title: The state of obesity management for women giving birth in Atlantic Canada.
abstract: OBJECTIVE
  The purpose of this survey was to gain insight into the status of birthing facilities across Atlantic Canada regarding obesity management. Specifically, we were interested in learning about the reported number of obese women entering birthing facilities, if body mass index (BMI) was determined from weight and height, and whether this was used to diagnose maternal obesity or not. Clinical, delivery, or equipment-related challenges and the state of existing or planned policies or guidelines specific to this high-risk population were also sought.
  
  
  METHODS
  An online, cross-sectional survey (audit), distributed via email to key staff members at birthing facilities in Atlantic Canada, including nurse managers, nurse practitioners, registered staff nurses and obstetrician-gynecologists.
  
  
  CONCLUSIONS
  Twenty-two responses were received from 38 invitees (57% response rate), representing half the birthing facilities in Atlantic Canada. Despite the fact that the majority of facilities recorded maternal height and pre-pregnancy weight upon admission, these measurements were not used to calculate and document maternal BMI, nor to make a diagnosis of maternal obesity. More troubling, no birthing facilities in our survey had guidelines or care plans in place to deal with this high-risk population, and two-thirds of those surveyed had no plans for their creation in the near future. While maternal obesity was considered a problem, a third of respondents reported no direct access to properly sized lifts or transfer devices in their units. This study provides a useful baseline for monitoring improvements in the care of obese women giving birth in Atlantic Canada.
authors.affiliation: Canada Research Chair in Health Services Research, Applied Research Collaborations for Health (ARCH), School of Health Administration, Dalhousie University, 1318 Robie Street, Halifax B3H 3E2, NS, Canada. Sara.Kirk@dal.ca
authors.forename: Sara F L
authors.initials: SF
authors.lastname: Kirk
authors.forename: C Lisa
authors.initials: CL
authors.lastname: Cramm
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Price
authors.forename: Tarra L
authors.initials: TL
authors.lastname: Penney
authors.forename: Lorraine
authors.initials: L
authors.lastname: Jarvie
authors.forename: Hilda
authors.initials: H
authors.lastname: Power
mesh_terms: D001291:Attitude of Health Personnel; D016550:Birthing Centers / Q000458:organization & administration; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008485:Medical Audit; D009509:New Brunswick / Q000453:epidemiology; D009523:Newfoundland and Labrador / Q000453:epidemiology; D009674:Nova Scotia / Q000453:epidemiology; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016134:Organizational Policy; D010347:Patient Care Planning; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011325:Prince Edward Island / Q000453:epidemiology; D011795:Surveys and Questionnaires