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??

"What is the recipient supposed to do about it though?"

Be aware of what might happen & eat sensibly & excercise?

OP so do you think they are making it up?

Well there are any number of things that might happen in pregnancy. I question whether it's right to hand out blanket statements about stillbirths and blood clots and so forth. OK so you don't have much time in your consultation but could people not just be told there and then not be careful not to put on extra weight because of potential complications.

But I suppose handing out a scarey leaflet means the job is done.

the tone it's written is totally patrionising and completely presumptious

YANBU to think that the tone is patronising and the but YABU to be 'shocked and disgusted' because you're presented with information on how the lifestyle choices you make can affect your pregnancy

Well some of it may be quite true but it is poorly worded and the 'will' should def read 'may' you are quite right.

But there seems to be a lot of this in medical care these days; I've noticed this quite often. You get handed a 'leaflet' about whatever you have and off you go, job done

People should be treated as individuals and with respect where their health is concerned. Not handed a leaflet.

Did it not mention smoking,drinking alcohol,taking drugs too.

Not very tactfully put, but a lot of that info is true and based on actual stats

Sorry it made you feel crap, but they would be failing in their duty of care not to point out the risks you run compared with a woman of normal BMI.

Posted too soon... I was going to say that I would much prefer that a MW/the NHS be brutally honest about risks than dance around the issue so much that I had a false sense of security. Not pregant but I had a very major op a couple of months ago and before I went into theatre the surgeon came out and went through all of the things that could possibly go wrong, how bad recovery was going to be, how they might need to take out an awful lot more than they thought etc. and it was scary but I preferred to know the risks beforehand than wake up in ICU with a major disability that I didn't know was coming... or not wake up at all.

The truth is often hurtful, especially when so blunt.

YABU

If they dress these things up with candle light and soft music, people tend not to take a blind bit of notice.

At least the wording has made you actually read it...even if it has annoyed you.

They got tough on pregnant smokers years ago, now they're getting tough on pregnant overweight Mums for the same reason.

Shock tactics work better than softly softly. Not sure why you have "obese" in inverted commas...sounds li,e you are very sensitive about your weight, which is totally fair enough. There are increased risks if you are overweight and pregnant...they have to make that clear.

Sorry OP but I think at 13st and 5'2" health professionals have a duty of care to point out that you are very overweight and this has been linked to complications in pregnancy.

As for the quality of literature made available to the midwife to pass on to you, sounds like shock tactics to me. Obesity and the problems it has been linked to is a massive drain on NHS resources and it only seems to be getting worse. If it get's people discussing the problem then that's great. It's only really worked if it gets people to eat less and exercise more though....

YANBU. What a lot of rubbish!

FFS people really don't listen do they? . I look forward to the similarly worded information leaflet handed out to lung cancer sufferers then.

If insulting people and making them feel like shit at a vulnerable time is the best way they can think of to get information across then the wrong people are producing the leaflets.

I agree when a lot of you say that these are the facts and the nhs has a duty to inform people of them. I am not dismissing that in any way. I appreciate how important a lot of that facts in this leaflet are and some of them do apply to me. But I stand by my original statement of being shocked and disgusted. My booking in appointment lasted over 2 hours (!) and most of it was spent filling in questions like 'are you employed?' and 'what is the highest level of education you recieved?'. Instead of utterly useless questions like that, the mw could have been explaining these issues to me personally.
I know that the 'Examinations will be difficult' meant palpating as I've been pregnant twice but what would a first time mother think to that?!
The way the whole thing came across to me was as if they were saying 'Look what you've done you silly fat cow, how dare you?' Like I said before. So many better ways they could handle this.

OP, when I worked in a large NHS hospital there were zillions of patient leaflets floating around, often written by an enthusiastic doctor, usually unchecked by anyone else, sometimes of shockingly poor quality. It sounds as though your leaflet has been written by some shmo who knows everything there is to know about obstetric cholestasis but not how to communicate well with their patients. They need to be told.

Do think about giving feedback - I don't think there's much to be gained by going in all guns blazing saying how very dare you (because you'll just come over as someone in denial) but i do think you should say to them something like, "There was useful information in that leaflet but I found it hard to concentrate on because I was so enraged by the didactic and patronising language. I would really like you to feed back to whoever is responsible for the leaflet that it needs improvement, and I would be happy to provide further comment as part of that".

The time would have been better spent talking to you about weight control during your pregnancy, how to keep your blood pressure down, and how to manage your increased risk of blood clots. Was any of this mentioned in this leaflet?

What would you prefer they use instead of "bigger ladies"? Would "The obese" have been better?

They have to get the facts across somehow. Just because you didn't have these problems in previous pregnancies does not mean the statistics and comments are wrong.

IME, all pregnant women are patronised. I say this as I was a severely underweight pregnant woman, twice, due to severe hyperemesis. I was told during both pregnancies that a) the hyperemesis was in my head (excuse me while I vomit on your shoes, fuckwit), b) that exercise would help (I couldn't raise my head off the fucking pillow without going all 'Exorcist') and c) I was starving my baby. All extremely helpful I always felt that health professionals generally treated me as a rather dim and nervous cow when I was up duffed

I'd be interested to see the leaflet if you have it please? I have seen several, including this one and this one - but I haven't seen one that is like the one the OP describes. I am shocked that a UK health authority would be allowed to publish one that makes such statements.

All 'official' leaflets are supposed to be well written, good English and lowish reading age

This is plain wrong. You may be at increased risk of these things but to say you will suffer them is daft.

Is the same crap given to to 13 st and 23 st women? Does it suggest the risk is proportional to size? Does it have any useful advice and what is it's purpose other than to scare you?

No one can stop you having a home birth. BMI Police don't exist. Yet

ps Are you a Lady ?

yanbu. they shouldn't be giving misinformation out. and should balance the hectoring with positive advice, just saying get counselling/dietician referral is a bit unrealistic, the sort of info atyourcervix gave in her post, about diet/not putting on more weight would be useful.