Midwives to share obesity work with the world

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A SERVICE to tackle the health of seriously obese pregnant women in a Yorkshire town has been deemed so successful the midwives behind it have been invited to share their expertise at an international conference.

Carolyn Garland and Alison Williams set up the “Monday Clinic” in Doncaster to help women with a Body Mass Index (BMI) of over 40 – ie weighing more than 16 stones 10lbs for the average 5ft 4ins woman – have healthier pregnancies and healthier babies.

The scheme has been deemed “highly successful”, not only in tackling women’s weight but also reducing the Caesarean section rate and increasing the number of women who breastfeed their babies.

Earlier this year, the two midwives won the national Royal College of Midwives Award for Innovation, and have now been invited to share their knowledge before the International Confederation of Midwives in Prague next year.

“Midwives from all over the world are invited to share evidence of good practice,” said Mrs Garland, from Sheffield.

“We put in an abstract earlier this year and have just found out it’s been accepted.”

The service has gone from strength to strength after being set up by the two midwives to tackle the growing problem of obesity in pregnancy in Doncaster.

The percentage of pregnant women in Yorkshire and the Humber with BMIs over 35 is above the national average, accounting for 5.6 per cent of all pregnancies compared with 4.9 per cent nationally.

In Doncaster, however, the figure is even higher where some nine per cent of pregnant women have BMIs of over 35 – almost double the national average.

Mrs Garland said: “The average weight gain recommended in pregnancy, for women with a BMI of over 30, is 7kg.

“The average for our women, so far this year, this year is 5.2kg.

“They really are being encouraged by the plan and not gaining excessive weight.”

Being obese in pregnancy is associated with problems including a higher risk of miscarriage, gestational diabetes, high blood pressure and pre-eclampsia, blood clots and haemorrhage after the birth.

Obese women are also more likely to require intervention during labour, such as having a ventouse or forceps delivery or a Caesarean section.

Mrs Garland said: “Woman with a high BMI also have more problems with breastfeeding, as they don’t lactate as easily.

“Through the Monday Clinic we’ve really increased the number of women with a high BMI who initiate breastfeeding, though.

“Lots of women don’t know that breastfeeding burns around 500 calories a day – the same as running five miles.

“When I tell them that, they say they’re more likely to try.”

At the Monday Clinic – so-called after research with women who said they wouldn’t attend if it had a name with “negative” connotations related to obesity – the two midwives see women 16 weeks into their pregnancy, then at 20 weeks, and again at 36 weeks shortly before they give birth.

They are weighed, advised to eat healthily, asked to keep a food diary and given information on suitable exercise, such as aqua-natal classes.

They are also advised about the birth options that may be suited to them. As such pregnancies are deemed “high-risk”, women need to be monitored while giving birth, so some options such as water births will be unavailable to them.

Working with Sheffield Hallam University, a new text-messaging service is also being established, which will see women being sent personalised texts to help them live a healthier lifestyle.

The texts, for example, may remind them about exercise classes or give healthy eating tips.

“We don’t want women to diet during pregnancy, but we want them to be healthy,” Mrs Garland said.

“We try and make a partnership, where we support that woman and listen to her.

“We have an 87 per cent attendance rate at our clinic. I like to think we’re welcoming. It’s about being supportive and listening.”