Caring for Three Generations at a Time: Clinical Perinatal Care of Individuals With Obesity
Obesity affects more than 35% of women ages 20-39 in the United States. This presentation will summarize recent research that reconceptualizes obesity as adipose disease associated with smoking; socio-economic disparities in employment, education, health care access, food quality and availability; and environmental toxins, ultimately altering microbiomes and epigenetics. Obesity is an adaptation to an unhealthy environment more than poor individual eating choices. The female fetus forms her lifetime complement of ova during pregnancy; therefore, the effects of obesity may affect three generations in one pregnancy.
Individual prenatal care of women with obesity includes early testing for diabetes, counseling on epigenetic diets, advice supporting weight gain within national guidelines, and vigilance for signs of hypertensive disorders of pregnancy. Intrapartum care includes mechanical cervical ripening measures, patience with prolonged labor and uterotonic medication readiness in the event of postpartum hemorrhage. Postpartum care includes thrombus risk amelioration through early ambulation, use of compression stockings and anticoagulation. Delays in lactogenesis II can be offset by measures to support early breastfeeding. Sociopolitical actions for midwives at national, state and community levels to reduce population disparities in racism, education, employment; reduce pollution from obesogenic chemicals and improvement of food quality and distribution policies will be reviewed.
Cecilia Jevitt is the Midwifery Director and a tenured associate professor at the University of British Columbia, Faculty of Medicine. From 2013 to 2018, she directed the Yale School of Nursing’s Midwifery and Women’s Health Nurse Practitioner master’s degree programs. She has done capacity-building teaching and curriculum consultations in Switzerland, Laos, China and Ghana.
Jevitt studied midwifery at Emory University. Her 1993 doctorate in applied medical anthropology is from the University of South Florida. She established an academic division of midwifery with the University of South Florida College of Medicine while jointly appointed to the Colleges of Nursing and Public Health.
She is an elected Fellow of the American College of Nurse-Midwives and is the At Large Member of the FACNM Board. Jevitt was a Florida Nurses Association Great 100 Nurse in 2009, the 2010 Reviewer of the Year for the Journal of Midwifery & Women’s Health, the University of South Florida Department of Anthropology’s Distinguished Alumni in 2012, and a 2014 Connecticut Nightingale Excellence in Nursing Award winner.
Jevitt’s scholarship focuses on perinatal weight gain optimization and integrating obesity prevention and management into women’s health especially the perinatal and lactation periods.
Objective 1: List at least two characteristics of white adipose tissue that may cause maternal and fetal complications during pregnancy.
Objective 2: List at least 6 environmental factors that contribute to obesity.
Objective 3: Define obesity and excessive weight gain during pregnancy.
Objective 4: Describe hormonal pathways altered by obesity that may cause perinatal complications.
Objective 5: List at least 6 measures to ameliorate the effects of obesity on pregnancy, birth, the postpartum period and breastfeeding.
Objective 6: Recite descriptors for obesity that are person-centered and stigma-reducing.
Obesity affects more than 35% of women ages 20-39 in the United States. This presentation will summarize recent research that reconceptualizes obesity as adipose disease associated with smoking; socio-economic disparities in employment, education, health care access, food quality and availability; and environmental toxins, ultimately altering microbiomes and epigenetics. Obesity is an adaptation to an unhealthy environment more than poor individual eating choices. The female fetus forms her lifetime complement of ova during pregnancy; therefore, the effects of obesity may affect three generations in one pregnancy.
Individual prenatal care of women with obesity includes early testing for diabetes, counseling on epigenetic diets, advice supporting weight gain within national guidelines, and vigilance for signs of hypertensive disorders of pregnancy. Intrapartum care includes mechanical cervical ripening measures, patience with prolonged labor and uterotonic medication readiness in the event of postpartum hemorrhage. Postpartum care includes thrombus risk amelioration through early ambulation, use of compression stockings and anticoagulation. Delays in lactogenesis II can be offset by measures to support early breastfeeding. Sociopolitical actions for midwives at national, state and community levels to reduce population disparities in racism, education, employment; reduce pollution from obesogenic chemicals and improvement of food quality and distribution policies will be reviewed.
Accreditation
Midwifery CEUs - MEAC Contact Hours:
This program is accredited through the Midwifery Education & Accreditation Council (MEAC) and is approved for 1 Hour, the equivalent of 0.1 CEU. Please note that 0.1 MEAC Midwifery CEU is equivalent to 1.0 NARM CEUs.
CERPs - Continuing Education Recognition Points Applicable to IBCLC Lactation Consultants, Certified Lactation Consultants (CLCs), CBEs, CLE, Doulas & Birth Educators. This program is approved for 1 R-CERP. GOLD Conferences have been designated as a Long Term Provider of CERPs by the IBLCE--Approval #CLT114-07
If you have already participated in this program, you are not eligible to receive additional credits for viewing it again. Please send us an email to [email protected] if you have any questions.
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