros, Dr. Eugene Declercq.  Far from being a researcher who pushes women to schedule elective cesareans, Dr. Declercq is an advocate for midwives, for reducing the cesarean rate, and for overall improvements in the maternity system — all because the epidemiology tells him to be. If you are not familiar with his work, check out these videos.

 

 

All of this is to say, please midwives, please take obesity seriously.