Author Topic: Growing Obesity Increases Perils of Childbearing  (Read 4175 times)

Offline Reginald Hudlin

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Growing Obesity Increases Perils of Childbearing
« on: June 11, 2010, 12:17:51 am »
from the NEW YORK TIMES:

June 5, 2010
Growing Obesity Increases Perils of Childbearing
By ANEMONA HARTOCOLLIS

As Americans have grown fatter over the last generation, inviting more heart disease, diabetes and premature deaths, all that extra weight has also become a burden in the maternity ward, where babies take their first breath of life.

About one in five women are obese when they become pregnant, meaning they have a body mass index of at least 30, as would a 5-foot-5 woman weighing 180 pounds, according to researchers with the federal Centers for Disease Control and Prevention. And medical evidence suggests that obesity might be contributing to record-high rates of Caesarean sections and leading to more birth defects and deaths for mothers and babies.

Hospitals, especially in poor neighborhoods, have been forced to adjust. They are buying longer surgical instruments, more sophisticated fetal testing machines and bigger beds. They are holding sensitivity training for staff members and counseling women about losing weight, or even having bariatric surgery, before they become pregnant.

At Maimonides Medical Center in Brooklyn, where 38 percent of women giving birth are obese, Patricia Garcia had to be admitted after she had a stroke, part of a constellation of illnesses related to her weight, including diabetes and weak kidneys.

At seven months pregnant, she should have been feeling the thump of tiny feet against her belly. But as she lay flat in her hospital bed, doctors buzzing about, trying to stretch out her pregnancy day by precious day, Ms. Garcia, who had recently weighed in at 261 pounds, said she was too numb from water retention to feel anything.

On May 5, 11 weeks shy of her due date, a sonogram showed that the baby’s growth was lagging, and an emergency Caesarean was ordered.

She was given general anesthesia because her bulk made it hard to feel her spine to place a local anesthetic. Dr. Betsy Lantner, the obstetrician on call, stood on a stool so she could reach over Ms. Garcia’s belly. A flap of fat covered her bikini line, so the doctor had to make a higher incision. In an operation where every minute counted, it took four or five minutes, rather than the usual one or two, to pull out a 1-pound 11-ounce baby boy.

Studies have shown that babies born to obese women are nearly three times as likely to die within the first month of birth than women of normal weight, and that obese women are almost twice as likely to have a stillbirth.

About two out of three maternal deaths in New York State from 2003 to 2005 were associated with maternal obesity, according to the state-sponsored Safe Motherhood Initiative, which is analyzing more recent data.

Obese women are also more likely to have high blood pressure, diabetes, anesthesia complications, hemorrhage, blood clots and strokes during pregnancy and childbirth, data shows.

The problem has become so acute that five New York City hospitals — Beth Israel Medical Center and Mount Sinai Medical Center in Manhattan, Maimonides in Brooklyn and Montefiore Medical Center and Bronx-Lebanon Hospital Center in the Bronx — have formed a consortium to figure out how to handle it. They are supported by their malpractice insurer and the United Hospital Fund, a research group.

One possibility is to create specialized centers for obese women. The centers would counsel them on nutrition and weight loss, and would be staffed to provide emergency Caesarean sections and intensive care for newborns, said Dr. Adam P. Buckley, an obstetrician and patient safety expert at Beth Israel Hospital North who is leading the group.

Very obese women, or those with a B.M.I. of 35 or higher, are three to four times as likely to deliver their first baby by Caesarean section as first-time mothers of normal weight, according to a study by the Consortium on Safe Labor of the National Institutes of Health.

While doctors are often on the defensive about whether Caesarean sections, which carry all the risks of surgery, are justified, Dr. Howard L. Minkoff, the chairman of obstetrics at Maimonides, said doctors must weigh those concerns against the potential complications from vaginal delivery in obese women. Typically, these include failing to progress in labor; diabetes in the mother, which can lead to birth complications; and difficulty monitoring fetal distress. “With obese women we are stuck between Scylla and Charybdis,” Dr. Minkoff said.

But even routine care, like finding a vein to take blood, can be harder through layers of fatty tissue.

And equipment can be a problem. Dr. Janice Henderson, an obstetrician for high-risk pregnancies at Johns Hopkins in Baltimore, described a recent meeting where doctors worried that the delivery room table might collapse under the weight of an obese patient.

At Maimonides, the perinatal unit threw away its old examining tables and replaced them with wider, sturdier ones. It bought ultrasound machines that make lifelike three-dimensional images early in pregnancy, when the fetus is still low in the uterus and less obscured by fat, but also less developed and thus harder to diagnose clearly. “You really need to use the best equipment, which is more expensive,” said Dr. Shoshana Haberman, the director of perinatal services.

