Obesity ramps up the risk in childbirth

Here perhaps is one clue to the conundrum of why maternal mortality in the United States is relatively high for an industrialized nation, 12.7 deaths per 100,000 births in 2007: Two thirds of the women who died giving birth in New York State between 2003 to 2005 were obese, the New York Times reported on Sunday. The Safe Motherhood Initiative provided the figure.

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

Not only that, but very obese women, defined as having a body mass index (BMI) of 35 or higher, are three to four times more likely to experience a Caesarean section with their first baby than other as first-time mothers are, Anemona Hartocollis reports in the NYT story.

Obesity is not only hard on mothers, but it may also pose problems for their infants. Babies born to obese women are almost three times as likely to die within their first month of life than those born to women with BMIs within the normal range. Obese women are also nearly twice as likely to have a stillborn baby, Hartocollis reports.

About one in five women are obese when they become pregnant, according to data from the Centers for Disease Control in Atlanta, Ga. Obesity is gauged by a BMI of at least 30. A woman who stands five-foot-seven inches tall and weighs about 195 pounds has a BMI of 30.

C-sections at all-time high in new CDC report

The rate of births that ended in Caesarean-sections climbed by 53% in the years between 1996 to 2007, when they stood at 32%, the highest rate ever reported in the United States, the National Center for Health Statistics reported on Tuesday.

The rate is higher than those most other industrialized countries are experiencing, according to the report from the NCHS , which is an arm of the Centers for Disease Control, based in Atlanta, Ga. The cost of a C-section is almost double that of a vaginal delivery, the report notes.

C-sections were up for all groups across the board in the 11 years that were the major focus of the study, in terms of age, race, location, and how far along women were in their pregnancies.

About 1.4 million women gave birth by Ceasarean in 2007. In 2006, Caesarean delivery was the surgical procedure most often performed in American hospitals.

Here are the major findings of the report:

The U.S. C-section rate, 21 percent in 1996, was 32 percent in 2007, an increase of 53 percent. The steepest rise occurred between 2000 and 2007.

C-section rates went up by 50 percent or more in 34 states. In six states -- Colorado, Connecticut, Florida, Nevada, Rhode Island, and Washington -- the rate increased by more than 70 percent.

The rate rose for women of all age groups, with women under 25 having greatest rate of increase, 57 percent.

All racial and ethnic groups experienced increases. Black women had the highest C-section rate in 2007, 34 percent. Native American women had the lowest rate, 28 percent.

Caesarean rates increased for deliveries of infants of all gestational ages. C-sections for pre-term babies (less than 34 weeks gestational age) increased 36 percent; the rates for late pre-term babies (34 to 36 weeks) and term and post-term babies (37+ weeks) went up nearly 50 percent.

Early and late pre-term babies were more likely to be delivered by Caesarean section than were babies born at 37+ weeks.

The report cited possible reasons for the increases in Caesarean sections, in addition to medical indications for the surgery, as "maternal demographic characteristics," like advanced maternal age, fears of malpractice suits among physicians, doctors' preferences, and maternal preferences.