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??

A low fat diet still has a reasonable amount of fat in it.

Anything below about 25% fat becomes unpalatable.

Of course controlling calories is a way to keep the weight off.

You either eat lots of protein and fibre and no refined carbs and reduce your fat intake at which point you can eat virtually as much or you like, or you eat what you like but you need to accept that you will have to watch portion sizes and control calories.

A pregnant obese woman who has only gained 5lbs after 40 weeks gestation has actually lost weight herself.

So despite her weight having gone up, she will have added on the 20 odd pounds or so that is the energetic cost of carrying to full term (baby, placenta, amniotic fluid, fat stores for lactation etc...).

Does that make sense?

Your weight will have gone up 5lb as a mother and baby duo, but your weight as a mother will have gone down.

This is what I'm referring to Thunder and this is not unhealthy or ill-advised for a very obese pregnant woman to do under many circumstances

Good post manic insomniac.

And yes judy, that's it. But maybe the " blinking obvious" isn't so obvious to a person with an eating disorder. It's kinda hard to exist on a day to day basis if you always are conscious to the fact that you are out if control, putting your health at risk, a useless piece of shit who can't just do a simple thing like eat well and excersize. And when you are aware of that, it's usually so overwhelmingly scarey and crushing that it's very hard not to just turn to your tried and tested way if anaesthetising your emotions ( with food). Usually completely on autopilot. It's horrible. I hate it so much about myself. I've tried my whole adult life to get a handle on it. And I'll keep trying. But a leaflet designed to scare and shame me isn't a help. I'm scared and ashamed anyway. That's the problem, not the answer

Ditziness you sound really troubled and I feel for you, I really do.

My SIL is a compulsive over-eater and CBT is doing wonders for her.

She doesn't at least hate herself as much and is getting a little more control over it.

Have you considered CBT?

I've had cbt. It did help. I lost six stone in the year following and for a few years felt good. But then life fell apart, and I fell
Back into old habits to cope. I am more aware these days, but still not able to beat it. Thanks for your concern, nice of you!

Chicliteeth nobody said that controlling calories isn't a way of losing weight. However it's another of these stupid approaches, like only looking at BMI rather than someone's whole lifestyle. These are sledgehammer approaches not ones that are paying attention to good or healthy nutrition.

The massive dieting industry which is based on calorie controlled weight loss isn't a huge business because that kind of dieting works, it's because it doesn't.

Are you a dieter?

No, not a dieter thunder.
I'm a very much one for the holistic approach, I can assure you and despite my classical western medical and scientific training, I certainly know it's not simply calories in/calories out lark.

You're right the dieting industry is based on the fact that you are likely to fail.

Which is why you shouldn't diet, you should permanently change your eating habits and don't look back and watch the changes occur slowly over time.

I do agree with you on the use of the word syns though.

It's not helpful at all.

If you play a word association game with a Brit and show them a picture of chocolate cake and they will say "naughty" "fattening" or some other such word. Play it with the French and they will say "celebration". It speaks volumes really doesn't it.

Oh and looky, even scientists are undecided about the effectiveness or otherwise of BMI as an indicator of health risks. There are even articles about it in Nature:

www.nature.com/nrendo/journal/v4/n6/full/ncpendmet0809.html

Well stick with it ditziness deep down you are stronger than you think you are and taking back control can only lead you from strength to strength

Good luck

I think that, 'blinking obvious' was an ill-judged turn of phrase. It is interesting that cbt had some help. I honestly think that all diets are wrong and a way into problems.

Well, I'm disgusted that my taxes have to be wasted on communicating basic, common-sense health information to wilfully irresponsible people like you, OP. Not shocked, though - one only has to walk down the street in this country to see how many people have let themselves get grossly, dangerously fat. You're clearly in denial about the extent to which you're compromising your own health, and being reminded that you're now compromising your baby's has sent you into a temper.

