Maternal Obesity Problem - Research Paper Example

? Maternal Obesity Maternal Obesity Introduction Maternal Obesity is the obesity of a woman during pregnancy. This condition affects the maternal metabolism and growth of the offspring. Maternal obesity causes undesirable results and disrupts including the fat oxidation, amino acid synthesis, glucose homeostasis, and insulin resistance. Individuals have said to possess obesity if having a Body Mass Index (BMI) of 30 or greater. The index shows that a woman with a height of 5 feet and 5 inches should possess the body weight of not more than 180 pounds. The maternal obesity rates are very high in the United States, and the health care providers have significant implications to overcome this dreadful situation. The Center for Disease Control and Prevention reports reveals that at the beginning stage of pregnancy, one in five women are obese. Hence reducing obesity during, before, and after the pregnancy should be considered as a matter of public health importance. The obesity in pregnancy has been rapidly increasing and has now become a common risk obstetric condition in many countries. The reason for the health organizations to take extra care in the issue of maternal obesity is that the consequences of it are high and associated with adverse reproductive outcomes and hypertensive disorders and also causes for gestational diabetes mellitus, cesarean delivery, and increased risk for obesity of the child. Theory of Planned Behavior (TPB) As Rivis and Sheeran (2003) explain, the Theory of Planned Behavior (TPB) was derived from the Theory of Reasoned Action (TRA) and explains the three predicator of behavior – attitude, subjective norm, and perceived behavioral control. Attitude refers the beliefs of an individual about the outcomes of the behavior mixed with an evaluation of the significance of these outcomes. The Theory of Planned Behavior is somewhat similar to the Health Belief Model. A comparison of both the models shows that a study report conducted using each theory bore similar results, where TPB predicator model explained 35% of the variance in follow-up dieting and 67% in intention and HBM model portrays 38% of variance in follow-up dieting and 57% in intention (Nejad, Wertheim & Greenwood, 2005). The results explain that both models were able to predict an important part in the variance of dieting and fasting follow-up behavior. The direct aspect of the perceived control evaluates the extent of access that the individuals believe to have in formulating the behavior question. On the other hand, the indirect aspect of perceived control is normally obtained by assessing some definite aspects, called control beliefs, which have the capability both to make it easier and to make it difficult to achieve a behavior. The Theory of Planned Behavior analysis reports no direct connection between the intention to eat healthfully and eating behavior. Besides, age, gender, and BMI were the important factors forming the response of the people. The TPB is formulated on the idea that the stronger the intention to carry out a provided behavior, the greater the chance that a person will execute that behavior. The results from the various studies prove that TPB is helpful in predicting the factors that are directly connected with healthy eating behavior. Many factors lead to healthy eating behaviors, and the TPB can be used as a tool to formulate intervention strategies to promote healthy eating habits among the youth, especially the women who are more faced with the risk of obesity and overweight. Other factors such as attitude, barriers, are subjective norm which have chances to influence the eating behaviors, are also added to the model of TBP. At last, the suggestion is towards the parents to take reasonable care in maintaining a healthy eating habit for their children. Social and Cultural factors affecting the maternal Obesity. The causes behind the obesity are multifaceted and consist of social, cultural, genetic, behavioral, and environmental factors. Generally, obesity is occurred when a person takes more calorie than what the body burns up. According to the report of American Academy of Child & Adolescent Psychiatry (May, 2008), there are 50% chances for a child to become obese if one of his/her parents is obese, and up to 80% chances if both of them are obese. Besides, there are some medical disorders which become a cause for obesity and also some physical problems too, but these amounts to only less than 1% of all obesity cases. Obese women must undergo thorough medical evaluation by a pediatrician to determine the cause behind the obesity. The methods of HBM can be utilized to determine how to cut down the amount of calorie being eaten and to involve the body in any physical activities to burn up the extra amount of calorie. A permanent weight loss can be expected only if there is efficient guidance and care given to the patient and that in turn creates self-motivation within the patient. Adopting a healthy eating habit and regular exercises a person can eliminate the chances of becoming obese and can successfully maintain the BMI. Literature Review A study was conducted to examine the impact of maternal obesity and overweight on the pattern of labor progression by Anjel, Jun, James, David & Maria (Nov 2004). The