Dr. Wolfgang Henrich, the Chief Physician at Berlin's Charite Hospital's Obstetrics Unit was stunned by the recent birth of a thirteen pound baby at that clinic, but even more stunned by the mother's decision to give birth to the child naturally. Doctors typically recommend cesarean sections for any woman whose baby is estimated to be ten pounds or more.

The pregnancy would have been deemed high risk, no matter where the woman gave birth. She is over forty years old, weighs more than five hundred pounds and had gestational diabetes. Doctors also suspect that the woman may have metabolic syndrome which typically develops in obese people and increases the risk for a number of other serious, chronic conditions. The woman claimed that she did not know that she had gestational diabetes, but Dr. Henrich disputed that. Being as little as ten to fifteen pounds overweight at the start of a pregnancy can increase the risk of developing gestational diabetes. Higher body weights also increases the risk of problems with the pregnancy.

Gestational diabetes is diagnosed in early pregnancy, typically after a glucose tolerance test. The risk for developing this condition is distinctly related to the woman's weight before she becomes pregnant, the amount of weight that she gains during her pregnancy, and other factors. Women who have had gestational diabetes in previous pregnancies are at a far higher risk of developing it in subsequent pregnancies. In addition, women who have had gestational diabetes are also at higher risk of developing Type II diabetes later in life as well.

But, gestational diabetes does not just impact the health and safety of the mother. During the pregnancy, the baby is exposed to the elevated blood sugar which causes his system to release high levels of insulin. Just like in adults, the insulin causes the baby's body to pack on more fat. Babies that are born to diabetic mothers risk low blood sugar for several days after their birth and will need frequent monitoring until their sugar levels are stable. That low blood sugar can lead to brain injuries or defects and other issues that can affect health and development.

The bigger the baby, the higher the risk of injury during birth, especially if a natural birth is attempted. Shoulder dystocia, which occurs when the baby's shoulder catches on the pelvic rim can lead to serious and permanent injury, including paralysis. Mothers can run the risk of tearing in the birth canal which increases their risk of infection.