You are in deep denial if you think that your risk of having the pregnancy and birth complications the leaflet mentions is not increased by your obesity. Statistically, it is - even if you've been lucky enough to beat the odds with your first two babies. Would you expect the NHS to warn TTC/pregnant women who drink heavily, smoke 40 cigarettes a day, or use drugs, of the associated risks to their babies? Or do you think the health service should mind its own business? If you want to call the shots, you're welcome to abandon the NHS and go private. I for one would much rather the NHS were able to use its limited resources caring for people who haven't had the luxury of choosing to cause their own health problems.

hairy, as dieting usually results in the dieter ending up heavier than they started then simply remaining obese is healthier actually.

chiclet, the low fat diet I did, the old school RC Hip and Thigh was very low fat. All oils, nuts etc. were banned and any food item had to have less than 4% fat in it.
It was quite unpalatable.

I can't read it, don't subscribe.

What does it say?

I've thoroughly pissed off the midwife from the healthy living team during my pregnancy. Job done. Their leaflet and their assumptions have been advised to take a running jump, and I am trundling through my pregnancy merrily, healthily and without adhering to any of the things on their list of doom.

What I didn't appreciate was being spoken to like an imbecile. The midwife was shocked that I am educated, and fully aware of the possible risks to pregnancy as an overweight woman. She didn't like that I couldn't be cowed and that I was more aware of my issues than she was, having lived with them for many years, not just assumed a bunch of stuff because I had been referred to a specific team within the service.

As it is, I have lost weight, my blood pressure is perfect and my GTT test came back with numbers so shiny and admirable that she had literally nothing to say about them. My scans were fine, though the 20 week scan took a while as the baby was asleep.

I've been referred back to the 'normal' midwifery team and although I have to see a consultant next week I am fully prepared to tell her to go to hell away if she starts telling me what I will be subjected to in labour. I am pretty easy going, and my birth plan is quite short and fluid really and I'm open to discussion and compromise. I just hope the consultant is, because if she has the same attitude as the midwife I saw for the first half of my pregnancy the appointment will be very very short, as I will politely make my excuses and leave.

I"m just reading the abstract which says that researchers are not in agreement about BMI as a tool to measure obesity related risk. So this idea that it can be promoted as an agreed upon scientific tool is a mistake.

"What I didn't appreciate was being spoken to like an imbecile."

Well that seems to be par for the course for a large number of the medical profession. They don't think it's possible for people to grasp even the most simple facts, like the idea that a woman who maintains the same weight in pregnancy has lost weight because when she gives birth, she loses the weight of the baby inside her. Well I never.

Researchers never agree about anything thunder.

It's par for the course.

I do agree with it's use when taken with a full medical history. Of course there are exceptions to every rule; it's a self-selecting population who have high BMI's and are on this thread, so this level of resistance doesn't surprise me.

Do you diet thunder

I stuck to it as it was working I guess, I lost weight.

Dieting is the other side of the disordered eating coin for the binge/compulsive over eater. It isn't healthy eating though so it's not sustainable in the long-term.

I never tell patients to diet.
It is not a word I use.

We discuss changing eating habits and how this will benefit them and most importantly, how to practically achieve this without ever using the word diet or deprivation.

This thread is a mine of information - researchers never agree about anything. Who knew?

No of course I don't diet. As I said calorie controlled dieting is not a good idea.

That sounds great chiclet, it's what many people need.

It would be a wasted appointment without an additional series of sessions with a psychiatrist for many though.

That seems to be the main problem on these threads is that the fat-haterz don't understand that for many obese people there's a big psychological component.
One can know and understand all the risks, all the nutritional and exercise advice and want to change and still be unable to. And not know why.

It's good that you don't tell your patients to diet either. Positive messages about eating well are far more useful.

You didn't seem to understand that earlier thunder when you said twice we weren't having the same conversation.

This thread is about pregnancy, not dieting in general; like I said you were either being obtuse or you are ignorant.

I presumed the least offensive of those two when considering my explanation to you

I am making obvious statements in response to your desperate attempts to dash the legitimacy of using BMI.

So in response to your "who knew" I would suggest that you, (your attempts at what seems like eye-rolling please don't state the bleeding obvious statements) that you, you don't know.

This thread really isn't about dieting thunder why are you turning it into one.

You don't diet then thunder?

You are very interested in diets considering they don't actually affect your life?

Are you a failed dieter?

Either way, my guess is your BMI is not within the healthy range since you protest too much of its relevance.

I could be wrong of course