The British Fertility Society is recommending that women with BMI's of 36 or greater be denied fertility treatments and that "merely" obese as well as "underweight" women be compelled to address their weight before such treatments can begin. As it is, Britain's National Health Service, which provides health care to all citizens regardless of the ability to pay, already limits obese women from having fertility treatments.
Excess weight is associated with a variety of adverse pregnancy outcomes, including increased risks of gestational diabetes, pre-eclampsia, induction of labor, Ceasarian section, postpartum hemorrhage, genital tract infection, urinary tract infection, wound infection, birthweight above the 90th percentile, and intrauterine death.
I expect that fat activists will have something to say about this, as they have in the past. I am consistently amazed at the sort of reasoning some people employ when presented with such figures -- e.g., "I know a fat woman who had a healthy baby so the stats are wrong" or "I know a skinny woman who had a miscarriage, so there" -- but apparently abandonment of reason is more comfortable for some people than cognitive dissonance and fear.
Comments
Interesting. I think the activists would have a case, though. Yes, the risks are increased over a number of areas, but the ORs aren't all that high for most of them, even with BMI>30. Do you know if they similarly deny women treatments for other conditions known to cause adverse outcomes, such as smoking?
Posted by: Tara C. Smith | August 30, 2006 2:49 PM
Tara -- I'm not sure (re. smoking and coverage) and wondered the same thing myself. But if the fat activists respond, it most likely won't be along the reasonable lines of "but what about smokers?" or complaints that same-sex couples and single women are still entitled to fertility treatments; they'll be more inclined to continue claiming that the medical evidence regarding obesity-pregnacy risks has been manufactured by shady conspirators.
Posted by: Kevin Beck | August 30, 2006 3:23 PM
Big Fat Blog has indeed chimed in, noting a couple of things I was unaware of previously: that fat people are discriminated against when seeking to adopt children, making the anti-IVF proposal that much more nefarious; and that U.K. docs' reluctance to help extremely overweight women get pregnant is rooted not in the likelihood of these women having of medical complications, but in a greater plot to prevent even more fat people from entering the gene pool.
Posted by: Kevin Beck | August 30, 2006 6:50 PM
Uh oh. Time to whip out the tinfoil hats.
Posted by: quitter | August 31, 2006 2:11 PM