Many experienced obstetricians complain that as Americans have grown larger, the perception of what constitutes obesity has shifted, leading to some complacency among doctors. At UMass Memorial Medical Center in Worcester, Mass., Dr. Tiffany A. Moore Simas, the associate director of the residency program in obstetrics, demands that residents calculate B.M.I. as a routine part of prenatal treatment. “It’s one of my siren songs,” Dr. Moore Simas said, “because we are very bad at eyeballing people.”

Dr. Haberman said there was obesity in her own family, and she had seen how hurtful even professionals could be. “We as a society have issues with the perception of obesity; anatomically, you get turned off,” she said.

So she was sympathetic to Ms. Garcia, making sure she got a room with a window, and calling to check on her after hours.

Ms. Garcia, 38, a former school bus dispatcher, is 5 feet tall. She said she had tried diets, weight-watching groups and joining a gym. She was 195 pounds before her pregnancy (B.M.I., 38) and ballooned to 261 pounds, which she attributed to water weight and inactivity.

“I’m the smallest one in my family,” she said. Her older brother weighed more than 700 pounds before having gastric bypass surgery.

She wiped tears away as she confessed that she worried that she might die and leave her baby without a mother.

At Ms. Garcia’s stage of pregnancy, every day in the womb was good for the baby but bad for the mother, Dr. Minkoff said. “She’s making a heroic decision to put her own self in peril for the sake of the child,” he said.

She survived, but was dismayed by the size of her son, Josiah Patrick, who had to be put on a breathing machine. At first she could see him only by remote video. But after a month, Josiah was off the ventilator, taking 15 milliliters of formula and had smiled at his mother, and doctors said he was where he should be developmentally for a preemie his age.

The hospital estimated that the cost of caring for the mother and baby would be more than $200,000, compared with $13,000 for a normal delivery.

Ms. Garcia promised Dr. Minkoff that she would lose weight and see her baby graduate from college. “I’m going on a strict, strict, strict diet,” she said. “I’m not going through this again.”


Offline Magic Wand

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Re: Growing Obesity Increases Perils of Childbearing
« Reply #1 on: June 11, 2010, 04:08:48 am »
I was just chatting with a friend about this last night.  How is it that fat chicks GET pregnant in the first place?
It drives me bananas!

Would someone please explain to me logic of expensive weave/extensions, fake nails, designer jeans on a 300 pounder?
I just don't get it.
:-\
"It is the mark of an educated mind to be able to entertain a thought without accepting it." --Aristotle, Greek philosopher

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Offline moor

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Re: Growing Obesity Increases Perils of Childbearing
« Reply #2 on: June 11, 2010, 10:56:06 am »
Weird that the article didn't mention the exhorbitant medical and operational cost of the actual delivery (upwards of $200k) in cases where Mom is severely obese as opposed to normal delivery conditions (averaging $30K).

Offline Curtis Metcalf

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Re: Growing Obesity Increases Perils of Childbearing
« Reply #3 on: June 11, 2010, 11:12:50 am »
Keep going. It's all the way at the end.
"Seek first to understand, then to be understood."
"Be hard on systems, but soft on people."

Offline Hypestyle

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Re: Growing Obesity Increases Perils of Childbearing
« Reply #4 on: June 11, 2010, 12:40:26 pm »
I was just
Would someone please explain to me logic of expensive weave/extensions, fake nails, designer jeans on a 300 pounder?
I just don't get it.
:-\

The Maury Povich and Jerry Springer shows may have some answers.. or not..  ;)
Be Kind to Someone Today.

Offline Battle

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Re: Growing Obesity Increases Perils of Childbearing
« Reply #5 on: June 11, 2010, 01:28:22 pm »
I was just chatting with a friend about this last night.  How is it that fat chicks GET pregnant in the first place?
It drives me bananas!


I'm sure if you conducted another study to find out when fat chicks ...f*ck ...do it... eerr-r-r-...  copulate(?) during the course of a year, I'd wager  it would be during the winter.


Ever been to Bangor, Maine?   Those winters get mighty cold! ;D

Offline Vic Vega

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Re: Growing Obesity Increases Perils of Childbearing
« Reply #6 on: June 11, 2010, 01:50:59 pm »
I was just chatting with a friend about this last night.  How is it that fat chicks GET pregnant in the first place?
It drives me bananas!

A fat chick that will #$%^ you is worth ten skinny chicks that won't.

Besides, alcohol is a hell of a drug.