study was carried down on a group of nulliparous women including 297 normal weighted women, 115 overweight cases and 200 obese. These women had undergone the Pregnancy, Infection, and Nutrition (PIN) study that was conducted under the criterions of being maternal age of sixteen or above, singleton pregnancy, telephone access, English speaking ability, parental control and the place of planned delivery. An interval-censored regression model having the normal distribution log was used to evaluate each millimeter of the median on the aggregate values of the labor duration. The results of the evaluation were further examined according to each category of the gestational weight gain. They found out that the cases with overweight and obese had significantly higher duration of labor, where the median showed a higher degree of 4cm to 10cm, which they interpret as, the labor time by normal weight women is 6.2 hours, overweight women 7.52, and obese women 7.94 hours (Anjel, et al, 2004). James, David & Maria Nov 2004). Their conclusion was to take sufficient action against the spread of obesity, the epidemic of the 21st century. Helms, Coulson and Galvin (2006) made a retrospective cohort analysis and observed the proportion of women with inadequate weight gain during their pregnancy in North Carolina for a period over sixteen years. Their analysis was carried out on 1,463,936 pregnancy cases over sixteen years until 2003. Women where categorized into different groups considering the rate of obesity, whether they rally with the singleton criterion. The term was subdivided further into groups of insufficient weight gain (below 15punds), ample weight gain (15 to 40 pounds) and excessive weight gain (above 40 pounds). A trend analysis also was conducted using the chi-squared test to evaluate the trend changes over the sixteen years. Great differences were noticed in all the categories throughout the years, more cases were reported in the excessive gain category and in the insufficient gain category. There had been an increase from 15.5% in 1988 to 19.5% in 2003 among the pregnancies with excessive weight over the suggested rate (Helms et al, 2006). The conclusion arrived from the study shows the dangerous situation of the society’s trend towards obesity. Objectives of the Model The prevalence of maternal obesity is at an all time high rate. This places several health risks on the mother and child during pregnancy, at the time of labor, and into their future lives. Maternal pregnancy is thus a critical issue to the society in general, and puts a significant health risk on two vulnerable segments of the population. One sentinel objective of this intervention is to make shorter the proportion of people who are obese or overweight. Maternal obesity is one of the most important health issues the western countries are faced with. Probably, the United States would stand in the first place of having the largest maternal obesity cases. The Health Belief Model is always reviewed for its applicability in patient education. Health promotion is an easy ground where the health care providers have the role of teaching the patients and families. Once the people are aware of the need for overcoming the obesity problems, they themselves will engage in healthy behaviors. Motivation to make behavioral alterations will always promote health. The interventional efforts will involve the dissemination of adequate information on the health risks to maternal pregnancy and the benefits that emerge from maintaining a healthy diet. Reducing the incidence of maternal obesity is an important goal for public health care providers. Community level interventions involve the use of HBM to improve the attitude towards diet to maintain the optimum weight during pregnancy. The objectives also include the use of the print and visual media for a continual flow of reminders on the benefits of maintaining a healthy diet, from the perspective of health and general acceptance in society. The model is equipped with various frameworks for applying health promotion to patient education. The current approaches of the intervention on health promotion consists of methods to improve the health status by applying healthy lifestyles, implementing immunizations, and taking variety of actions to make individuals realize themselves the need for sustaining a healthy body. Appropriateness of the Model The Health Belief Model (HBM) is significant for the prevention of weight gain and obesity to enable the person to accomplish the objective of living healthier. It can affect the convictions on health and the decision process in constructing behavioral changes. This model is equipped with a comprehensive framework to analyze and determine the psychological elements related with observance, and is widely used in health education applying it on various issues, health conditions, interventions, and populations. The Health Belief Model is considered to be a behavioral transformation model which is used as a technique for assessing and treating the obese and overweight patient. The importance is given to address the psychological co-morbidity which will enable the long term success of the model. The HBM is often used as a method of determining the general health-related problems of a patient including personal prevention policies. Strategies