PURPOSE:
This session will identify the weight-related research that many clinicians use for recommending that individuals living in large bodies (those with body mass index measurements > 30) leave their communities for birth (birth evacuation) or be transferred from midwifery care to obstetrical management. Research from the last decade will be summarized to demonstrate that more than 50% of individuals living in large bodies have uncomplicated pregnancy and birth outcomes and that body mass index alone is a poor predictor of health and pregnancy outcomes.

DISCUSSION:
National guidelines that include recommendations for place of birth based on body mass index or weight will be compared and critiqued. The research literature is moving away from definitions of obesity based on body mass index alone and urge holistic assessments of health during antepartum and intrapartum periods. Furthermore, evidence-based, holistic assessment of health will enable more individuals to remain in midwifery care which increases vaginal birth rates and lowers societal costs associated with high rates of caesarean birth.

EVIDENCE WHERE RELEVANT:
Research studies demonstrating healthy outcomes for individuals with obesity and new international statements that urge holistic health assessment and a move away from body mass index as a health indicator will be summarized. The concept of metabolically healthy obesity and the 2025 LANCET Commission non-clinical and clinical obesity labels will be summarized using case studies and research studies.

KEY MESSAGE:
Evidence-based strategies and international research about obesity in pregnancy can be applied to assist Individuals living in large bodies to remain in midwifery care and to remain in their communities for birth, thereby increasing their chances of uncomplicated vaginal births. Pregnancy - antenatal