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??

mummylovesnancy "But, shock horror, I'm actually happy with my body. Why does everyone assume I'm sensitive about my weight? (because you have reacted in a very sensitive manner to some facts about pregnancy in over weight women) I sensitive to the fact that some little idiot has sat at his little desk and written a load of crap (of course they just made it all up and none of it is based on medical experience ). 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." But presumably you already have the information about the health risks of being obese and yet you have done nothing about it to date

Sorry if you find this offensive but it is important that people take responsibility for their own health. The NHS does not have unlimited resources to pick up the pieces. You may not have had any problems yet, but you undoubtably will have some weight related problems in the future.

ColdSancerre I'm not trying to make you feel like shit...I don't even know you.

If you feel like shit as a result of any of the comments on this thread, I'm sorry but that's not something I can do anything about.

I agree with RobotInDisguise. The issue is with the wording, not with the point it is trying to make.

I'd be pretty fucking pissed off with the midwife for lying though - she cannot tell you that you cannot have a homebirth or that you have to have consultant led care - you can decline consultant care if you wish (as can anyone) and it is the mother's decision as to where she chooses to give birth, however big or small she is.

By telling you you have to have consultant care (and therefore probably a CLU delivery) your chance of having an epidural (and the subsequent possible cascade of intervention) increases from the second you step into the booking-in appointment, regardless of actual risk factors.

No, I didn't slate HCPs in general, I spoke about my experience - anecdote does not equal data!

And actually they were all good MW - I had no issues with their competence or medical skills, but 2 had very school-mam style delivery which I, as an adult, found amusing.

I think what I would like to see in these leaflets are actual numbers and references. 'More' likely means nothing to me - how much more likely would, along with a reference to where they're getting those numbers from. That's how I can make my most informed decisions.

chiclet, people like things to happen how they expect them to. It's nothing against hcps in particular.

Jeremy, the majority of people who diet put all the weight back on and more. Add pregnancy into that and it's tempting fate.

If you eat less calories than you need to maintain weight, then you are eating less food than your body needs, so will be getting less nutrients than your body needs.
Care can be taken, but many diets that are commonly tried, low-fat, high-protein, atkins, dukan, lighter life etc. are not sensible healthy eating plans.

I also think that it is probably more of a problem for your body if you start out at a normal weight ,then pile on 3-4 stone in 9 months like some people i know ,myself included during my first pregnancy.

If you eat less calories than you need to maintain weight, then you are eating less food than your body needs, so will be getting less nutrients than your body needs.

Not if the weight you are maintaining is too much though, surely!

OP- it sounds like you are exactly the sort of person that the leaflet is trying to reach- you say you are happy with your weight, therefore, despite being very fat, which is clearly unhealthy, you aren't bothered so are not going to listen to any gentle advice. Seems like the shock factor has hit a nerve though.

betterwhenthesunshines The most annoying thing is, is that I've already had 2 children as an obese woman and have NEVER been advised on anything to do with my weight. Not even when I had my home birth and I was ever so slightly heavier than I am now. When I mentioned this to MW she just shrugged her shoulders and said 'new policy'.

As a very big lady myself I appreciate how offensive that leaflet was HOWEVER

you can't stick your head in the sand I'm trying to loose some weight before ttc so I know in my mind I've at least tried.

sorry to hear about miscarriage op , hope all goes well,

also bear in mind very underweight women have a high possibility of misscarriage due to the extreme in weight just to balance it out.

I disagree with your first sentence in your last post.

I don't like to see my patients with glucose intolerance develop gestational diabetes, even though I almost always often suspect it will.

And re eating less food than you need to maintain your weight, well if you weight 17 stone and are 5'4, why would you want to maintain your weight?

It does not follow at all that you are getting less nutrients than your body needs.

What your body needs it to not have 6 stone of extra fat stored on it (using the height and weight of my fictitious example earlier)

Part of me thinks YABU reasonable because there are risks associated with being larger, but then YANBU because you MW shouldn't have given you the leaflet without asking about your previous pregnancies.

I was 13st 7 at my booking appointment and I'm 5ft 8. So my BMI was 29. I was given a similarly nasty leaflet. This appointment trigged GTT tests, additional scans etc.. I'm sporty and was wearing a size 16 pair of jeans on that day. I went home and cried because I was putting my baby at risk. I lost 7lbs due to the stress in about a fortnight.