to accomplish objectives and to obtain assistance Community Health Nurses should be placed at the position to provide assistance for the primary prevention of maternal obesity, beginning with educating the teenage and young adult women and married women on their clinical encounters prior to conception. They should be skilled enough to identify the obese who are at adverse health consequences. The health instructors must be equipped with the adequate tools to identify the infants too that are in risk of obesity due to obesity of the mother. The intervention strategies for dealing with the challenges of maternal obesity at the community level include creating awareness of the health risks associated with maternal pregnancy with regards to women themselves and the outcomes of children born from obese women which will in turn construct a desire for women to maintain a socially acceptable body weight. The intervention strategy at the community level for reducing maternal pregnancy based on HBM will thus require several actions on the part of the health care professionals. The first such action is providing the required information on the risks involved in maternal pregnancy for the mother and child and also the required dietary information to maintain optimal weight during pregnancy. Monitoring the effect of this information input during the regular check-ups that pregnant women make and the appropriate changes in information input will also be required Factors other than intentions, like attitudes, barriers, and subjective norms are to be taken into consideration. Nutrition professionals should cooperatively work with the community health leaders to provide adequate knowledge of healthy diet and nutrition. The recommendations include avoid eating junk food and fast food and perceptions of healthy eating, especially to avoid eating in front of the TV. Reaching the desired goal of chopping down the obesity health problems, we need an effective diagnosis system. Diagnosing the problem in time will help in formulating appropriate weight management plan. Therefore the need for an evidence-based clinical practice guideline is to be successfully implemented. The complications and risks of the client should be categorized according the Body Mass Index, giving keen interest to overweight and obesity. The challenge ahead is to make use of the available opportunities to make the people aware of the need for changes in lifestyle. The policy against the health issue of maternal obesity is to bring down the obesity rates to 15 percent in adults and to cut down the occurrence of obesity among the adolescents and children to below 5 percent. The public health care providers have the important role of evaluate and educate the obese woman with providing sufficient care to overcome the health issue. The health care providers get the chances to assess the obese women at the routine parental visits, preconception visits or at the yearly well-woman tests and they should make use of such The next step is to present the suggested strategies and recommended measurements to the local governments and state governments to get it approved. After the approval from the state governments and Center for Performance Measurement Dissemination the projects can easily obtain the financial support for its implementation. Programs like The Maternal and Child Health Epidemiology Program are ready to provide financial and technical support for the implementation of the projects for preventing maternal obesity if approved by the state. These obesity prevention policies and strategies must be implemented in communities to eliminate the environment of obesity epidemic. Conclusion Maternal obesity, the epidemic of the 21st century and its co-morbid conditions are continuing to rise at an alarming rate. It affects not only the pregnant women but also influences the child’s health and leads to childhood obesity. Regardless of developments of our understanding of this endocrinopathy, our health infrastructure still has to cross many barriers to provide adequate care for such patients. More obstetrician-gynecologists are to be trained to play the key role in treating and preventing this outbreak. References Anjel, V., Jun, Z., James, F. T., David, A. S & Maria, A. S. (Nov 2004). Maternal pregnancy overweight and obesity and the pattern of labor progression in term nulliparous women. Obstetrics & Gynecology. The American College of Obstetricians and Gynecologists, 104(5). 943-951. Helms, E., Coulson, C. C & Galvin, S. L. (May 2006). Trends in weight gain during pregnancy: A population study across 16 years in North Carolina. American Journal of Obstetrics and Gynecology, 194(5). Nejad, L. M., Wertheim, E. H & Greenwood, K. M. (2005). Comparison of the health belief model and the theory of planned behavior in the prediction of dieting and fasting behavior. E-Journal of Applied Psychology: Social section, 1(1):63-74. Obesity in children and teens. (May 2008). American Academy of Child & Adolescent Psychiatry, (79). Retrieved from http://aacap.org/page.ww?name=Obesity+in+Children+and+Teens§ion=Facts+for+Families Rivis, A & Sheeran, P. (2003). Descriptive norms as an additional predictor in the theory of planned behavior: A meta-analysis. Current Psychology. University of Sheffield, 22(3): 218-233. Read More