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??

We really do need to see the actual leaflet. Who was it published by, OP?

I feel like you're talking to someone who isn't in this conversation chicleteeth.

I'm talking about dieting to lose weight, which some women do in pregnancy (more than probably people talk about - there are occassionally women who come on here to talk about how they are pregnant and are going to join Slimming World or whatever). You talking about controlled eating to maintain a certain weight is irrelevant.

But if you can link me to the studies that show that morbidly obese women who go on weight loss diets and actually lose weight in pregnancy have better outcomes for themselves and their babies, then I'll be interested to see them. Otherwise what I said there stands.

queenof at 5'4" and 13 stone 7lbs I wore a size 12 and was triathlon fit entered in to the cologne Sprint triathlon. I guess we are of differing builds. :)

Timewasting - The ignorant should stfu

Ooer get you.

Anyway. My cousin was under the care of the Portland. She was enormous and struggling with BP and diabetes. She was placed on a healthy eating plan (about 2,500 calories a day) and lost 2 stone during pregnancy simply through eating healthily for once in her life. Her normal calorie intake was around 4,000.
Simply reducing calorie intake to what is normal for a pregnant woman (instead of overeating) resulted in weight loss. BP went down. Gestational diabetes was managed very effectively.

Queen I'm with you on the denial thing. I understand it though - it actually came as a shock to me when I was told that I was clinically obese. I thought I was just a little tubbier than I should be.

It was pretty evident that I couldn't put my high BMI down to being triathlon fit. My BMI was similar to that of my friend's Royal Marine dh - he was fit. I was fat. But until I was told I had no idea just how fat I was.

Joining slimming world when pg is not a bad idea- they tailor the diet if you are pg - encourage you to eat lots of healthy foods. The morbidly obese do not gett there by eating a normal diet- slimming world foods are the ones eaten by 'normal' weight people who eat a healthy diet.

alpine "triathlon fit" suggests serious athlete which as already discussed rather skews weight. Either that or you were buying your size 12 somewhere bizarre.

I am 5' 3" weight 8st 12lb, I am still carrying a little extra weight round my middle from the birth of DC4 in March but couldn't do up (several) size 12's in Oasis this week.

Crikey. Women & weight. Can we have a polite conversation about it ever? I hope some of you are a bit less angry in RL.

Slimming World is food eaten by people who want to lose weight, not normal weight people. It's low fat, when fat is an important part of good nutrition.

This normalisation of calorie controlled weight loss dieting, alongside the demonisation of overweight people is not a good development.

OP you are being a little unreasonable i think. They may have been upsetting points to read and i do get it i am pretty much the same weight and height as you (before pregnancy was 5 foot 3 and 12.5 stone) and tbh i dont like being told that my weight can cause problems but actually the evidence shows it does and it would be really negligent of any doctor or midwife to ignore this.

The points on the list do apply in part to me i DO have raised blood pressure in pregnancy, i have had 4 miscarraiges. I have dieted to conceive my other children so was smaller but still overweight (for example was 11 stne at the start of my last pregnancy) this pregnancy was a surprise not ling after the birth of m last child and i am significantly bigger that i was 2 years ago.

Other points such as loss pf mobility i would think would only apply to very obese people i still manage the walking to the school etc but i suppose it depends on the person.

I have never had anyone tell me of any problems with examinations and scans etc have been fine. I am having the diabetes test as i have an increased risk and i am seeing a consultant bith because of previous history of preelclampsia (which IS more common in overweight and obese people) and simply because of the weight.

It is hard to hear but the information in the leaflet is correct i dont see the problem.

