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??

Next time I get a case of gestational diabetes referred to me, I'll just sit there and smile and ask about their weekend and whether they like my new farrow and ball paint shall I?

Is this what people want from their HCPs?

breastfeeding might become an issue as fatties might smother their infants in their giant boobs and rolls and rolls of fat. Or perhaps it's just that it might bother the other customers in McDonalds?

I'm all for informing people about risks and complications. But they should do something to actually help you when they are informing you. The most important advice would be about what a reasonable weight gain, if any, would be, and dietary advice. Not scaring you shitless about neonatal deaths.

I'm not in denial. I know I'm fat, as I said. But, shock horror, I'm actually happy with my body. Why does everyone assume I'm sensitive about my weight? I sensitive to the fact that some little idiot has sat at his little desk and written a load of crap. I've said it before and I'll say it again, yes, they should be giving out this information, it's very important but they also should be giving it out in a more responsible way. 'breastfeeding will be challenging' - well how the hell do they know that it WILL be challenging, not all fatties have big boobs! 'you WILL have restricted mobility' - well bugger me, will that happen over night? I am annoyed with this but I know not to take it as it's written. Some people won't.

Chunkypickle - you are also in denial.

You'd be healthier if you weren't fat.

So would I.

There's a reason why you almost never see people over 80 who are carrying large amount of extra weight. It's because they mostly die in their early 70's and sixties, often after many, many years of poor health.

When it comes to obesity - reaping what you sow tends not to happen until you hit your fifties. I know plenty of very overweight mums in their 30's and 40's who have lots of energy, great skin, healthy blood pressure etc. But they're still at higher risk of cancer and heart disease. And of dying young. And when it comes to childbirth, yes you are right that poor outcomes associated with obesity are still not the norm (which is why we're not conscious of them in our day to day lives) but when they do happen they're devastating to everyone involved.

No, out of 4 midwives in the practise I attended, there were 2 with a style that was definitely lecturing and judgemental, and 2 who explained the risks, and gave information without being patronising.

The most important advice would be about what a reasonable weight gain, if any, would be, and dietary advice

I should imagine that's what happens when you go to see the dietician at the appointment they arrange like the bastards they are.

And it also shouldn't be actively promoting epidural, in my opinion.

It's not a load of crap MLN. It's just badly worded, very badly worded.

Bin it and forget about it, if you are aware of possible complications (and you sound as if you are) then put it out of your mind. Others who get that leaflet, may have no clue and may actually learn something.

I was responding to the comment "there are selfish people who actually plan pregnancies when they are overweight".

Why on earth shouldn't an overweight person plan a pregnancy? Not a single one of us has perfect health or is perfect in other ways. ALL people who plan a pregnancy will have failings of some kind.

"Why does everyone assume I'm sensitive about my weight?"

Mostly it's because they assume that you probably don't want to die in your 60's and spend the last 10 years of your life battling diabetes, heart disease or cancer.

ColdSancerre, love - hide this thread. Stress is the demon of conception.

There are some (deliberately?) vile postings on this thread.

Empathy FFS! Not feathery-strokey crap, just a bit of bloody empathy.

You said it says you may want and epidural?

How is that promoting it?

Then why bother with the leaflet? Why not a chat saying, "look, you know you are significantly overweight, and that increases several risks during pregnancy, such as an increased possibility of high blood pressure, clots, and diabetes. Since these are serious risks we are sending you to a dietician to discuss your diet and weight management"

Surely that little conversation would have done the trick without the awfully worded leaflet?

ElaineReese

chiclet, just basic psychology.

Queen, losing 8 stone in a year would be losing weight very quickly for instance, not recommended. Over two years that would be a healthy loss, but still likely to regain some during pregnancy, and still likely to be vit/min deficient.

Timewasting - well yes, it'll all be piled back on if you eat too much again (during pg or any other time). It's not inevitable and lots of women pile on lads of weight in pg anyay- I dont think thats a risk reserved for those who have been fat in the past. Certainly not a reason to NOT lose the weight in the first place.

And yes, I'm sure some LC diets are lacking in nutrients if not done sensibly, in theory (and in reality for lots of people) a diet for weight loss should be brimming with vitamins and minerals, makes sense really, doesnt it?

And a diet that leads to/maintains an obese frame is no more likely to be providing V&M's really, is it?

ColdSancerre - of course you should keep TTC.

Don't read this thread. Fingers crossed for you and if and when you conceive, you will (hopefully) be given the correct information re all aspects of a healthy pregnancy and you will undoubtedly do the best for you and your baby.

What is basic psychology?

OK, I think that:

• "Will" should have been replaced by "may" or "in many cases".

• In the case of the physical examination, they should have been more specific. For example:

"Examinations may take longer, which could cause you some discomfort. This is because generally it's harder to locate the cervix in women who are overweight."

Which puts it to you straight rather than leaving you to jump to the conclusion above, which I'd imagine is the conclusion most people would jump to.

"Will be more difficult" is their end of things, not yours, which sounds like they're being accusatory.

I think you should write and give them feedback. Also send back the leaflet with all the grammatical mistakes ringed - or if you wish to hold onto it, give feedback as an editor would, ie:

1. Literal error par 2, replace "it's" with "its"
2. Literal error par 4, replace "there" with "their"

etc.

I'm not in denial - of course I would be healthier if I wasn't fat, we all have various risk factors in our lives, and that is one of mine. I'm not going to spend my life worrying or being guilty about it though, because I went through enough of that as a fat teenager, and stress/unhappiness would just be further risk-factors.

We all pick and choose our risks. Everytime we cross the road, eat food left out overnight, or walk in the rain we're taking risks, and you just have to choose which ones you're comfortable with, and which ones you're going to take the effort to mitigate

I'd like to see some stats on this 'fatties not making it past 80' thing, because I see plenty of well-padded 80 year-olds..

Arguing that you don't have restricted mobility when you are 30% heavier than ideal sounds like denial to me.

TSC - rather than being enraged and indignant.

I read that as enlarged and indignant...

Why would any person take medical advice from someone who is incapable of using punctuation correctly and who includes fundamental inaccuracies in their leaflet (will, instead of may ). Does no one proof read this shit before handing it out to patients? This hardly inspires faith in their medical abilities.

I am overweight and have had 4 dc - I'd like to know where the bloody hell my epidurals were, because i certainly didn't get them, despite repeated requests screams.

yes chunky but you only mention the crap ones don't you.

Same as another thread earlier in the week about how crap some GPs are (and they are, mine is terrible but at least I have more leverage with him).

So you have two good MW's and two bad MW's yet you sit here slating HCP's in general.

Bad form IMO

I was obese when i got pregnant last time , i am 5'7 and weighed 14 stone , cant remember what my BMI was but the MW was happy for me to have a homebirth. I was careful with my diet though and only put on about 14 pounds during the whole of my pregnancy . My bp the day i went into labour was 95/50 , but i normally have a lowish bp and pregnancy doesnt apppear to effect it . never had a uti and never had gestational diabetes. The day before labour i was pushing a wheel barrow round three acres and shovelling horse poo , after which i took the dog for a nice long walk .
Clearly life would of been nicer had i weighed less , i would of been more yummy mummy to be , but i was fit and healthy.
Oh and none of the student mw or mw who examined me had any trouble palpating any part of me .
Advice should be given in a way which helps people feel they can easily make changes to their lifestyle if necessary ,not patronise or alienate .