To wonder why its become ok to be so overtly cruel and unprofessional to overweight patients, and why do we (overweight patients) tolerate it?

[PasstheBucket89]

Its something ive experienced first hand, i know others have experienced over and over again, i used to work in a community role dealing often with alchoholics and ex drug users and other forms of 'bodily abuse' and they didnt recieve the same level of contempt either. from us or higher up medical staff.

Im currently expecting, due to a raised BMI i took the glucose test, i don't mind i understand why (to test for GD) ive never ever had it in past pregnancies and dont have it this time. I don't mind taking growth scans as i do understand why, the baby is actually small, likely due to my hypermesis.

Well, ive had many microaggressions that i braved out but this was totally over the line. At the growth scan i was asked why my Glucose test wasn't on the system, i said id definitely been but not sure why, i wasn't angry just assumed a system error., but i was concerned that i could have a bad result and not know. She seemed annoyed (midwife A), Midwife B appeared who actually did my test and had written it down and seemed miffed. She said must have been a system error and she launched the notepad on the desk and said "i dont know how but its normal" gesturing at me and left. Im ashamed to say i said nothing, my face i think said it all, i quickly got up and left, i was also angry at midwife A for not saying anything, that could be U. Ive made a formal complaint, but truth is I imagine there will be little said and buisness as usual. when i go back im likely to see her again. , but i wonder why on earth its got this bad and what should i say if it arises again??.

I am a recovering bulimic. i stopped the vomiting but did not really stop the bingeing and put on alot of weight. i went for an asthma review and my GP said i was obese and I said to her cheerfully ; 'Yes, but I used to binge and vomit and now I have stopped the vomiting so I think on balance I am healthier'. i was PROUD of the fact I stopped vomiting. She just eyeballed me then said she could refer me to weightwatchers.

What sort of GP tells someone who has just told them they have an eating disorder they can be referred to weightwatchers? i was disgusted.

A few months later I went back for a review of my antidepressants and told her I was going to the gym 3 times a week and she asked 'if you are going to the gym why are you still fat?'.

I am NOT joking. I coud say that English is not her first language (another european language is before anyone starts accusing me of anything) so may something was lost in translation but I was fucking upset.

I don’t think Graphista has ever used a hoist on a soaking wet unconscious person. The point is it’s not rude to deny someone a waterbirth if it’s too risky.

@strappedup, because they don’t need to know. It’s too fucking late once the woman’s pregnant and scaring and upsetting them serves no useful purpose. Especially when it’s said in a nasty, judgemental way.

Aw OP that's absolutely disgusting so sorry that happened to you.

Sadly the answer as to why overweight people (let's face it overweight women) get stick and not other body abusers is patriarchy means if you're not skinny, svelte, beautiful, eat like a rabbit you're offensive to the male gaze and is this world there's no worse offence. That's what I believe anyway - we also as a nation have a weird obsession with food. Just look on MN and the competitive under eating posts - it's pathetic. It seems to be offensive when people eat heartily and enjoy it. I've encountered so many people who have weird rules about food, it's not healthy

@Graphista

I've had a crash cs. I can understand if there are other risk factors too but to blanket refuse ALL overweight mothers a water birth if they and baby are otherwise healthy I don't understand, also don't understand why hoists etc aren't easily to hand in obstetrics if so many mothers are unreasonably fat!

it doesn’t matter if they and the baby are otherwise healthy, it’s irrelevant. maternity staff are constantly aware of the fact that ANY woman or baby can suddenly become life threateningly unwell during birth. The difference is that removing an unconscious obese woman from a birth pool is vastly different to removing a slim woman from one

Does anyone know what BMI is generally used for the obese water birth cut off? Is it the one calculated with the booking weight or the weight taken from my appt at 36 weeks?

When I was having fertility testing I had to hit weight goals (fair enough) and I made excellent progress throughout.

I went for a routine blood test and the nurse looked me up and down, smirked, and said I see you haven't had x procedure due to your weight.

I said I'm doing my best. She grinned again and said in a sing song voice 'limits are there for a reason'. Given she was about twice my size I said 'hope you don't need treatment soon and looked her up and down.

I left that blood test with a very bruised arm...........

I'm a (non practicing for many years but still) a doctor. I'm so so sorry for the way you've been treated. Please do complain.

What we seem to have forgotten in this country is that everyone contributes towards the NHS ams therefore everyone is entitled to use it, overweight, smokers, drug addicts, everyone. It is what makes this country more compassionate than others, namely the USA where quality of healthcare is proportional to the size of your bank balance.

Congratulations on your pregnancy and for the shit you endured today.

I don't really understand why it's ok for normal weight women to have a water birth then. Getting someone who is 13 stone and 5 foot 6 out of a water birth bath thing is hard, ok, understood. I don't see why it's massively easier to get someone who weighs 11 stone and 5 foot 6 out. It's not like everyone with a BMI under 25 at birth weighs the same as a balloon.

@wigglerose

I don't really understand why it's ok for normal weight women to have a water birth then. Getting someone who is 13 stone and 5 foot 6 out of a water birth bath thing is hard, ok, understood. I don't see why it's massively easier to get someone who weighs 11 stone and 5 foot 6 out. It's not like everyone with a BMI under 25 at birth weighs the same as a balloon.

there has to be a cut off somewhere

Erm, a water birth was mentioned in passing by another poster, and i simply said its a shame for blanket denial as id probably quite like one. Ive never asked for one, and its not the crux of this post. its interesting thats what some posters are choosing to fixate on 🤔.

