Are there higher risks involved in doing a caesarean on a larger woman?

Question

We live in country SA. My sister in law has had 2 caesareans and her doctor is refusing to let her even attempt a natural delivery. She is currently 6 months pregnant and was told by her dr if she gains any more weight he will not perform a c-section either and she will have to travel to our nearest capital city to have the baby. She is not THAT BIG. I think she should seek another opinion as there is several dr's in our community but she is very upset now and has just accepted what he said. It's just not possible for her NOT to gain anymore weight when she still has 3 months to go.

Eilene D · Accepted Answer

There are a few more risks for larger women having to undergo a c-section. The risks are not that great. I myself am a large woman and had to have a c-section 13 mo ago.  I had no complications from my surgery.

Anonymous · Answer

Well I myself have had 4 ceasars. I have 6 children whom 2 were natural births. Ceasars are a major operation.  The reason being your sister n law will most likeky have another one. On the outside it would seem everything is ok but internally if she was to have a normal birth there is a possibility she can tear from the inside out as the tissue on the inside has not healed properly. Being in country Australia the country hospitals are not as equipped to handle such major things as repetive ceasarians. It may be best she thinks about travelling to a major city for her and her babies's health. I know this probaley isn't what she wants but I do believe it is best. I certainly do not agree with her GP as to say he will not operate if she puts on more weight. she is in her third trimester and this is the time of her nesting and her body preparing for the birth. Maybe she should try a 2nd opinion as this is not what she wnts to hear at this point of her pregnanacy. Good luck I hope all goes well.

saffrondoula · Answer

This is horrible!  She needs to switch practitioners NOW. It is dangerous for her to stop gaining weight at this point.  The last trimester is when the mother basically stops gaining weight for herself and the majority of weight-gain is for the baby.

She cannot stop gaining weight now.  This is horrible.  This guy is putting your sister and her baby at risk.

I'm not sure what country you're referring to, but in the U.S. a doctor cannot demand for her to have a caesarean without her signed permission.

Take this as a streak of luck that this doctor is giving her three months to get the heck out of his practice.  He is a dangerous man and should never work again.

How can he tell her not to gain weight?  This is horrible.  She needs to get a new doctor, or better yet, a midwife.

Anonymous · Answer

Let me stress that I'm not saying that I agree with the doctor. A second opinion sounds more than indicated; VBACs are not rare now. But, this is interesting:

"It's safe for obese moms-to-be to lose weight during pregnancy, new SLU research finds
Doctors should encourage most overweight women to diet and exercise
ST. LOUIS – Most women who are obese can safely exercise and diet to lose weight during pregnancy, according to a small pilot study conducted by Saint Louis University researchers.

“Doctors hadn’t encouraged pregnant women who were obese to limit their weight gain or have them lose weight because they were afraid it would hurt the baby,” says Raul Artal, M.D., principal investigator and chair of the department of obstetrics, gynecology and women’s health at Saint Louis University. 

“We found that obese women do not have to gain any weight, and, in fact, can lose weight and it won’t hurt the baby. Pregnancy is an ideal time to start an exercise and fitness program, particularly for women who are obese.”"

http://www.eurekalert.org/pub_releases/2007-06/slu-isf060507.php

Google "VBAC" -- the risks are pretty overstated.

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Are there higher risks involved in doing a caesarean on a larger woman?

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