Exploring the prenatal, labor and delivery and post-natal experiences of obese and overweight mothers

Background: Increasing rates of obesity among women of child-bearing age have led to growing concern over the negative health impacts on mothers and infants, but little is known about the actual experiences of these women in pregnancy, labor, delivery, and postpartum. Past research has demonstrated adverse health impacts such as early obesity among the children of obese women, and higher rates of gestational diabetes, pre-eclampsia, and cesarean delivery for women with prepregnancy obesity.

Methods: This study will utilize data from Listening to Mothers II, a national sample of 1573 women's child bearing experience in the United States in 2006. Maternal BMI was calculated pre-pregnancy and at delivery. Respondents were asked about the full range of their maternity experiences.

Results: Mothers who were overweight, (26%) and obese (25%) pre-pregnancy were more likely to be black, report a household income of under $75,000 and have earned less than a college degree. Prenatally, women who were obese pre-pregnancy were more likely to report seeking special medical care to achieve pregnancy (8.1% compared to 4.2% of under and normal weight women.) and less likely to report an unplanned pregnancy. They had higher rates of primary cesarean sections (31%, compared to 19% for overweight; 15% for normal and 10% for underweight women) and gave birth to larger babies. Rates of depressive symptoms were comparable between obese mothers and mothers in normal weight ranges.

Conclusion: The experience of obesity profoundly impacts aspects of the process of maternity care as well as birth outcomes.