Offline jefferson L.O.B. sergeant

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Re: Growing Obesity Increases Perils of Childbearing
« Reply #7 on: June 11, 2010, 03:37:20 pm »
I was just chatting with a friend about this last night.  How is it that fat chicks GET pregnant in the first place?
It drives me bananas!

Would someone please explain to me logic of expensive weave/extensions, fake nails, designer jeans on a 300 pounder?
I just don't get it.
:-\

The "Fat chicks" are overflowing with love!

Of course there is the irresistible factor to most men.. large breasts. 8)

Offline moor

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Re: Growing Obesity Increases Perils of Childbearing
« Reply #8 on: June 12, 2010, 08:54:04 am »
Keep going. It's all the way at the end.

Yikes! And I was wrong on the low figure, to boot!


Offline Cheirel

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Re: Growing Obesity Increases Perils of Childbearing
« Reply #9 on: June 12, 2010, 03:21:20 pm »
I'm so confused. Are we shocked that big girls get men in the first place? Because that would hinder childbearing.
 Which obese are we talking Beyonce or like one my patients that stood up,and she was so big that her ass actually got stuck in the chair. :o

Big women have problems ovulating ~big guys have problems with their sperm.

Magic you don't really want me to tell how fat chicks get pregnant do you. Trust me I have some stories. Everyone wants to be sexy-fine for their man. If you heavy might have to work a little harder.

Offline Magic Wand

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Re: Growing Obesity Increases Perils of Childbearing
« Reply #10 on: June 13, 2010, 11:07:38 am »
I'm so confused. Are we shocked that big girls get men in the first place?
Not shocked....but bewildered. ???

 Which obese are we talking Beyonce or like one my patients that stood up,and she was so big that her ass actually got stuck in the chair. :o

Beyonce is considered obese?





Magic you don't really want me to tell how fat chicks get pregnant do you.

Nahhhhhh I don't wanna read the mechamics of it, but.....
Trust me I have some stories.

Sure!  Share a weird story or two!
Everyone wants to be sexy-fine for their man. If you heavy might have to work a little harder.

According to the guys here, they (the guys) hafta work LESS hard to get a fat chick
"It is the mark of an educated mind to be able to entertain a thought without accepting it." --Aristotle, Greek philosopher

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Offline Magic Wand

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Re: Growing Obesity Increases Perils of Childbearing
« Reply #11 on: June 18, 2010, 04:12:24 am »
Heavy women, but not men, lack sex partners
Obese women 4 times likelier to have unplanned pregnancy than slim ones

By MARIA CHENG
AP Medical Writer

updated 7:01 p.m. ET, Tues., June 15, 2010
LONDON - Scientists say being fat can be bad for the bedroom, especially if you're a woman.

In a new study, European researchers found obese women had more trouble finding a sexual partner than their normal-weight counterparts, though the same wasn't true for obese men, and were four times as likely to have an unplanned pregnancy. Fat men also reported a higher rate of erectile dysfunction.

Experts interviewed nearly 10,000 French men and women aged 18 to 69 about their sexual experiences and analyzed the results based on their Body Mass Index.

Obese women were 30 percent less likely than normal-weight women to have had a sexual partner in the last year. In comparison, there was little difference among obese men and normal-weight men as to whether they found a sexual partner.

The results were published online Wednesday in the medical journal BMJ. The study was paid for by several French government agencies.

People with a BMI of 18-24 are considered to have a healthy weight. Those with a BMI of 25 or above are considered overweight and people with a BMI of 30 or more are classified as obese.

Previous studies have found similar trends, but researchers were surprised by the discrepancy they found between the genders as to how excess weight affects peoples' sex lives.

"Maybe women are more tolerant of tubby husbands than men are of tubby wives," said Kaye Wellings, a professor of sexual and reproductive health at the London School of Hygiene and Tropical Medicine and one of the BMJ study authors.

Experts said the problems faced by obese people were probably due to a combination of physical problems linked to obesity as well as other issues, like low self-esteem and social prejudices.

Obese people are at higher risk anyway for diabetes, depression and urinary stress incontinence, all of which can hinder sex. If people are extremely heavy, they might also have muscular or skeletal problems that make sex challenging.

The researchers found that obese women were less likely to ask for birth control services, and thus, four times more likely to accidentally get pregnant. Pregnant fat women and their babies also faced a higher risk of complications and death than normal-weight women.

Dr. Sandy Goldbeck-Wood, a specialist in psychosexual medicine at a London sexual health clinic, said physicians must talk to obese women about birth control.

