to be completely shocked and disgusted at the leaflet I've just been given by my mw???

[mummylovesnancy]

This leaflet, titled 'Raised BMI in Pregnancy' was passed on to me by my midwife at my booking in appointment yesterday. Along with the words 'You can't have a home birth, you probably won't deliver naturally and you'll be given consultant led care.'
I'm 28, I have 2 PERFECTLY healthy children who both have perfect height to weight ratios, eat well, are active and are generally normal children. I weigh 13st and I'm 5'2 which puts me in the 'obese' catagory according to the good ol' BMI index of wonder. I have been roughly this weight and exactly this height for all of my adult life. I am overweight, I accept that, but what I don't accept is being told to read this sodding leaflet which tells me, among various other little pearlers, that:
*I will have raised blood pressure. (Not 'I may', 'I WILL')
*I will be prone to urinary tract infections. (never had one in my life!)
*'Bigger Ladies' (exact wordage) get more blood clots. (Dumb Fuck)
*Examinations will be difficult. (Why? Because you have to part all my layers of fat to get to my vag?! How fucking degrading)
*I will have restricted mobilisation. (Will I? Because I don't now, will it automatically come with being fat and preggers?)
*Putting in a drip will be difficult. (yeah because my hands are so freaking chubby.)
*Breastfeeding will be challenging (I've managed it with two babies, now because you've changed your guidelines I think I might struggle.)
And my favourite one yet:
*The risk of stillbirth or your baby dying in the first 28 days is increased in 'larger ladies' (Thanks for that one, nhs, I just had a misscarriage 8 weeks ago. Was it because I'm fat?)

It also mentions on about 7 occasions that I may want an epidural. Is that to keep me quiet?! It also offers to refer me to a dietician and a counsellor.

I have been overweight (or a larger or bigger lady, as the nhs prefers) and given birth naturally twice with absolutely no complications and one of them was a home birth. I can't believe I have to read all this shit. The idiot who wrote this doesn't even know how to place an apostrophe or comma ffs!

Does anyone agree with me that this is a disgusting, degrading, scare mongering piece of shit or am I being an unreasonable pregnant wreck??

blimey no yanbu! what a badly written pile of junk that sounds!

YANBU! Jeez!

Sounds awful. I would find out who produced it and write to them. It would also be interesting to ask for references for the published, peer reviewed research that supports all these statements.

Bad punctuation drives me up the wall too.

You know that thing in your kitchen, has a lid, called a bin? Put it in there. Then forget you read it.

YANBU. Obviously being overweight during pregnancy does carry some health risks but the tone of that leaflet is absolutely awful. And it is a bit shit to scare people like that when it is too late to do anything about your BMI. I am a bit fat too but have not received anything awful like this.
Also they should take into account that you have had two uncomplicated pregnancies. I would put in a complaint and perhaps ask for a different midwife.

YABU. you may not like it and it may be worded badly but it's pretty much true.

I'm in the 'how dare you consider getting pregnant' BMI range and luckily haven't been given that leaflet. There would have been hell to pay if I had. What a pile of shite. But then what they're saying is pretty much the way I've been treated, they just didn't write it down. One thing to make us aware of increased risks etc, no problem with that. But things like that are one step short of the circus tent. Roll up and see the fat pregnant lady...

I think you're probably over-reacting but appreciate that it doesn't sound like a particularly well written leaflet. I think if you are at risk of anything during pregnancy (whether that be high blood pressure / complications / anything else) that its only right that you are given information on how to minimise those risks. The fact that you've managed to avoid those risks in your previous pregnancies doesn't necessarily you will avoid them this time.

Well, I seem to recall that there are increased risks in pregnancy for women with a higher BMI (the fact that you have not had any problems does not mean that others won't).

Having said that, it does sound like the leaflet was badly thought out/written (not unusual in my experience. Some of the leaflets I was given were so badly written they were almost funny), but "shocked and disgusted" is perhaps a bit of a strong reaction...

They are real concerns though. And I say this as a larger lady myself (about the same size as the OP).

YANBU to expect these things to be explained in a sensitive manner though. Plus they should look at your history as there's no reason you shouldn't have another trouble free pregnancy.

It is badly written and should say "may" instead of "will" but statistically obese women do have more complications in pregnancy and need to be aware of the possible risks so they can make an informed choice about whether or not they need to take extra care. Your previous postive experiences mean that you don't need to take action but not everyone in your position will be so fortunate.

