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!!

I agree with KurriKurri
I've taken part in a few studies now,
( i'm not skinny btw).
I've always thought if my taking part could help others in the future then that's good.
How are researchers supposed to get volunteers without doing this?

I don't think it's targetted at all - I was invited to a weight clinic when I was last pregnant. I have never been overweight and put on a total of 11lb when pregnant with that baby (who weighed 7!)

I think it's fine to send a letter inviting people to participate in a research trial. It happens all the time and you either opt in or out.
I'd have liked the opportunity to discuss my weight after my pregnancy. My health visitor was brilliant but her healthy eating advice consisted of telling me to increase my calories because I was breastfeeding.Being able to discuss health and nutrition with someone a bit more experienced would have been beneficial.

Women who gain a lot of weight in pregnancy may do so for many reasons. It could be normal for them, or could be over eating, it could be pregnancy diabetes which isn't apparent.....plus many more.

It's important to study this ...outcomes in birth for women who are overweight can be adverse. It's worth bearing this in mind.

However, as an ex-Midwife I think this could have been done better. Even an explanation in the notes that a study is ongoing and you might receive a letter.

Likewise they may have contacted you to see if you will take part as a control.

Snot the NHS already supports pregnant women with weightloss using SW as their only recommended commercially available programme. Simply because SW is about changing your eating habits and making healthy choices and not dietary deprivation to achieve weightloss. It offers the support that huge numbers of people looking to lose weight need because there are almost always underlying issues which influence eating problems.

Op you've simply been invited to participate in a study. You've been chosen from statistical data, you're just numbers on a sheet. Nobody is judging you, they simply want to learn from you in order to better help others. If you're not interested just decline or simply throw the letter in the bin.

dd is expecting her first baby in 5 weeks and in our area we have a health in pregnancy adviser who sees all those whose BMI is either too high or too low and she will also see those who smoke. She has much more success with the ones with higher BMI than the others and Dd has found her visits very useful. This means that so far she has only put on 6kgs, which she has been told, is just the weight of the baby, placenta and womb growth.

Dd would love to have support after the baby has been born to help her lose any non pregnancy weight.

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.

This ^^

Did you tick a box saying you were interested in taking part in studies? Sometimes, early on in pg, you agree to things and then completely forget that you have.

I would have been interested in this and would have taken part tbh.

If it's part of a research study it will have been approved by an ethics committee who focus on the rights of the participants and how patients are recruited etc. They scrutinise everything from how you identify and contact potential participants to the wording of any letters sent out etc. If you have felt that the letter was inappropriate I would seriously consider contacting the ethics committee to let them know (the researcher should have made it clear that the research was approved by an ethics committee and who they are). Having worked closely with some ethics committees, they do generally welcome feedback.

Yeah I agree with others that it should have been mentioned in the beginning of the pregnancy that your area was participating in a study. An out of the blue letter is a little annoying.

I'm not sure why you got one though as you don't seem to fit the criteria? I've put on 16kg and I'm 37 weeks luckily my midwife was really nice about it and said it is the upper end but no worries as I was healthy weight before. I'd have felt quite shamed if she's said anything different.

I am surprised this research got through ethics. Did the women sign something at book-in to say they were happy for their private information to be shared as part of a research study (as opposed to shared for routine care). What is an "organisation affiliated to the hospital"? OP is upset about this and therefore one could argue the invite has caused "harm", again a key issue of concern on any research proposal that goes through ethics. What if women who got letters were struggling emotionally about weight gain? What if a letter like this made this worse and tipped them into depression? And for those blaming people who put weight on - its really not as simple as eat less/eat healthy and move about more. The "official" advice Eatwell plate has been forced down our necks for yonks now and is making us fatter rather than healthier!!! Its been removed from the curriculum at my (research intensive) institute but is still the offical NHS advice. Plus, many many women struggle with various physical impairments during pregnancy which can make exercise (or at least the extent and degree of exercise neeed to impact on weight) impossible. I could go on and on about how the food industry is pulling the wool over our eyes about sugar/fat etc but when official guidance still trots out the same old tosh, its hard to get people to change habits. Much easier to blame those who put on a lot of weight and just tell them to cut back on eating and walk around a bit.

