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The Royal College of Physicians (RCP) has
warned that obesity in women and people of
childbearing age is an urgent and growing public
health concern in the UK, and that action must be
taken to reduce preventable risks to women and
babies.
In its new RCP View
on Obesity and Maternal Health, the
Royal College of Physicians calls for urgent
action across the whole system to support women's
health before, during and after pregnancy,
highlighting that one in four pregnant women in
England is now living with obesity.
Obesity in pregnancy is linked to far higher
rates of gestational diabetes, pre-eclampsia,
caesarean birth and postpartum haemorrhage. Rates
of maternal obesity are highest in the most
deprived communities, reinforcing existing health
inequalities.
These risks can be fatal: the 2021–24 MBRRACE-UK
Confidential Enquiry into Maternal Deaths
reported that 64% of women who died during
pregnancy or within six weeks of birth were
living with overweight or obesity.
The RCP has warned that rising rates of maternal
obesity are increasing pressure on maternity
services and contributing to avoidable harm.
Emerging evidence shows an association between
maternal obesity and the increased risk to their
children of cardiometabolic disease and other
adverse health outcomes later in life,
compounding inequalities across generations.
The College's new policy briefing calls for
coordinated, system-wide action across seven
areas:
- tackling the wider determinants: transforming
food systems and strengthening prevention to
prevent obesity in the first place
- improving pre-pregnancy education,
considering the impact of obesity on reproductive
health
- embedding compassionate and inclusive obesity
care into healthcare training
- improved interconnection between maternity
services, weight management services and primary
care
- tackling inequalities through targeted local
action
- strengthening data and surveillance to
monitor maternal and infant outcomes related to
obesity
- investing in research on the safety and
long-term impacts of obesity treatments in
pregnancy
The RCP recognises obesity as a chronic, systemic
illness, shaped by health inequalities, genetic
influences, ethnicity, social and commercial
factors, stigma, mental health and the
environments people live in.
Dr Kath McCullough, special adviser on
obesity at the Royal College of Physicians,
said: “Maternal obesity is one of the
clearest signs that we need to tackle the root
causes of obesity and weight gain, recognising
the benefits not only for pregnancy but also
women's health and future generations. We know
that obesity is driven by inequality, poverty and
environments that make healthy choices harder
every day.
“We need bold, joined-up action across the system
- from food policy and education to healthcare
services, professional training and research to
better prevent obesity in the first place and
better support women living with obesity in the
pre- and postnatal periods. Getting this right
would transform outcomes for families and deliver
lasting benefits for the NHS.”
Dr Anita Banerjee, obstetric physician
and Royal College of Physicians censor,
said: “Too often, women arrive in
pregnancy already at risk, having had little
support beforehand to address the factors
affecting their health. By the time they are
pregnant, opportunities for preventing obesity
and the risks associated with it have already
been missed.'
“This is why action before, during and after
pregnancy matters so much. If we want safer
pregnancies and healthier babies, and a healthier
society, we need to prioritise women's health
long before they reach a maternity unit.
Prevention is better than treatment.”
Dr Alison Wright, president of the Royal
College of Obstetricians and Gynaecologists
(RCOG) said: “We were delighted to
contribute to this vital work led by the Royal
College of Physicians and fully support this
holistic, integrated approach to
care. Stigmatisation of women and their
weight remains an issue, which is exacerbated by
health inequalities. This must be replaced
by the provision of accessible, non-judgemental,
evidence-based information support and care,
before, during and after pregnancy.
“The RCOG has developed clinical guidance to
support clinicians in caring for pregnant women
with obesity, which can increase the risk of
pregnancy complications, the likelihood of
intervention during labour and conditions such as
gestational diabetes and pre-eclampsia. We must
see maternity services appropriately resourced,
with the right staffing levels, training and
facilities to care for women with increasingly
complex pregnancies.”
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