AIBU to think that this is not an appropriate letter to send to pregnant mums?

[Magicmonster]

I am 33weeks pregnant. I have received a letter from an organisation that appears to be affiliated to my local hospital inviting me to participate in a study for women 'who consider that they have put on too much weight during pregnancy'. The study seems to involve participation in a number of weight management projects from 6 weeks post pregnancy including following a slimming world programme.

Having carried out some research online it appears that women are invited to participate in this study if their bmi was over 25 at the time of their booking appointment or they are considered to have put on too much weight during pregnancy.

My bmi at booking appointmnet was 24 and I have put on 11kg during the pregnancy.

But leaving aside the issue of whether I need to lose weight (which is not what this thread is intended to be about), my view is that sending an unsolicited letter like this to women who are heavily pregnant is not the best way to go about supporting women?

I personally don't think that women in the third trimester or who have very recently had a baby should be focusing on weight loss, unless of course their weight is a real problem, in which case I believe that a doctor or midwife should sit down and talk to them about this in person in a sensitive manner, rather than recommending them for a weight management programme without further discussion. Especially when pregnancy hormones can make you feel irrationally upset at the best of times!

I would be interested in people's views as I do feel it was an inappropriate letter to send to any pregnant woman out of the blue. For some people it could place unnecessary pressure on them and lead them to feel like failures at a time when (barring a major weight problem) weight loss should not be high on their agendas. But maybe I am just being too sensitive because of those pregnancy hormones!!

Totally agree with you and I would be contacting the health board to complain formally that my personal info had been passed on and used in this way without any prior discussion.

To be honest, I think the "OMG we must never discuss weight with overweight people" attitude, really isn't helping our rapidly growing obesity problem.

Most NHS staff are overstretched and really don't have time to sit and gently discuss these things, with people who are quite likely to become offended anyway.

They recommend all sorts of things from smoking cessation to drink/drugs etc, to benefit the health of the mother and baby.

I don't see why weight should be any different.

What Worra said.

You don't have to be offended about everything you know.

Too many people are unwilling to see, and talk about the truth. Being fat is bad for you. And most fat women get fat because of pregnancy weight.

And I speak as someone with 15 k to lose.

Think you're being too sensitive. Sorry OP if you need to lose weight (and I say that as someone with a BMI of 36) then you do - I think what has prevented me was living in a shadow and not thinking i should do anything about my weight.

I would say this is a really good idea I certainly would have been interested.

Pregnant women get seen once a month at least by the midwife. If this discussion needs to be had, there is time for it during appointments.
Weight is an emotive subject and caught up with so much of what goes on in our heads, so blithely sending this out to pg women, who are already affected by hormones and are more vulnerable is wrong.

Not sure how medics are supposed to carry out research in this particular area without inviting people who fit the criteria to participate. Progress only happens with research and understanding a problem. I had plenty when I was pregnant for various reasons.

Unless the letter said 'oi fatties come fill in my questionnaire', I think you're over thinking it.

When I had a serious illness- I was invited to take part in lots of studies - many of them I did take part in - with the idea that eventually it might help people who were going through the same thing.

I imagine this study is trying to find out the best way to help women (who want to) lose weight after pregnancy, if it is offering a variety of weight loss programmes. Some people would find that info very useful.

If it's not for you then you don;t have to take part - just throw the letter away, I don't think it is offensive to ask people - one can always say no.

I think its inappropriate unless there had already been a discussion at booking or a later point when individuals were weighed AND you had agreed to details being passed onto another organisation.

That letter could be sent to someone who already has disordered eating habits, to someone who has recently split from their partner during pregnancy, suffering from pre-natal depression... it is inappropriate unless the midwives are doing a thorough screening and that would require a discussion.

To be honest, I think the "OMG we must never discuss weight with overweight people" attitude, really isn't helping our rapidly growing obesity problem.

Absolutely. Look at the outrage everytime parents are told their children are overweight.

Thanks for the replies. I do agree that people need to take responsibility for their weight loss and that the issue should be talked about and not swept under the carpet. I think my main issue is with the timing of the letter, as well as it's wording. I would not have an issue with a letter going out say 3mnths post childbirth asking whether they would be interested in participating in this weight management programme. I think my main issue is with making women feel like some medical professional has judged that it should be one of their priorities in the third trimester or shortly after childbirth, especially when the criteria for sending the letters seems to include people who do not have major problems with their weight.

I do appreciate the different perspectives though, which is why I asked on here (friends in real life are obviously much more likely to just agree with you!)

Seems reasonable to me, if people are indicated by being overweight by Bmi at booking in they will already know that they are overweight it's literally just opening a really good opportunity to those people. My Bmi wouldn't let me qualify for this however if it did I'd be really pleased.

