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??

Knowing how many times and by how many people leaflets need to be checked before going to press in my area I'm surprised and a little skeptical of the OP comments. Quoting is fine but I can't help feeling some are taken out of context. I would love to see the full leaflet. If it is as bad as it sounds, then its worth a complaint to communications department at relevant PCT about political correctness as they are utterly obsessed with it.

And yes at 13st 5'2" OP is technically obese with a BMI of 33. I'm not sure how arguing about that really makes any difference. BMI is "bull" to a point and I say that from the other end of the scale and get equally upset about it and sweeping generalisation at times. BMI works less well, if you are particular short or tall too. You can be obese and fit under certain circumstances - if you are sportsman such as rugby player for example, but even that carries extra risks. Being thin isn't a guarentee of fitness or health either. But its only "bull" to a point.

(In answer to if most NHS leaflets are online, the answer they are trying to do a lot more to save costs, but it isn't the case for all. And they tend to be specific to the PCT or Trust they are for - though some are generic throughout the country.).

thunderbolts utter tosh.

Athletes are usually excluded from BMI because of their high muscle ratio.

13 stone at 5'2 is very fat indeed. And cannot be healthy, stop making out it is!

Everyone knows that those with high proportion of muscle mass dont get accurate results using a BMI chart? Don't they?

But then, its not really athletes that need to use them, is it?

I honestly cant stand anti-fat nonsense but some of you lot sound utterly bonkers! #

I have no issue with someone saying 'I'm fat and its none of your business, keep your nose out' but all the justification and skewing of facts makes you sound ridiculously defensive and silly.

BMI doesn't apply to elite athletes.

Fairly obvious isn't it, if you weigh more because you are solid muscle, the issues of extra fat on your frame (which for the vast majority of people, BMI is a good indicator of) is non-existent.

Am now waiting for some anecdotal evidence from someone else telling me they're 5'8, 20 stone (so very fat), and run marathons (or the like).

The level of cherry picking with this information is truly astounding

none of my children are over weight but they do have my bone structure and display similar traits as in having larger breasts early on etc so its possible they will be genetically predisposed to be bigger. thought there father is tall and thin so it depends who they take after.

Basically OP, you have come on here to say that you are very fat indeed and have had a leaflet to that effect and are pissed off.

Either suck it up or lose the weight but don't expect sympathy. Well, not form me anyway!

althought there is a gentic componant for weight, it is something like 7 pounds difference.

if i eat more than i need, i put on weight. i kind of think that applies to all of us.

It's lowest common denominator shite, that leaflet.
However, it is true that being within the correct range BMI-wise is best for health. But you know this and do not need an insulting and condescending leaflet to tell you about it!
I'd chuck it in the bin.
Just try not to put on too much during your pg - afaik, if you are overweight then try not to gain more than a stone, if poss.

Indeed Tilly.

BMI, apart from at the extreme ends is not the best way to ascertain a person's health or fitness. There are much more direct ways of doing that e.g. asking a person about their diet, exercise, alchohol consumption and smoking habits.

But there's a sense of moral superiority about fatness which is why people love to seize on it.

The OP admits she's fat and her weight, unless she is musclewoman, would indicate that.

As to the superiority. hmm, it takes an enormous amount of work and effort for most people to maintain a high level of fitness and healthy body size. You cannot eat whatever you want and you have to work at it daily sometimes. So it's not about moral superiority but certainly pride in self discipline etc.

You would use BMI in conjunction with those things thunder.
A decent medical professional will take a full medical history and advise you accordingly.

The fact remains that on a population level, if you are very overweight or obese, you are more likely to suffer greater morbidity with regards to CVD and related illnesses as a result. This is why BMI is so useful.

The literature is very clear on that.

The only proven thing that being very overweight has shown to benefit, is bone density, but in the bigger picture this is negated by other problems that will likely arise.

i dont believe the OP has copied the leaflet acurately. i think she is in denial about her weight and the risks it involves.

5ft2 and 13 stone is fat. BMI or no BMI .

I am that height, and was that weight too.. I was fat.

I may have been in denial and said I was healthy etc etc, but after losing 2 stone, I am now a hell of a lot healthier, my mobility is much better, and I still need to lose a fair bit more.

A healthy weight for someone of my height is around the 9.5stone mark, and a size 10.

Once again, it may not be an official NHS leaflet. NHS services can do produce their own leaflets - often a doctor (or medical student) will write it, secretary will photocopy it, out it goes. That shouldn't happen, but it does.

