MORE THAN 56 per cent of woman are now overweight or obese when they give birth at the Bendigo Hospital, heightening the risk of health complications for them and their babies.
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A "significant" increase in maternal obesity has been witnessed at the hospital over seven years, a research team led by Madeleine Ward have found.
Maternal obesity has risen nine per cent over seven years, the study of 6661 women who used the hospital from across the region shows.
The new figures, published this week in the Australian and New Zealand Journal of Obstetrics and Gyneacology, have come as Bendigo Health deals with some of the highest rates of maternal obesity in Victoria, director of obstetrics and gynaecology Nicola Yuen said.
"People aren't understanding the importance of healthy weight coming in to pregnancy ... but of course, we don't see them until they are already pregnant," she said.
"So it's a difficult group to target for preventative health."
That is not stopping Bendigo Health and others in the industry turning their attention to preventative health ideas, but the main focus is making sure woman with obesity have safe and positive birth experiences, Dr Yuen said.
Mothers with obesity have increased risks of birth defects, gestational diabetes and diseases including preeclampsia and eclampsia, the ANZOG study notes.
They are also more likely to have inductions and other complications during and after birth.
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More than 27 per cent of women tracked were overweight when they had their first baby at Bendigo Hospital, between 2010 and 2017.
Just over 29 per cent were classed in the "obese" range.
Forty-one per cent of women were in the "normal" weight range, while 2.2 per cent were underweight.
Bendigo Health is expecting rates of maternal obesity to rise, assuming current trends continue, Dr Yuen said.
"The flavour of pregnancy in Bendigo is certainly weighting towards higher-risk outcomes. We are much more of a higher-risk service than we anticipated being," she said.
"Some of that is because of the facilities we have here. We are able to accommodate a lot more women here who would previously have gone to Melbourne for care.
"We also have new special care nursery cots that opened last year and allow us to do more work in Bendigo. We've also recruited a lot more obstetricians in the Bendigo area."
The report found that vaginal births had decreased between 2010 and 2016 across all body types, which could lead to poorer health outcomes.
However, Dr Yuan is pleased to see the hospital's C-section rates remain stable in recent years, after the World Health Organisation recommended that health professionals be more discerning about the operations.
"If anything, we've had a reduction in c-section rates over the past three years," she said.
"Everyone argues that there are a certain amount of ceasareans that are necessary, but that there is a tipping point where you increase maternal risk.
"There's an increased risk of blood-loss, infection, problems in pregnancy. Obviously, too, that time recovering in hospital is much more significant too.
"So there's an obvious benefit to having a vaginal delivery - but not at the expense of the mother or baby."
Preventing stillbirths among top priorities
The study, has triggered more work to reduce C-section rates, as well as post-birth complications, La Trobe researcher Melanie Bish said.
"Whilst there aren't any specific results at this point for release, they will follow in the two future planned papers being worked on right now," she said.
The hospital has already changed its practices as maternal obesity becomes increasingly familiar in hospital obstetrics departments.
"Obesity in pregnancy is a relatively new field so the state guide guideline around managing obesity in pregnancy was only published last year," she said.
"We've been at the forefront, relatively speaking, around initiatives like regular scanning and increased surveillance, recognising them (women with obesity) as high risk, screening for diabetes and planning for these women who have poorer obstetric outcomes."
Reducing stillbirths in woman with BMIs over 30 is a priority for hospitals like Bendigo Health's, Dr Yuen said.
Bendigo Health could consider other areas where it can help prevent bad outcomes and make pregnancy experiences more positive, the study has suggested.
They include more pre-pregnancy counselling, work targetting preeclampsia and breastfeeding support.
Attention could also turn to ways to change pregnant women's lifestyle choices longer term, Dr Yuan said.
"So really seeing this as an opportunity ... to implement preventative health strategies that will make them healthier for future pregnancies - and the children they will raise," she said.
A quarter of women in the study returned over seven years to give birth again, while 3.6 per cent returned two or more times.
The research team included experts from La Trobe University and Bendigo Health.
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