View Full Version : Obesity Behind Over Half of UK Maternal Birth Deaths
Polly
12-04-2007, 10:58 AM
http://news.yahoo.com/s/nm/20071204/hl_nm/britain_maternity_dc;_ylt=AvG7kOxMTgX_y_7ooHrCtUha 24cA
By Andrew Hough
Tue Dec 4, 5:47 AM ET
LONDON (Reuters Life!) - More than half of British mothers who died during child birth were overweight, a report found on Tuesday.
The Confidential Enquiry into Maternal and Child Health (CEMACH) said maternal-related deaths in Britain are at a two decade high.
In its annual report, "Saving Mothers' Lives: reviewing maternal deaths to make motherhood safer," it found that of the almost 300 women who died during childbirth between 2003 and 2005 from pregnancy-related conditions, more than half were obese. The deaths left 520 children motherless, it added.
Obese pregnant women are more at risk of dying, suffering heart disease, miscarriage, diabetes, infections and blood clots.
Although the death rate has not changed significantly since 2000, it has risen by around 40 percent since 1985/87, the study showed.
It also found that women from poorer backgrounds were up to seven times more likely to die from pregnancy-related complications.
About 40 percent of deaths were preventable, it added.
Tuesday's report criticized doctors for failing to identify and manage common medical conditions or potential emergencies outside their immediate area of expertise.
It comes just a few days after the Healthcare Commission found that one in four women giving birth in NHS hospitals were left alone during labor, in clear contravention of official guidelines.
The report said that maternal obesity was now a "major and growing risk factor for maternal death."
It called for more pre-conception counseling and advice for obese woman to help tackle the problem.
CEMACH director, Gwyneth Lewis, said the report "clearly shows the impact that a mother's overall health has on the outcome of her pregnancy."
President of the Royal College of Obstetricians and Gynecologists, Professor Sabaratnam Arulkumaran, said maternal obesity puts more pressure on resources.
"Obesity is fast emerging as the public health issue of our generation and its impact on maternity must be taken seriously," he said in a statement.
"Maternity services are already struggling to cope with the increasing birth rate."
(Editing by Stephen Addison and Paul Casciato)
The concern I have with this is labelling any maternal death of an obese woman as "obesity-related." There are so many correlations between things like race, economic status, obesity, and maternal health that I think making the assumption that obesity is the cause of any death of any obese pregnant woman is probably flawed.
Ok I kind of find this to reflect the opposite- 47% of British women are above a UK 16 (usa 12/14?) which in terms of BMI is 95% of the time into the obese catagory, many shorter women who are a smaller size also fall into this catagory- more than 50% of women would fall into the overweight catagory, if not the obese and morbidly obese so in that sense it really doesn't seem that bizarre that if 50% of the female pregnant women are overweight that 50% of the maternal death rate will also be- all down to ratios.
As for the rapid rise in maternal death from 1985-2000, i think if you look that directly correlates with NHS funding cuts to maternity services and moves to attempt to focus care- it failed miserably, the government admits it's a declining service and they're flailing to keep their heads above water in many areas. During 3 of my 4 labours I've only had a midwife in the room for the actual pushing stages and to catch the baby, only 1 of the 4 did I have a midwife with me for any significant amount of time, with Jude David had to literally drag one into the room as they felt I was too calm to be giving birth!
Ok I kind of find this to reflect the opposite- 47% of British women are above a UK 16 (usa 12/14?) which in terms of BMI is 95% of the time into the obese catagory, many shorter women who are a smaller size also fall into this catagory- more than 50% of women would fall into the overweight catagory, if not the obese and morbidly obese so in that sense it really doesn't seem that bizarre that if 50% of the female pregnant women are overweight that 50% of the maternal death rate will also be- all down to ratios.
That's exactly the lines I was thinking along. If, for example, 1/2 the population is obese, and obesity causes MORE risk of maternal death, you'd expect more than 1/2 of women who die in childbirth to be obese. And if we're talking about the population most likely to have poor maternal health--racial minorities and the poor--in general we find a much higher obesity rate there anyway.
I just think it's important not to confuse causations. It seems very odd to me that if a non-obese woman gets gestational diabetes, her weight isn't considered a factor in it, but if an obese woman gets gestational diabetes, it's automatically considered "obesity-related." Isn't it possible that whatever non-obesity-related factors that caused the non-obese woman to get GD could also cause the obese woman to get it?
