The challenges of caring for these patients begin early. “We perform an anatomical survey of the fetus, but in an extremely obese woman, the ultrasound signal often can’t penetrate through all the tissue,”Dr. Mark Chames, an obstetrician at theUniversity of Michigan Health Systemin Ann Arbor, says. He must use a vaginal probe instead. A thorough examination is especially important in obese women, Chames said, because they are at greater risk of having babies with neural-tube defects and other malformations.
Birth brings more difficulties. The fetuses of obese women are often too large to fit through the birth canal; their mothers are about twice as likely as normal-weight women to need a Caesarean section. Longer surgical instruments are required, as are extra-wide operating-room tables, reinforced to support hundreds of additional pounds.
To head off such problems, patients at the bariatric obstetric clinic atSt. Louis University in Missouriare counseled not to put on any pounds at all during pregnancy, and are even encouraged to lose weight.Dr. Raul Artal, the chairman of the ob-gyn department and the clinic’s director, acknowledges that the notion of weight loss during pregnancy can be startling. “It goes against everything we were taught in medical school, everything we’ve always told our patients,” he says. Some scientists warn that we still know little about the potential dangers of this approach. Emerging evidence, however, suggests that obese women who maintain or lose weight during pregnancy experience significantly fewer complications and deliver healthier babies.
Getting fat and pregnant is a dangerous cliché. Clearly, an obese mom is not eating healthfully—bad idea! According to Dr. Fuhrman a pregnant mother’s diet is vitally important to a developing baby’s health. He explains:
We know that children have sensitive vulnerabilities that are quite distinct from adults. Their exposure to chemicals in our environment is more potentially damaging than the same exposure at a later age. It is important to realize that the diet a woman eats during her pregnancy and even before her pregnancy effects the adult health of her future offspring. For example, a recent study shows a strong association in children who develop brain tumors with the mother’s consumption of hotdogs during pregnancy.1 Scientific evidence suggests that cigarette smoking during pregnancy is associated with testicular cancer in sons thirty-five to fifty years later.2 We may get away with risky behaviors when we imbibe in our later years, but when we gamble with our children, the stakes are much higher and the damage more profound.
Maybe I’m going out on a dangerous limb here, but, if you’re pregnant and eating unhealthfully. You’re perpetrating a tremendous act of irresponsibility and selfishness. Am I wrong on this?
1. Sarasua S, Savitz DA. Cured and broiled meat consumption in relation to childhood cancer: Denver Colorado. Cancer Causes Control 1994;5(2):141-148.
2. Clemmeson J. Is smoking in pregnancy a cause of testicular cancer? Ugesr Laeger 1997;1359(46):6815-6819.