Diffcult one.

YANBU to react on a personal level - yes many of the facts do not apply to you as an individual - but the statistics quoted in the leaflet are correct.

Changing the word "will" to "may" should help.

Well while it's of course necessary for them to alter the care they offer according to a woman's circumstances (I got a leaflet on gestational diabetes for example as I have 2 close relatives with type 1), this leaflet does sound faintly ridiculous in its exposition. Is that it? A leaflet and some assertions? No discussion about things you can do during this pregnancy, right now, to lessen those risks?

They do have to make you aware of all these risks, but in the time it's taken for me to write this, I can think of 78 better ways for them to handle it. Bigger ladies? FFS. With all due respect, I'd track the author of said leaflet down and sit on them. I'll come too (still a 'larger lady' or shall I say 'cuddly' after having ds).

I think you need to chill out.

Bin the leaflet.

Then and breathe.

Well, I think you're partly right and partly wrong. I'm afraid it is absolutely undeniable that, IN GENERAL, obesity is a risk factor in pregnancy. It does mean increased risks, to both mother and child. It does make examinations more difficult (I have no idea about vaginas - I took this to mean it is harder to palpate the uterus i.e. by feeling the stomach). It can create problems in labour.

That doesn't mean that you are not fit and well and perfectly capable of having a healthy pregnancy and healthy children. Of course not. Some overweight people are fine physical specimens. Others are not. But arguing that because YOU are not suffering health problems as a result of your weight means that midwives should ignore the very real raised health risks that overweight women GENERALLY experience, does not make sense. It's like the old, "My nan smoked till she was 90 and never had a day off sick" line.
And as you get older and have more pregnancies, any risks are likely to be raised.

However, it does sound like a bit of a crappy leaflet. Fat women get horribly patronised and degraded, and I'm with you on phrases like 'larger ladies'. Perhaps you could provide feedback on how the leaflet could be improved?

Finally, many many sympathies on your miscarriage. I've been there are know how sensitised you get to any suggestion of blame. Nobody is saying you caused your own miscarriage - they happen, it's just shitty bad luck, and you just don't need to connect this silly leaflet with your feelings of pain around this.

Thanks all.
I am just disgusted that they would publish this utter drivel.
I'm going to have a word next time I see my midwife and ask her if she thinks it's helpful or just plain awful.
I know there are risks with being fat and pregnant but there are so many more sensitive ways they could have put all this crap across.

YANBU the leaflet sounds awful. Obviously aimed at much larger ladies, not nice to read. Congratulations on your pregnancy.

it is much more difficult to find a cervix in an obese woman.

you get a leaflet because there simply isn't time in your 5 minute appointment to discuss everything that needs to be flagged up. so smoking obesity, diet, exercise, birth choices, everything gets put onto paper. your choice then whether you read it or not.

What is the recipient supposed to do about it though? Can't exactly get 3 stone off while pregnant. So therefore it seems somewhat finger-pointing handing it out to people who are already pregnant.

It's not about whether it's true or not. It's about respect. Overweight women are generally treated like freak shows when they're pregnant. Hester is right, patronising and degrading is the tone most of the time. There is no excuse for that.

YABU not to have mentioned that its opening line was:

"So you're fat and pregnant - who fucked you fatty?"

What a bloody horrendous leaflet.

I haven't had one single examination during either of my pregnancies (I'm now 25 weeks) - is this because the medics didn't know where to find my vagina?

"Examinations will be difficult. (Why? Because you have to part all my layers of fat to get to my vag?! How fucking degrading)"

I assume it means palpating?

Badly written I agree, but I assume being given out to all "larger ladies"?

My first was pre-pre 30 weeks & just over 1kg.

Consultant came to see me the next day-"Ah, hello I´m Mr XXX-did you smoke, drink, do drugs? No? Oh! Well, you won´t be having another, will you?"

Me-"why-am I now infertile?"

The "S" in NHS certainly isn´t for sensitivity!

And yes, I did have another!

Congratulations & I hope it all goes well!

The recipient is supposed to then go and think about her diet, take up the offer of a referral to a dietitian, eat healthier, exercise more and not pile on an extra 4 stone just because she's pregnant.

Would you rather nobody mentioned it at all? or the risks?