"Doctors need to get over their own embarrassment and ask the difficult questions," she said. Goldbeck-Wood was not linked to the study but wrote an accompanying editorial in the BMJ.

Wellings and colleagues found obese men and women with a partner were no different from normal-weight people in terms of how often they had sex.

They also found that women tended to have partners with a similar body shape. Nearly 70 percent of fat women reported having a partner who was also heavy, while only about 40 percent of fat men had a similarly proportioned partner.

Some experts said the growing obesity epidemic in the West would worsen sexual dysfunction problems.

"This is not a heart attack or a stroke...but it's an important quality of life factor and a public health problem," said Dr. Andrew McCullough, an associate professor of clinical urology at New York University of Medicine and director of male sexual health at NYU's Langone Medical Center.

He said the study's findings should provide another reason for people to trim their waistlines.

"It seems like a no-brainer," he said. "If you lose weight, you will feel more attractive and that could improve your sex life."
"It is the mark of an educated mind to be able to entertain a thought without accepting it." --Aristotle, Greek philosopher

Доверяй, но проверяй

Offline Kristopher

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Re: Growing Obesity Increases Perils of Childbearing
« Reply #12 on: June 22, 2010, 09:23:24 am »
Heavy women, but not men, lack sex partners
Obese women 4 times likelier to have unplanned pregnancy than slim ones

By MARIA CHENG
AP Medical Writer

updated 7:01 p.m. ET, Tues., June 15, 2010
LONDON - Scientists say being fat can be bad for the bedroom, especially if you're a woman.

In a new study, European researchers found obese women had more trouble finding a sexual partner than their normal-weight counterparts, though the same wasn't true for obese men, and were four times as likely to have an unplanned pregnancy. Fat men also reported a higher rate of erectile dysfunction.

Experts interviewed nearly 10,000 French men and women aged 18 to 69 about their sexual experiences and analyzed the results based on their Body Mass Index.

Obese women were 30 percent less likely than normal-weight women to have had a sexual partner in the last year. In comparison, there was little difference among obese men and normal-weight men as to whether they found a sexual partner.

The results were published online Wednesday in the medical journal BMJ. The study was paid for by several French government agencies.

People with a BMI of 18-24 are considered to have a healthy weight. Those with a BMI of 25 or above are considered overweight and people with a BMI of 30 or more are classified as obese.

Previous studies have found similar trends, but researchers were surprised by the discrepancy they found between the genders as to how excess weight affects peoples' sex lives.

"Maybe women are more tolerant of tubby husbands than men are of tubby wives," said Kaye Wellings, a professor of sexual and reproductive health at the London School of Hygiene and Tropical Medicine and one of the BMJ study authors.

Experts said the problems faced by obese people were probably due to a combination of physical problems linked to obesity as well as other issues, like low self-esteem and social prejudices.

Obese people are at higher risk anyway for diabetes, depression and urinary stress incontinence, all of which can hinder sex. If people are extremely heavy, they might also have muscular or skeletal problems that make sex challenging.

The researchers found that obese women were less likely to ask for birth control services, and thus, four times more likely to accidentally get pregnant. Pregnant fat women and their babies also faced a higher risk of complications and death than normal-weight women.

Dr. Sandy Goldbeck-Wood, a specialist in psychosexual medicine at a London sexual health clinic, said physicians must talk to obese women about birth control.

"Doctors need to get over their own embarrassment and ask the difficult questions," she said. Goldbeck-Wood was not linked to the study but wrote an accompanying editorial in the BMJ.

Wellings and colleagues found obese men and women with a partner were no different from normal-weight people in terms of how often they had sex.

They also found that women tended to have partners with a similar body shape. Nearly 70 percent of fat women reported having a partner who was also heavy, while only about 40 percent of fat men had a similarly proportioned partner.

Some experts said the growing obesity epidemic in the West would worsen sexual dysfunction problems.

"This is not a heart attack or a stroke...but it's an important quality of life factor and a public health problem," said Dr. Andrew McCullough, an associate professor of clinical urology at New York University of Medicine and director of male sexual health at NYU's Langone Medical Center.

He said the study's findings should provide another reason for people to trim their waistlines.

"It seems like a no-brainer," he said. "If you lose weight, you will feel more attractive and that could improve your sex life."


I wonder how different the results would be if this study was conducted among African Americans? Since High School, I've heard too many black men say that they love a big woman. I have a few friends who won't even look at a woman unless she's at least 250 lbs.

According to the guys here, they (the guys) hafta work LESS hard to get a fat chick
My uncle used to say something similar: "Fat girls are easier to get/pull". I was never interested in finding out if this were true.