Everytime anyone goes into hospital or takes a prescribed medication they are benefitting from previous research / drugs trials that people before you took part in, even if it was of no direct benefit to themselves.
I have taken part in many nutritional studies because I live near a research centre and hope that their findings will benefit other people. I often get invited to take part in trials because of this, some studies request a certain age or sex or weight of participants, this is quite usual and I don't get offended if they ask if I would take part in a study recruiting overweight people ( I am overweight as it happens) for your details to be shared you would have ticked a box somewhere but probably not noticed at the time. I am also a volunteer with our local universities patient participant group which amongst other things aims to educate the public about the benefits of research. One of the things I do is to help draft questionnaires, information leaflets so that they are readily understandable i.e in lay mans terms.
If you don't want to participate in the study don't it's as simple as that, it's not personal anymore than inviting women for breast screening or smear tests at a certain age could be seen as ageist.

In response to the person asking what I meant by 'an organisation affiliated to the hospital', the letter came from an organisation called SWAN, which is apparently a (rather terrible) acronym for 'Supporting Woman with weight mANagement'. (I found the acronym even inappropriate than the letter itself to be honest ;-)). There were logos of two local hospitals at the bottom which is why I said 'affiliated to the hospital'. Thanks for all the responses - it has definitely helped me to see both sides of the argument.

We are becoming a nation of people who not only excel in the skill of being offended, but we actively search for things to be offended about. OP this is an invitation for those who think they have put on too much weight, it is not a court summons for every woman with a BMI of over 25.

I deal with children in my line of work and it is incredibly astounding the amount of parents who appear to be completely devoid of basic nutrition knowledge. I mean the utter basics, such as a packet of biscuits for a 4 year old's breakfast is not a healthy option just because they contain milk Obesity is on the increase and if a parent is obese the likelihood of their dc becoming obese is increased. There may be women who would like to do something post pregnancy regarding their diet and lifestyle and any increase in awareness is a good thing in my book.

I am smiling to myself about some of the comments about some people being offended by anything / looking for things to be offended about. Obviously none of you know me so won't know this, but I am usually so far the other way that it annoys people! This one just hit a nerve I guess, albeit unreasonably 😀

Advice from my gaene (going through IVF so had one from the start) was that women who have BMIs over 28, benefit from calorie restriction even during pregnancy. They see improved live birth rates, improved outcomes re Preclampsia, gestational diabetes etc. All of the pregnancy weight gain rules only apply to low/normal BMIs up to mildly overweight.

It's actually now advised that if you're obese you shouldn't gain any weight - as baby gets heavier that means mum has to get lighter. I got referred to a nutritionist.

No one gave a fuck that I was obese (BMI between 32 & 36 from memory) through my 2 PG's (2007 & 2011).
I even raised the issue both times and asked for some guidance and support and was told "it's not an issue don't worry about it".

I'm sure they wouldn't have got ethical approval to send out a letter like this out of the blue with no prior discussion, I'm that this has been allowed...

I would have loved getting this letter and any help i could have. I was 117kg when i got pregnant- had it been planned i would have lost weight first as I'd want to be a healthy weight to give my baby the best chance, however after fertility issues we thought we wouldn't be able to get pregnant then it happened out of the blue. I am now 8 weeks post partum and weigh 123kg and i feel so so massive and cant weight to lose weight but when i went to docs for check up he only really wanted to discuss contraception!

Sounds reasonable to me but I work in clinical research, recruitment to studies is hard and it's one way of finding potential interested people based on information they have (although not sure why you've received it since you didn't meet the bmi criteria...)

If it were a study my company was running the wording of the letter would have gone through many rounds of review by medical and legal professionals, it then goes for external review by ethics committees which this letter should also have done (it's not clear who's conducting the study).

I wasn't overweight but am currently losing weight post baby and it was definitely on my mind during pregnancy, although not the most important thing obviously!

Sounds like a reasonable offer. It's not forcing you, it's offering a service that you could opt in to.
I had a bmi of around 23 when I got pregnant, put on around 3 stone and really struggled to shift it with a baby who didn't sleep and breast feeding. I would've loved this and been very grateful for some support. It is so hard to lose weight post partum and there seems to be an attitude of 'oh eat what you want, you need cake to get through it'. This resulted in me feeling like crap for quite a while.