I certainly think it's important for all pregnant women to receive good prenatal care and for potential problems to be taken seriously and dealt with. I'm just not sure why obesity is targeted as opposed to say, poverty, when it seems like, from this study, poverty is far more correlated with poor maternal outcomes than obesity is.
Ok I kind of find this to reflect the opposite- 47% of British women are above a UK 16 (usa 12/14?) which in terms of BMI is 95% of the time into the obese catagory, many shorter women who are a smaller size also fall into this catagory- more than 50% of women would fall into the overweight catagory, if not the obese and morbidly obese so in that sense it really doesn't seem that bizarre that if 50% of the female pregnant women are overweight that 50% of the maternal death rate will also be- all down to ratios.
:thumbsup
That is what I was thinking. The article is interesting.
Golly, you mean the media is sensationalizing a story? I can't believe it!
;)
Polly
12-04-2007, 08:14 PM
Really? I never want to give birth in the UK. You had to drag a midwife in? Scary.
Polly
Yep - I apparently wasn't giving birth because I wasn't screeching but the woman a few rooms down was- she was 3cm, I was pushing :rolleyes
Birth #1- they registered us, put me on a monitor and left, came back & checked it- left, you get the picture- they stayed from around 10 minutes before i needed to push, delivered & checked her, left us for 40 minutes or so, came back and gave her to David whist they cleaned the room and i showered then they took me to a ward.
Birth #2- i arrived, was put in a room and they went out, came back to register me but had to check i was at least 3cm to book me in, found i was 9cm, register me and left me to pace, came back and offered to break my waters which i declined, vanished again and David had to run the corridor to grab someone when i hit pushing stage, delivered him, did their paperwork in the room, left me to shower.
birth #3- they stayed in with us for the last 1.5 hours or so as they were concerned she may need to be an emergency section as she took a tea break half way through. When she arrived they stayed to clean up whilst i was in the shower.
Birth #4- they popped in and out intermitently (I arrived at 11pm, they checked back 3 times before David had to call them that I was very close to pushing- the whole shaking bit-) because my waters had already gone so they had to keep screening for infection and monitor him, they were both (MWs) entirely shocked when he came through with his arm up above his head like superman - explained why he'd taken so long despite being a 4th, they wrapped him, clamped his cord, gave him to me to feed and went- came back around 30 minutes later to clean the room and when he fed I showered and called them back to take us to a room.
So none of them have we had a member of staff in the room throughout, and with Dyl we only had one there for any significant amount of time because they had concerns and wanted to watch for any fluctuations in her heart rate
I have to say though, as I don't much go in for medical interference with birth it suited me down to the ground- we knew where they were if we needed them, we knew we only had to ask if i wanted pain relief and it was nice to have the time just David and I. To be honest I never even realised they had a medical obligation to not leave a person alone in labour- they could never manage that at our hospital, the night Chase was born 5 MWs were delivering 16 babies- the night Loki was born there were 2 on staff for 3 delivering (and 2 have to be present at time of birth)
ohhh and did i mention my SIL1 gave birth to her 2nd in the hospital bathroom- her partner literally caught the baby, as the hospital didn't believe she was she'd advanced so quickly!
When I was taken in at 28 weeks with Loki a lady gave birth in the side room (on the ward- not in the delivery suite) next door to me as they didn't think she was in labour!!! (and didn't check)
Erika
12-05-2007, 03:44 AM
Beka, same happened over here. Two women across from me in the labour ward went so quickly that the midwives just barely got back in time.
As for me, my midwife was in and out a lot. But I didn't want her there that often so it suited me to a tee. Mothers who were having epidurals had the most midwife and OB attention. Since I was going natural and refused drugs, I didn't see mine that often. Not a problem!
Yep - I apparently wasn't giving birth because I wasn't screeching but the woman a few rooms down was- she was 3cm, I was pushing :rolleyes
Funny, I had the same problem with my midwife. I must've been 7 cm or more the last time I talked to her on the phone and I sounded basically normal and I know that's why she didn't think I was in labor. Apparently I was supposed to be writhing and shrieking or something. Stupid woman.