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??

If the OP is only 5'2" then she'd be more than 3.5 stone over. I weigh 10 stone at 5'7" and I am slim and muscular but not skinny!

The point of a good leaflet would be to explain why maternity care will be different - why it might take a longer time to palpate the abdomen, why hearing the baby's heartbeat might be tricky, why you might be offered extra monitoring, why you might need more help with bf, why raised blood pressure is an increased risk and what that means for care.....all this can be done without offending or insulting.

Advice on maintaining a healthy diet and fitness levels can be there, too, and encouragement to try to lose weight for next time, if you become pg again.

No good leaflet would assume it would be easy to go from being 'at risk' to 'no increased risk' if you have a high BMI already, but women in this group do need to know how and why their care will have certain aspects that meet their needs.

annoying I am taller than the OP, and weighed almost 13 stone. I was clinically obese.

The OP is about three and a half stone overweight. I think that the description 'slightly overweight' is not really fitting if we are talking about BMI.

It might not be so much of an issue if she was taller, but shes only 5'2". That means shes carrying a 1/3 more of her body weight than perhaps she should be. Thats a pretty big cause for concern even if you allow room for different body shapes and sizes.

Overweight is 25BMI. So slightly overweight is NOT 33BMI...

spooks, but not every morbidly obese woman will need intervention, or indeed have bp issues etc., whereas some overweight or obese women will.

More specifics on how much more at risk we are for each factor would be good though.

i think that there should be a defination between overweight, obese and morbidly obese then because i dont think it would be particularly common for an over weight or obese woman to need intervention assuming you mean ventuse etc but can see were a morbidly obese person could need extra medical intervention.

There is.

Normal range
18.5 ? 24.9
No increased obstetric or maternal risk

Overweight
25 ? 29.9
No increased obstetric or maternal risk

Obese I
30 ? 34.9
Mildly increased obstetric and maternal risk

Obese II
35 ? 39.9
Moderately increased obstetric and maternal risk

Obese III
greater or equal to 40
Significantly increased obstetric and maternal risk

lookattheears, I worked it out on the NHS BMI calculator. It is about 3 and a half stone from the most she could weigh and remain within the healthy weight range.

I am near the top of the healthy weight range for BMI and although I am technically of a healthy weight, nobody would call me skinny!

hey time i am with you time a leaflet pointing out that you are over weight/obese is just in my opinion pointless a leaflet discussing the general risks during pregnancy and then putting in about higher bmi, fine. since the risks being flagged are risks during all pregnancy's.

I'm actually bloody furious. What a load of shit.

quietly, what I want to know is re concrete I suppose, eg if say 20% of healthy weight women end up with cs, ?% of obese women will?
Telling me there's a risk, or even a significant risk doesn't tell me much.

I would love to see a scan or photograph of this leaflet

Being pregnant is the perfect time to lose weight sensibly - especially when you are as fat as the OP. The last thing you want is to pile on any more weight. 5'2" and 13 stone isn't plump, chubby, large or a bit overweight. It is well and truly obese.

Why do people view pregnancy as some delicately fragile state when all of life's normal functions should grind to a halt?
I have known women who have undergone chemotherapy whilst pregnant - nothing is tougher than that - so restricting your diet and eating healthily is a walk in the park by comparison.

Ok, maybe she is obese, but I do wish people would stop using the terms overweight and obese as if one is a bad as the other. They are not the same

This is the tv programme that was on about obesity and large babies:

www.itv.com/itvplayer/video/?Filter=262204

I will say it again.

A good leaflet informs the woman of why her antenatal and labour care will be different from the standard.

That's why she needs a different leaflet.

She doesn't need one saying 'Did you know you were fat? Well, you are. Here's a list of Bad Things that can happen because of it.'

The good leaflet linked to explains the impact on care, so the woman is prepared and understands why different things will be offered to her, than to her slim friend.

It could also include stats on (eg) CS, and show how risks increase with increased BMI. That again is preparing the woman.

Perhaps more women should be shown studies such as this one?

Women who are obese during early pregnancy have a significantly increased risk of their baby dying before, during or up to one year after birth according to research published in Europe?s leading reproductive medicine journal Human Reproduction today [1]. A second paper [2] also published in the journal today shows that obesity increases the risk of complications, such as bleeding and infections, during and after a hysterectomy operation.

In the first paper, researchers from Newcastle University, UK, studied 40,932 pregnancies involving deliveries of single babies during 2003 to 2005 at five maternity units in the north of England. They found that women who were obese in early pregnancy had nearly double the risk of the baby dying in the womb (foetal death [3]) or up to one year after birth (infant death) than women who were of recommended weight

The study estimated there were nearly eight more foetal and infant deaths per 1000 births among obese women than among women of the recommended body mass index (BMI). The total (absolute) risk among obese women was 16 in every 1000 births (1.6%) compared to nearly nine per 1000 births (0.9%) in normal weight women Obese women were categorised as having a BMI of 30 kg/m2 or more, while women of recommended weight had a BMI of between 18.5-24.5 kg/m2.

www.eshre.eu/ESHRE/English/Press-Room/Press-Releases/2011-Press-Releases/page.aspx/1325

OP - YABU, them's the facts.
If it was written more 'sensitively' people wouldn't get the message, it would be easy to ignore if it was expressed in gentle terms.
I wonder if your reaction is perhaps because you are actually a bit shocked to realise the risks being obese carries.
You sound as though you don't think much of the BMI categories, and I don't know them myselves, but you weigh not far of twice what I do + a bit shorter so I think you must be quite overweight.

YANBU about the apostrophes though.

Congratulations on your pregnancy, MummyLovesNancy. I hope it all goes very well.

I'm sorry the leaflet upset you so, maybe it could be better written, but seems to me like the NHS can't win. If they don't highlight the extra risks then their clients are misinformed, if they highlight the risks with weak language, they get accused of namby-pambyism not doing their job, if they are blunt they get accused of scare-mongering. At least I think most people, like you, can think for themselves and take the blunt information with a pinch of salt. We should all be like that, anyway.

Brilliant post tiktok - I think a leaflet should be practical and emphasise what the woman could do to maximise her chances for a normal birth (say ways to lose weight, aupport etc if the woman wants to diet) rather than being a harbinger of doom. What use is that to anyone.

Posts saying 'overweight women should not deliberately get pregnant' is so bloody rude I don't know where to start. As is equating overweight pregnant women with those who smoke and drink to excess whilst pregnant.

As is equating overweight pregnant women with those who smoke and drink to excess whilst pregnant.

So women who eat badly during pregnancy are ok? They should at least try and eat more healthy. Its still all about what you put in your body affecting your baby's health. Thats NOT rude.

I am at the low end of healthy bmi when not pregnant and my blood would clot permanently if not for medication, I struggled to breastfeed and I get UTIs. I had all types of assisted births possible bar a cs with dd1.

Weight is not the only factor for many of those things!

Personally, I couldnt give a flying crap whether another woman dines on lard, smokes a pack a day or gets sozzled during her pregnancy. I'm a bit uncaring like that.

But just dont spout nonsense that none of it really matters or is beyond your control. Cos its a bit irritating.

Well said JV

Should a women who is anorexic and more at risk of miscarriage or having a premature baby, not be encouraged to correct her eating habits? Or is that rude too? Just interested why obese women seem to think they shouldn't be told that what they are putting in their bodies is an issue. Might not like it, but it isn't rude.