Kaplan's agency is redoubling its efforts to identify obese women early in their pregnancies and to make sure their health care providers treat them as high-risk patients. It also is issuing health alerts to hospital delivery wards to diminish the risk of death in childbirth due to hemorrhage, which is more likely among obese moms.

"We recommended hemorrhage drills just like fire drills. For an event that doesn't happen very often, people need to practice. That's on the clinical end. On the bigger environmental end, our agency is involved in many areas related to obesity prevention that look at increasing access to healthy foods in the community. It's about raising awareness and engaging people in the community so that they are part of this work, so they can prevent obesity and chronic illness that can lead to maternal death," says Kaplan.

To promote change at the grassroots level, the city is building coalitions that bring together community and government agencies. It also is encouraging leaders at faith-based communities to educate their congregations about the benefits of a healthy lifestyle.

"We work to promote breast feeding to prevent childhood obesity, which is where it all begins in terms of child health," says Kaplan. "We work with schools to get unhealthy foods out of the schools and … promote health foods within the school environment. And we work with parents and community residents to really understand why this is so important, and for them to hopefully demand these healthy foods and places to exercise in their own communities."