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 you are overweight or obese pregnancy isn't a barrier to losing weight (excess fat) it is very possible to lose fat in pregnancy by eating healthily. In fact surely pregnancy is a really good time to lose weight if your weight is threatening your health or your baby's health.

Who is saying we should be skinny?

but you dont get monitored more closely, you get a consultant app and a gtt test which all woman have any way. so really the leaflet is for what?

Actually there is scientific proof that 'larger ladies' (lol) are more prone to still birth and miscarriage because of their high cholesterol and some other reasons that I can't remember (Got all this from my husband, who is a doctor) so the last point, although crude and entirely useless, is actually true, and your interpretation of it, "Thanks for that one, nhs, I just had a misscarriage 8 weeks ago. Was it because I'm fat?" essentially had some truth in it, IT COULD HAVE BEEN PARTY BECAUSE OF YOUR WEIGHT. :L

Erm, I don't think 'porking' up has ever been 33 BMI in the progress of human evolution. 'Porking' up would have been putting on just enough weight to survive. It probably wouldn't even be 'overweight' by todays modern standards.

No one said that being really skinny is healthy. I don't see what thats got to do with anything on this thread other than the fact that you're being ultra defence and so are coming up with some crackers to justify your opinion.

Given what toothbrush just said on the post prior to you, I find your comment somewhat ironic.

I can't comment without seeing the wording of the leaflet about whether YA or ANBU but I think part of the reason for this type of leaflet is the lawsuits that are becoming increasingly common these days. They have to be able to prove that the patient was made aware of the risks, ditto the home birth policy, I think a lot of the fear is that the NHS may be sued when something does go wrong.

Loopsy that's really not very nice. You have no idea at all why she mc'd. Blaming someone for their miscarriages is horrible.

The leaflets I hand out were designed by a media company and agreed by a national body having been advised by various steering groups for equality & diversity and disability discrimation. They have also been reviewed by users and staff and changes made in response to patients feelings. Finally an information advisior for the dept of health has ok'd them

Patients still complain.

Individuals they want the leaflet to say x or y or z

Frankly you're never going to get it right

YANBU, and everyone here who thinks you are is, in my opinion, being incredibly insensitive. Just because you are "larger" doesn't mean you will 100% be having every single one of those issues. And loopsylou, what on earth are you thinking?!

"the last point, although crude and entirely useless, is actually true, and your interpretation of it, "Thanks for that one, nhs, I just had a misscarriage 8 weeks ago. Was it because I'm fat?" essentially had some truth in it, IT COULD HAVE BEEN PARTY BECAUSE OF YOUR WEIGHT. :L"

It could have been down to a million different reasons, and if you had said that to someone in real life then they would have punched you. That's a really horrible thing to say.

I'd also just like to say that BMI is absolute BOLLOCKS. It doesn't take into account muscle, which weighs more than fat, and it doesn't take into account your general health and wellbeing, diet and other factors.

It's like being told "You're tall, therefore you have long legs". Not necessarily - it changes throughout the day, and the length of your body, neck, even the size of your head, coupled with the length of your legs has to factor into it.

I'd tell them that, actually, it's fucking insensitive, you've taken serious umbridge to it and they can stick it up their arse.

If i was a HCP i would have no hesitation in pointing to the dangers of obesity. In exactly the same way i would point out the dangers of smoking, drug taking or eating soft cheeses or pate.

Unfortunately the NHS leaflet is aimed at the lowest common denominator because they are the very people who are likely to ignore health guidelines while they are trying to conceive or are pregnant.

Stealth - have to actually read the thread?

StealthPenguin Without meeting the op i can personally guarantee that she is not an olympic standard weightlifter, she is obese.

This defensiveness is ridiculous.

According to BMI I'M obses, and yet somehow they don't seem to take into account that I'm a size 10-12 and an avid runner. But no, my doctor still claims that I'm "obese" and must therefore lose weight.

So my defensiveness is that I have to deal with this when I'm, in my opinion, not obese. And I'm defensive because 13 stone doesn't sound very bloody obese to me either. She just sounds like a lovely, normal woman.

Pardon me. *Obese.

I find the denial about obesity odd.

Be happy in your weight, if it's your choice. Why pretend that a BMI of 33 is due to increased muscle??

Yes the BMI is a crude indicator of physique but usually it's athletes which get caught out ...and not caught out to the degree of being obese.

It does increase risks, but if you don't wish to be informed about it, then say upfront to all HCPs I don't want your information thank you. It is a perfectly acceptable decision that you can make about your body.

It is not acceptable to force HCPs to deny other people the benefit of help to change, when confronted with facts.

There are many people who would like to lose weight and are unhappy with their weight. This brief intervention might be the trigger to help them change and get help to do so

At 5ft you'd have to be 11stone to be considered obese.

the person i was referring to was talking about being over weight.may have missed tooths post, sorry you feel i am being defensive in truth i dont feel overly defensive about my weight or anyone elses. its a matter of opinion verses medical stats. there are 101 reasons why someone may miscarry and no one can be sure why they do, again with SID but to tell people that being over weight is the possible reason seems unreasonable to me. again when you are discussing things that can happen to any woman during pregnancy, i am not really sure i understand your outrage at the fact that as woman that are over weight or obese we dont particularly want to be singled out when the things they are talking about are a risk to all pregnant women.
the other problem i suppose is that as a person that has a high bmi my opinion will not be held as valid by anyone because it will be decided by others to be based on emotions rather than the fact that a genuinely dont agree that it is right.
the your fat get over it brigade is in some ways right in the sense that we shouldn't really expect any different it is just playground bullying with a legitimate tag. if you are one of the people that are fat then you cant really hold an opinion because being fat obviously makes you wrong and defensive.
the nhs say so and they have never been wrong about anything.

If you are fat, overweight or obese and happy with your body, fine. However, you should never ignore, over look or try to pass off the health risks as nonsense and you shouldn't be offended when those risks are pointed out to you. Saying that is is unhealthy to be too thin is kind of pointless. Yes it is also unhealthy for different reasons, none of which make it fine to be fat.

11 stone? really

that would be the perfect weight for my height

How tall would you have to be for 13 stone to be a normal woman? I'm 5'7" and weigh ten. And I have a very high muscle content, massive feet, shoulders and hands.

If I weighed 13 stone I'd be bloody fat and i have a large, muscular frame. The OP at 5'2" must be very fat indeed, not a normal lovely woman.
All this denial is bloody ridiculous!

StealthPenguin I'm also 5'2. I'm 7 stone 6. I'm at the low end of the healthy range. She's nearly twice my weight.

Your doctor probably is better qualified than you to tell you, if you are obese. He would not needlessly tell you this. Even if you aren't obese, if he's saying that you are overweight and still need to loose weight... By hey ho. He's just trying to help you and you are pretty within your rights to ignore him.

Look at - 6 ft

spooks you are in denial & the thing about denial - and everyone does it at sometime in their life - is you dont know you are doing it.

its your brain protecting you from reality because sometimes life sucks & we arent in the right place to deal with it so we deny it...

why you cannot get anyone else to understand it that we are not in denial.

OP

Haven't read the whole thread, but the most constructive thing you can do is to rewrite the leaflet in a way you find acceptable, with a cover letter and ask the midwife to hand it to the head of the service. They may well be interested in ways to make their leaflets more acceptable to patients.

As atyourcervix said there is a need for written information as appointment time is limited, and it is important that people are informed about risk. It does not sound as though the person who wrote this had a good grasp of scientific language and 'larger ladies' is going to get anyone's back up, whether pregnant, obese or otherwise...

Hope all goes well with your pregnancy