Endocrine Abstracts (2013) 32 P780 | DOI: 10.1530/endoabs.32.P780

The medical and moral obligation of healthcare professionals to address complications in obesity during pregnancy

Benjamin Jones

West Middlesex University Hospital, Isleworth, London, UK.

Summary: This audit highlights a shortfall in healthcare provision when discussing the potentially sensitive issue of obesity. Given the significance of complications in pregnancy, and in future life, discussing such issues openly and encouraging patient responsibility without blame is integral to optimise antenatal benefit.

Introduction: The prevalence of obesity is increasing in the UK. Obesity in pregnancy is associated with various maternal and fetal complications. In the latest CMACH (2011) report, 30% of maternal deaths were associated with obesity. Appropriate antenatal interactions between practitioners and patients are crucial to ensure behaviours are adopted to minimise these risks.

Materials and methodology: An audit was performed comparing practice against CNST Criterion 10: obesity. Thirty sets of notes were randomly selected; ten from each BMI class.

Results: All of the patients had BMI’s recorded in the notes and were booked for appropriate maternity based care. However, only 3 out of 30 patients (10%) were explained the antenatal and intrapartum risks associated with obesity in pregnancy.

Discussion: A complex interaction exists between the appropriate balance between medical obligations and moral issues when communicating with obese patients. The media portrayal of obesity as a moral failure has resulted in discrimination towards such patients and consequent difficulty in engaging in sensitive conversations about potentially serious complications. Honest and open consultations, addressing responsibility and control, but without blame, are essential to invoke behavioural change. Adopting such behaviours antenatally is essential to minimise the significant risks associated with obesity in pregnancy.

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