Then consultant I saw was annoyed about MW following crib sheets rather than using her common sense, yes I was overweight but clearly not unhealthy with it. Every time I saw a MW I was told to watch my diet because my BmI was high (despite not weighing me again) and I only put on 2st. I shut up and put up because these HCP are scared to death of not following procedure.

Goodness, but we know being fat is unhealthy, we don't mind the advice, what we object to is outright lying on a leaflet rather than giving accurate information!

So your answer is not to lose weight in the first place?

Alrighty then!

And again, yes, there are SOME ways of losing weight which are not healthy...plenty are! And the diet of an obese person is not necessarily providing all the nutrients needed.

Taking in less calories than your body uses does NOT = taking in less nutriens, vitamins, minerals than your body needs! Dont know why on earth you would think that.

It's a new policy because it's becoming a bigger and bigger problem.

There are more complications, both short and long term, for both mother and baby when the mother is very overweight or obese

It's a medical and scientific fact.

Maybe you should move where I am op, no one's mentioned my weight in pregnancy at all! Though they'd probably print the diet advice on a pie up here (joking).

I really don't think there is possibly a woman of child bearing age in this country who doesn't know that being fat is not conducive to being healthy. We are constantly bombarded with this information whether we're pregnant or not. The reasons why people overeat can be complex and varied and advice that boils down to 'don't pile on weight' is not generally helpful, particularly at such an emotional time IMHO.

What about people who are too thin? Do they get leaflets telling them their diet will be depriving their baby of vital nutrients and may be more at risk of disability? Ha, I think not, but I think that it is a silent issue.

I've seen plenty of acquaintances that only put on the weight of the baby, purposely as not to lose their pre-baby figure. I personally think this is more of an issue especially if that women plans to breastfeed as your body lays fat down in pregnancy to facilitate the production of breast milk that is supposed to be 50% saturated fat! If that woman doesn't have any fat in her diet or on her body, wheres it gonna come from? Seems to be more socially acceptable to attack the overweight women.

YANBU. Eat well and look after yourself, do not diet. I don't know if you've heard of the Weston A Price Foundation, but they have some great info on what pregnant/nursing mums should be eating and guess what? Doesn't follow the current NHS/FSA healthy eating mantra.

worraliberty - The NHS are not there to blow smoke up our arses

You pay good money for that up West you know!

Oh

That wasn't supposed to happen!

I'd like to know what leaflet is given to people who are too judgy :o

Actually, TOWI, I was asked by one brash registrar if I had an eating disorder as he clutched anorexia leaflets. If he'd read my notes he'd have seen that I had just got out of hospital for the hyperemesis. The problem is that some HCP are, you know, twats. Just like the general population.

The most annoying thing is, is that I've already had 2 children as an obese woman and have NEVER been advised on anything to do with my weight. Not even when I had my home birth and I was ever so slightly heavier than I am now. When I mentioned this to MW she just shrugged her shoulders and said 'new policy'

But the advice is there any time you want to go and get it.

However, knowing you are putting your unborn child and yourself at greater risk of complications, you still maintain that you are "Actually happy with your body"

Well good for you. There are also women out there who are happy to smoke and drink to excess during their pregnancies too.

But you shouldn't have to be advised to do something about your weight!!!!!

That's the whole point, surely you realise you're obese and ARE putting yourself at risk FGS. If no one has ever mentioned this to you before it's probably because it's deemed to be not PC and too personal but YOU SHOULD BE ABLE TO WORK THIS OUT FOR YOURSELF.

However, I do agree that it sounds as though the leaflet wasn't well worded, and a case of shutting the stable door blah blah... Maybe they are just trying to catch people who are already overweight so that they don't do the 'eating for 2 excuse' to pile on even more when they are pregnant which is even harder to lose.

Good luck with your pregnancy. I hope it goes well for you.

MHaze

My point was that losing weight quickly before ttc would not be a good idea.
Losing weight slowly through healthy diet and exercise because you want to be healthier anyway, would of course be a good thing.
'Dieting' nearly always leads to all of the weight being put back on though, so yes Jeremy, if the choice is stay at 15 stone, or lose 4 and end up weighing 17 then yes, don't lose weight in the first place if it means going on a diet.