Maternal Obesity Can Cause Complications For Mothers And Babies, And Special Considerations For Labor And Delivery Nurses

Welcoming a baby into the world is one of life’s most precious miracles. Labor and delivery nursing (L&D nursing) focuses on assisting women before, during and after the labor process. 

But not all births are created equal, and complications do arise. Maternal obesity is one such risk factor that many healthcare professionals and organizations are calling attention to throughout the prenatal and postnatal stages. 

Obesity is defined by the Centers for Disease Control and Prevention as individuals having a BMI (body mass index) of 30 or greater; find out more with CDC’s BMI calculator.

Obesity-related risks and complications during labor and delivery

According to the American College of Obstetricians and Gynecologists (ACOG), there are several negative effects that can stem from obesity during the birthing process. 

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“Overweight and obese women have longer labors than women of normal weight. It can be harder to monitor the baby during labor. For these reasons, obesity during pregnancy increases the likelihood of having a cesarean delivery. If a cesarean delivery is needed, the risks of infection, bleeding, and other complications are greater for an obese woman than for a woman of normal weight.” 

Maternal obesity can also result in problems for the baby -- both prior to and during the birthing process. 

Obesity increases the risk of the following problems during pregnancy and labor and delivery, according to ACOG: 

• Pregnancy loss
• Birth defects
• Problems with diagnostic tests
• Macrosomia
• Preterm birth
• Stillbirth
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Greater awareness of the effects of obesity on pregnancy and labor and delivery can improve patient results related to labor outcomes. Obese patients can take action early to help minimize their risk of effects as a result of being overweight. 

Educating mothers on the effects of obesity during pregnancy

One way to combat the effects of obesity in labor and delivery is through patient education throughout the pregnancy. For example, ACOG has a section on its website dedicated to the topic of obesity during pregnancy. Providing information to expectant moms, their partners, and other healthcare professionals will help increase awareness of the problems that can occur as a result of obesity. 

According to a 2009 study published in the American Nurses Association (ANA) Online Journal of Issues in Nursing, obesity can cause several issues throughout the nursing care process, and this information applies to both pregnant patients and those who are not expecting. 

“Physical size can complicate even the most basic nursing interventions for obese patients,” wrote Susan Gallagher Camden Ph.D., MSN, MA, RN, CBN, and the study’s author. “Skincare, respiratory challenges, assessment and resuscitation measures, altered drug absorption, intravenous access, and immobility can pose nursing concerns.” 

Although there are concerns, obese patients can still have a healthy pregnancy. The ACOG recommends the following for the best outcomes: 

• Careful management of patient’s weight
• Attention to diet, nutrition, and exercise
• Regular prenatal care to monitor for complications
• Special considerations for labor and delivery

Obesity during the maternal stage is a difficult topic that requires sensitivity and strong partnerships between the healthcare team and the patient. Communicating and creating action plans can help mitigate risk and ensure positive outcomes for both mom and baby. 

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