By: Laurie Edwards for Uterus1For many, the lure of being able to choose when to deliver a baby and the desire for a less painful childbirth is strong. Though it is common for people to blame the recent increase in cesarean births to patient requests and physicians’ schedules, there may be another culprit to blame: Rising obesity rates.
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Staying fit before and during pregnancy helps in childbirth
If you are pregnant or planning to become pregnant and are overweight, consult your physician to come up with a safe, effective diet and exercise plan to reduce pre-pregnancy weight and monitor weight gain during pregnancy.
The number of C-sections – almost 1 million babies are born this way each year – is thought to be linked to the increase in obesity.
Overweight and obese women face an increased risk of pregnancy-related complications like hypertension, preeclampsia, gestational diabetes and failure to progress through labor which often require C-sections.
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The National Institutes of Health formed a task force to study requests for C-sections by patients and while it did find an increase, “it certainly didn’t account for the sharp increase in cesarean deliveries,” Dr. Mary D’Alton, chairperson of obstetrics and gynecology at Columbia University Medical Center, said at a meeting of the American College of Obstetricians and Gynecologists.
The number of C-sections in the country remained stable – around 5 percent – from World War II through the 1970s, when numbers began to rise. By the 1990s, the popularity of C-sections soared, accounting for 22 percent of births, especially when research suggested women who delivered their first babies via C-section might not need the procedure for subsequent births.
The numbers dipped a bit when more research found that returning to vaginal birth after C-sections might be dangerous after all. But with numbers now at all-time high – the National Center for Health Statistics estimates 29 percent of births are cesarean – some experts feel the corresponding rise in obesity is associated.
Obese women face increased risk of pregnancy-related complications like hypertension, gestational diabetes and blood clots, all of which may cause their physician to recommend a C-section over vaginal birth, said Dr. Frederic Frigoletto, Jr., professor of obstetrics and gynecology at Harvard Medical School.
Another reason obesity is linked to increased C-sections concerns the length of labor. The longer it takes for a woman to progress through labor, the more likely it is she will require a C-section. Previous researchers from the National Institute of Child Health and Human Development and University of North Carolina found that overweight or obese pregnant women progress through labor slower than women of normal weight.
Such information points to a larger need for women who are pregnant, or are planning to become pregnant, to consult their physicians in terms of exercise and nutritional plans that are optimal for both mother and baby.
“Nearly one-half of the women of childbearing age are either overweight or obese. This finding means that before they recommend a C-section, healthcare providers need to add to their other considerations a woman’s pre-pregnancy weight, as well as how much weight she’s gained during the pregnancy,” said study author Dr. Anjel Vahratian, Ph.D., M.P.H.
In terms of elective C-sections (those not necessitated by medical problems or complications) the American College of Obstetricians and Gynecologists finds they may be acceptable, but does offer recommendations. Namely, “elective cesarean deliveries when there is no known medical reason should not be performed before 39 weeks of gestation,” said Dr. D’Alton.
Also, patients should keep in mind that having more than three or four cesarean births puts them at risk for serious complications such as the placenta failing to detach from the uterus because it adhered to scar tissue from previous C-sections.
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