Hmmm wording from a leaflet in gloucester very interesting and not disimilar. Sample paragraphs. Its not quite as harsh. I suspect there has been guidance gone out about creating leaflet on the subject. Others I looked at were very similar for different PCTs. This particular leaflet looks fine to me... :

Why is BMI used in pregnancy?
BMI is now calculated for all women at their booking visit. The Confidential Enquiry into Maternal Deaths (CEMD,2002) highlighted the need for midwives to use this tool for all women at booking as part of the risk assessment. This report suggested that women with a BMI greater than 30 have increased risks in pregnancy. The National Institute of Clinical Excellence (NICE,2007)) have suggested using a BMI of 35 as the level when risks are increased. Within Gloucestershire, we have agreed that if a woman has a BMI level of less than 18 or greater than 35, we would advise her to deliver in a consultant unit rather than a midwifery led unit.

What are the risks of being obese?
Antenatal period: Women who are obese are at increased risk of developing pregnancy complications. You are more likely to have a miscarriage, become diabetic, develop high blood pressure and have blood clots. Scans to check for abnormalities of the baby are not as accurate in larger ladies. It is also more difficult to feel the baby in your tummy to check how big the baby is and to see which way the baby is lying.
Birth event: Women with a raised BMI (greater than 35) may have problems mobilising (moving about) in labour and it can be more difficult to hear (auscultate) the baby?s heart beat during labour.
Your baby is likely to be bigger than average which may make your delivery more difficult. This increases the chance of you having to have assistance with the delivery and you are more likely to have a Caesarean section. This may be more difficult to perform and therefore riskier for you. Epidurals or spinal blocks are more difficult to put in to larger women and general anaesthetics are riskier. After the birth you are at an increased risk of getting blood clots in your legs and if you have had a Caesarean birth you are more likely to have complications with your wound. Sadly we know that there is also an increased risk of the baby dying during the pregnancy (stillbirth) and following delivery. Long term your child can develop problems with obesity.

If also offers referral to a dietcian in another para.

I'd REALLY love to see the OP's leaflet after reading that...

I don't understand your issue with "normalisation of calorie controlled weight loss dieting" ?

If you are overweight you lose weight by restricting your calorie intake - that is and should be normal.

Slimming world food is mainly made up of fruit/veg/lean meat/fish and fewer portions of bread/cereal/dairy. Serioulsy overweight people often have food issues and the slimming world diet is close to normal eating. There is fat on it, there are more portions of healthy fat for pg women. It is not calorie controlled.

Esta, being placed on a controlled eating plan due to morbid obesity, high bp and gd is a bit different to your saying effectively that obese women should diet when pregnant.

It is calorie controlled, it's just less clear because their dieticians have done the calorie counting behind the scenes. The low fat aspect of it is a way to take calories out of the meals and that's what their recipes reflect. It is disturbing that pregnant women would think it was a good idea to go to Slimming World, or that Slimming World would encourage it.

Queen it is normal, and people normally put the weight back on.

Unless you low-carb, Queen (this is derailing the thread somewhat though).

Also anybody who has food issues should stay well away from an organisation that calls foods "syns" (sins).

But everyone should eat a healthy calorie controlled diet, pregnant or not. That is what healthy eating is all about.

Calorie-controlled is not a healthy diet. Healthy eating is about eating healthy food, when you're hungry and stopping when you're full.

Nope calorie controlled dieting is not healthy. It encourages obsession. Lots of women who get on the calorie controlled dieting merry go round are never able to get off and spend the whole of their lives yo-yo dieting, with their weight going up every time. Weight loss dieting tells your body you are in starvation so it adds more weight on each time you stop dieting.

Oh for goodness sake timewasting!

An obese person will need to be consuming a heck of a lot of extra calories to become obese and then to maintain that obesity.

You agree that an obese person should be advised to eat healthily, stop when full etc etc? Well you know what would happen then? They'd lose weight! Thats what happens.

So get picky over the word 'diet' all you like but it really makes no difference and NOBODY would advise a pg woman to go on a crash diet/ very low calorie diet/cabbage soup diet or anything else you seem to be fretting over.

Sorry to just single you out, timewaasting...thunders you are being bonkers too

Far too much naval-gazing and hand-wringing over losing weight.

It's actually very simple.

calories in must = calories out to maintain weight.

More calories in than out = weight on.

naval-gazing! arf...