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 received a very similar letter recently and my BMI was definitely within the 'healthy' range pre-pregnancy and I have had minimal weight gain during pregnancy. I assumed it was a blanket letter, rather than targeted at any specific group because it doesn't apply to me. It seems like a helpful initiative for anyone wishing to take it up although l agree that the timing of it was inappropriate.

I see your point but my midwife commented on my booking appointment when noting down my (normal) BMI that she hardly ever gets women under BMI 25 so it must be a big issue.

But they are definitely BU to recommend/include SW. A few people I know have had great success with it because they eat mostly fruit/veg/lean protein/complex carbs but so so many people I know who do SW seem to eat nothing but crap out of packets and way too much carbohydrate to be conducive to weight loss. Also, an avocado = syn? Wtf.

It was a blanket letter because this minimises NHS staff time - admin staff can just do a big mail out of people on their list and those inter respond. No clinical time is then taken up.

I'd hazard a guess that your details haven't been shared - NHS staff will have done the mailout. Can't imagine it getting ethical approval otherwise.

It's quite a few years since I sat as a lay member of a research ethics committe, but what used to happen was that the study would need to be approved by the ethics committee (including reviewing all the information to be sent to participants etc). If NHS patients were planned to be contacted, the participating NHS hospital would identify relevant potential participants from its records, these would be run past GPs - for instance to remove any individual with specific issues which might mean the invitation would cause distress, eg if they had eating disorders, and then the NHS would issue the letters on behalf of the study. I looked online, SWAN is the name of the study, which seems to be run out of a consortium of US institutions. However if you feel the invitation is inappropriate, badly expressed, I would contact the study organisers and tell them so.

Haven't RTFT but there was a thread just recently where a poster was 'distraught' at being referred to consultant led care as she'd started on a BMI of 30 so borderline overweight/obese and had subsequently put on 17kg by 30 weeks. Her gripe was someone should have mentioned it sooner so she 'could have tried to avoid' this situation. Why is it always someone else's responsibility?

At my booking in appointment I had an overweight BMI of 28 and because I'm not an idiot I realised this was a potential issue and watched my diet and exercise such that I only put on another 7kg in total. Baby has been born recently and I weigh less than my booking in appointment and the good habits are being continued so I can hopefully get back to a normal BMI before too long. I certainly wouldn't be offended by that letter though.

I think there will often be someone who is (unfortunately) annoyed, upset or aggrieved by being approached to participate in a study, particularly at a fairly emotionally charged time in their life. I'm currently pregnant and at 9 weeks had to have a trip to EPAU because of a bleed. All worked out fine in the end but it was a worrying time. While there I was asked to participate in a study about the benefit of EPAU facilities in general (rating level of anxiety before being seen, after and then a further 4 weeks down the line). I have no doubt someone would be offended or upset by the approach but I recognise the benefit it would have to countless women if it helps improve maternity services so was happy to participate.

Similarly, I'm classed as a "geriatric" mother being over 40 and have been asked to participate in multiple studies during this pregnancy to learn more about fetal outcomes in older mothers. I could have got the hump about it - I'm sure others might have - but I could see the value for future mums.

I think if researchers always trod on eggshells, they would never get any participants.

"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. "

There aren't enough doctors and nurses... the ones we have simply don't have time to do all the direct approaches to all possible patients. They need to save their time for people who want medical attention. You were probably chosen on the basis of rules of thumb, someone allowed to look thru all surgery or hospital records to find eligible candidates with the right statistics.

I would be mortified. My weight is quite tied to my emotions and my pride. I know it's something I need to work on.. but of my choosing, with people I want to help me.

So whilst I can see that this is a great opportunity in some lights, I would personally feel pressured and humiliated at a time I was already vulnerable.