Obesity and Pregnancy Just Do Not Mix!

Okay, Okay. You're looking at this picture right now and thinking, "Come on, you're totally exaggerating!" I wish I was. Not so long ago I tended to a 9-month pregnant patient that tipped the scales at 458 lbs! Yes, you heard me correctly. I was so disturbed by this experience that I knew I had to write a blog about it. Here are the highlights...

1) HOW AND WHO??? - When a woman of this size appears on my unit, I can only think of 2 simple questions... How did you get pregnant? AND Where is this man that did this to you? Unfortunately, there was no father of the baby present for her. Her mother was her only support person.

2) Veins? What are those? - Okay, so when I first admit a patient to Labor & Delivery, the first thing I need to do is start an IV. Need I say how difficult it is to find a good vein in a morbidly obese patient? She continued to look at me skeptically, thinking I didn't have the experience or skill to get this IV in her. To add insult to injury, she says to me, "Okay, I hope you're good at this because I am afraid of needles and I don't want you to stick me in my hand, wrist, or forearm (okay, she didn't actually say forearm, but she pointed to that area)." I'm sitting here, thinking, "You come here with all 458 lbs of yourself and have the nerve to make demands like that?!" I stuck her in her hand anyway :o).

3) When breathing is a chore... I took care of this patient for over 9 hours that day, and after she got her epidural (yes, they were able to get an epidural in her after about 5 or 6 tries), she went into a sleep that absolutely terrified me. For those of you that don't know, most people that are morbidly obese like her, suffer from sleep apnea. This means that she stops breathing in her sleep. Well, between her horribly chilling snoring and her apnea, I was so disturbed. I mean, she couldn't possibly be comfortable or rested after that. It was a scary sight to watch.

4) "You want me to hold her WHAT???" Okay, so it's about 5pm and she is now 10 centimeters dilated. So, you know what that means... it's time to push! Now, with the combo of her weight and her numb epidural legs, you know there's not much a 145-lb woman can do to help her. The resident turns to me and has the nerve to say, "Okay, now we need to help her hold her legs back so she can push this baby out." Are you effin' kidding me??? I pulled her aside nicely out in the hallway and let her know I wasn't touching those legs. I like my back just the way it is... strong and healthy. Well, we eventually came up with a good solution and she delivered a beautiful baby girl at about 6:30pm!

Of course, this was still a beautiful miracle to watch despite what I went through that day. The outcome was perfect... healthy baby and mom was fine. I joked in my blog a lot about his patient, but in reality this is no laughing matter. Women with morbid obesity have very poor pregnancy outcomes. My take home message for all women is that before you decide to have a baby, please take good care of yourself. Eat right, exercise, and try to get plenty of sleep at night. Women, respect your bodies and take care of yourselves first!