And that would explain why you can't find it online and why the 'official' leaflets sound very different. From what OP has said, I think it highly unlikely that this is official because if it was it would have had input from people who understand how you talk about health risks in a way that is accurate and not insulting.

A few posters have asked why this is a leaflet and not a one-to-one discussion. From my experience working in maternity care, I'll bet that the midwives are very uncomfortable having these discussions (as they often are talking about smoking or DV). They often struggle to find the balance between being tactful (and being ignored/facing denial) and being forthright (and causing offence). They are not behavioural change experts, they don't have time for a long discussion, they don't want to be seen as insulting to their patients, and so they prefer to give out a leaflet.

I'm not defending any of this, but I do understand how it can happen.

Ah I see the old 'althletes are obese according to BMI therefore it must be bullshit' line is being wheeled out again! Funnily enough usually by people who are obese themselves and trying to justify it.

No wonder there is such a problem with obesity in this country at the moment when people are so firmly in denial. I have seen on here many times 'size 16 is the average UK woman these days so you dont need to worry'. Er yes, it is average, that does NOT make it normal or healthy, all it does is illustrate the problem we have. 13 stone is not obese for a 5'2 lady? It most certainly is, and could lead to problems later in life. And if anyone dares to suggest so they are branded judgy (the most heinous crime on MN apparently) and a 'fat hater'.

Oh and for all you 'Im 50 stone and have had 8 healthy babies' lot, here is my anecdotal evidence: I have 2 very obese friends, both in their mid 30s. Both are constantly riddled with health problems, and niether of them had anywhere near a 'normal' pregnancy or birth.

As worraliberty said earlier (and once again I agree with her wholeheartedly!0, the NHS are not there to lick our arses, they are there to help and sometimes that means telling a few home truths. It seems they cannot do it because people just get offended, and therefore the problem will just get bigger.

Sorry that I sound like a total bitch about this but it really gets my back up!

thunderboltsandlightning no - the denial & bullshit overweight people come out with is annoying.

OP, can you please link to the leaflet you were given.
The raised BMI in pregnancy leaflet I've read absolutely DOES NOT say the things you have said it does.

I don't know how I feel about this. I watched a tv programme the other day about babies born big (over 9 pounds 9), and how this is much more likely if the mother is very overweight.

I found the programme very distressing. The risks to both the mother and the baby that the doctors were talking about were awful. I have never been overweight (5 foot 10 and 9 and a half stone when I became pregnant) and I had a baby over 10 pounds. Because of this, I had diabetes tests, additional scans and was induced on my due date so that my next baby was only 8 pounds. Now, I would have found it incredibly distressing to receive a leaflet telling me that because I had a previous big baby there were various additional risks, as it would have worried me while I was pregnant. On the other hand, if somebody had told me exactly what all the risks were, I would have been much more comfortable with having various extra medical appointments, scans etc than my friends were having.

So I think if you are at higher risk for any reason, you are better off being told exactly what those risks are.

thunderboltsandlightning it is like a heavy drinker claiming its ok to drink 7 bottles of whisky a week because their nan did & lived to 90.

its tedious crap.

It also has an impact on the NHS in terms of extra resources . Even something simple like a scan may take longer and be more difficult if you are obese.

YANBU to object to tone of leaflet, but bin it if it causes offence.

YABVVU to think being obese (and by which I mean, if you fit the BMI definition, assuming you are not exceptionally muscular) shouldn't be raised with pregnant women through fear of causing offence. It is a risk factor, and like all risk factors should be addressed.

What I want to know is why everybody who states the health risk of being overweight or obese, without being insulting, is called a fat hater?

There have been two derogatory comments on here the first being "who fucked you fatty" (or something like it) and then the questioning of the midwife's advice by the OP, because she (midwife) herself is fat. These anti-fat comments were both were made by fat people.

I really don't understand the persecution complex so that many (not all) fat people suffer from, when they haven't actually been insulted.

It only seems to be on here, none of my patients, who are referred to me for issues largely caused by their weight, feel this put upon because of it. I really don't get it.

The leaflet FlyingStart linked to is excellent.

It's important women in the relevant group are informed of likely changes to the care they will be offered in their pregnancy and labour - that's the main aim of that leaflet (which may not be the one seen by the OP - in fact they sound very different). The idea is to inform the woman of what to expect from midwives and doctors and why their care will be the way it is, rather than to scare them about the risks.

Given that leaflet is available, it makes it all the more odd that the OP was given something that seems to be useless and badly-written.