I think sending it out of the blue is a bit insensitive but I don't think it is a terrible idea per se.... I'm pregnant with a high BMI and would be happy to participate in something like this although I was fat prior to pregnancy

It should have been mentioned earlier (maybe at booking appointment?) and mums should be advised something along the lines of 'you'll receive a letter in your last trimester which is going out to all mums with a BMI over 25 at booking. It's an optional weight management scheme, aimed to support those who feel they need help and isn't intended to cause any stress or offense'

It is definitely the letter arriving out of the blue I'd take issue with and not the actual idea of weight loss support. I bloody hope my hospital offer me something like this [I'll be heading to SW at 6 weeks PP anyway]

These kind of studies are vital. If you don't want to participate, just say no. It's not compulsory.

"I believe that a doctor or midwife should sit down and talk to them about this in person in a sensitive manner, rather than recommending them for a weight management programme without further discussion."

I take it you're going to volunteer to pay 99% income tax to afford this amazing personalised-shopping Selfridges style free healthcare system? And you'll be training the tonne of new doctors needed it staff it?

You are being super unrealistic. It sounds like an efficient way to reach women who have gained a lot of weight during pregnancy to me. Take it or leave it.

I agree with what worra said. Plus I'd be delighted to be in a study -- would incentivise me!!

Research needs to happen. Ignore the letter if you want too - or participate and be grateful for the NHS and the doctors trying to improve it!

I agree with worra, our own self esteem issues are blocking any dialogue about improving our health. If no one discusses weight loss then it does sort of normalise pbeing overweight.

Frame the letter as if it was talking about high blood pressure in pregnancy, how do you feel about it then?

I think you are over thinking it too. They need to do the research, and there probably are quite a few women who would like the extra support.

Please don't bring the hormonal thing into it as well. We are women, we have hormonal things going on. But the "at this hormonal time" bollix needs to stop. We do ourselves a massive disservice by blaming our every reaction to every single thing on it.

They're not trying to support women, they're trying to do a study. If that study gets results they can then use that information to support women. It's an invitation, not a summons!

It would be different if the approach came from the MW who felt it was appropriate for your circumstances rather than a blind mail out based on data.

There's lot's of reasons why women gain weight in pregnancy. I started off comfortably in the healthy zone, lost weight while clearly gaining bump while barely able to eat from nausea. By the time the exhaustion wore off and my appetite resumed, I'd lost a lot of fitness and muscle tone. SPD then kicked in making me increasingly sedentary. In the last couple of months sitting and eating was one of the few pleasures accessible to me and I craved sweet foods and drinks for energy as my sleep was so disturbed by the pain. In less than 5 months I gained 50% of my bodyweight. Much of that was baby related and water retention, but I was left with a couple of stones to lose after the easy birth weight settled. Returning to decent eating habits and rebuilding my fitness meant that it was a fairly straightforward process with some patience and I was successful at losing it, and actually settling under the original weight.

Weight is a complicated issue and shouldn't be brushed under the carpet, but it does need addressing in an appropriate manner to the trigger conditions. A general data driven letter like this may be more harmful to more people than it is beneficial.

Maybe they ought to look at the putting on of unnecessary weight during pregnancy rather than worry about it after it's happened.

Medical issues aside there is no need to pile on 2 or 3 + stone during pregnancy and maybe giving pregnant ladies help and support to not pile it on in the first place would be more beneficial than trying to deal with it afterwards.

It's a good thing imo.

Some (including me) was already a bit too heavy at booking in, especially the second pg because I hadn't lost weight from the first pg.

I would have welcomed the idea of some guidance and support after (or during even) the pg beyond "eat lots of leafy greens, pulses etc"... we all know that but it's turning it into a workable everyday diet that's the issue!

I wonder how much PPI was done when funding applications were made fr this project. They would have got short shrift from some members of the panel I'm on if they had even suggested that sending out letters indiscriminately was in any way appropriate or efficient.

I think they are certainly BU to recommend Slimming World which will only make you fatter in the end.

Eat more healthily, move more is OK advise. Pushing people over to the odious megacorp, WeWillFuckYouUpAndMakeYouFatterAndMakeProfitFromYouTooSlimmingWorld is completely U.

Syns my arse!

Why does it cost extra money for the midwife to mention this during a routine antenatal appt? People are not cattle. Not all pg women are coming into pregnancy with the same background. Some have eatong disorders already, or mh issues. If women are to be cared for properly, then medicine has to be personal.

That the nhs is stretched, is not a valid reason to accept slack attitudes towards patients. State of mind is really important.
I'm not saying this study has no value because of course it does, but it is likely to be more successful if it is discussed in advance.