All the other posters with bad, unprofessional experiences, solidarity its not ok it needs to change. And no, i did not misinterpret the meaning. especially when some of my examples i listed i didn't go off at.

Well I think it’s fine to be honest with patients; I never said shaming was acceptable. Doctors can be honest and what I would call ‘severe’ i.e. saying someone really should lose weight as it’s endangering their health, but in a supportive way.

I am overweight and I know why (pregnancy then laziness at shifting it); I am quite robust when it comes to hearing about this, but many people are overweight due to mental health or some other condition/ drug side effect or whatever, and may not be so resilient to the news. So doctors absolutely must take care and present the information in a supportive way. Most weight loss resolve, I’d say, has to come from the person, so making someone feel shit is never going to help that. Being pragmatic, understanding and helpful with ideas about how to change things may do.

I had similar. I used to be an average weight, say a size 12. I was prescribed treatment for a chronic medical condition which caused me to gain over 2.5 stone in three months. This treatment was administered via subcutaneous injection in the abdomen. The nurse, at the third injection (after the weight gain) made a comment about having plenty of fat to inject into. I was already in pieces through the rapid weight gain and not recognising myself in the mirror any more. Not long after I had a breakdown, ended up in an abusive relationship as I thought I didn’t deserve or couldn’t do any better, and gained even more weight. Emotionally I’m much better these days. Physically I’m not.

Most birthing rooms don’t have space for a hoist! And getting a hoist sling under someone who is obese and heavily pregnant in a birthing pool is dangerous for mother, baby and all the HCPs involved!
Especially if the mother is unconscious, bleeding out or panicking because she’s stuck! The sling has to be rolled under her (and the mother rolled side to side to allow this which can injure the midwives) then secured before the hoist can lift her. In an emergency this could mean a fatal delay in getting to theatre.

The midwives have to put safety first. And many birthing units are underfunded and understaffed, so stocking up on extra hoists isn’t high on the priority list!

This is close to my heart and I was thinking of this just recently. I'm going through the menopause and am a stone over my optimum weight 11stone and should be 10stone max so overweight by BMI scale not obese. I went to ask for HRT a few months ago. To say I was 'fat shamed' by the GP is putting it mildly. I did complain to her and to the Practice but I came out in tears and she didn't let me get a word in edgeways. I have been anorexic in my teens which I mentioned to her and weighed just 6 stone at age 20. I also have been a victim of sexual abuse as a child which I believe led to my anorexia. So in my head I'd rather be a stone overweight and more content where I am now than back there. I'm a vegetarian and walk miles every day with my dog and have, thankfully very few health problems which she would know if she had taken the time to read my notes. It has really put me off going the Drs again. As SecretSpAD says we all contribute and in my opinion not many people lead a perfect lifestyle.

On the water birth thing, I was bmi 40+ in my pregnancy. Had ah individual risk assessment where I agreed if things weren't going well in labour I would get out ASAP. They also planned to keep a hoist just outside the room.

The shitty comments from midwives and attitudes of some posters on here really do suck though. With those and the constant lose weight for Covid messages I seem to have developed an eating disorder. I've not eaten more than 500kcal most days, usually much less for 7 months.

I'm 6 months pregnant. HCP have congratulated me on weight loss. It's a long fucking way from healthy

That is ridiculous.
I had GD with my last one, I wasn't even a pound overweight. Then, I developed type 2 diabetes and guess what? Still wasn't overweight.
In my 50's, still have diabetes, still not overweight.
So, it's not even like it always makes a difference anyway, let alone how rude she was.
I'm glad you complained. for you.

Some of the comments on this thread are absolutely appalling.

I had a hysteroscopy recently and it took over an hour as the doctor struggled to get the probe through my cervix. I was in a lot of pain and crying, and she snapped at me that it was because I was fat. Strangely, I’d had another one a couple of months earlier, which was over in ten minutes and was painless.

i used to work in a community role dealing often with alchoholics and ex drug users and other forms of 'bodily abuse' and they didnt recieve the same level of contempt either. from us or higher up medical staff

I completely disagree with this. I’ve worked on detox wards and in the community and I’ve seen first hand people with alcohol addiction anc drug addiction being written off by multiple consultants, doctors and medical staff. I know of alcoholics who medics refused to refer for korsakoffs assessment because “well- what’s the point”. I know of many inadequate care packages being given to those with addictions because well, what’s the point? And I know many who don’t have access to befriending services due to stigma about their condition, not to mention an utter lack of support or care for the mental health issues that often go hand in hand with addiction. So I very much disagree that addicts get respect and support- they bloody well do not and they are largely written off and ignored by the medical community.

@FairfaxAikman

Havelock yet a different midwife (afterwards) said she would have allowed it had I presented to her in active labour. DH is an ex rugby player and more than capable of lifting me too. However my issue is not so much the refusal but the way it was framed as me being stubborn. Aside from my weight (which is linked to MH issues) I had no other risk factors - my B0 and heart rate are below average and my GTT bloods were back to my hasting level after two hours.

I get that you and another midwife felt it would be safe for your OH to move you, but during active childbirth you cannot rely on the father to do anything - if asked to move their partner who is refusing to move (or actively hemorrhaging), very few dads would be able to follow directions quickly and safely. If your first midwife felt it was unsafe, it probably was. However, she could have been much clearer when explaining the issue, which you are justfied to be cross about.

I would definitely complain to PALS about her behaviour, even if she is stressed or whatever that's an unacceptable way to speak and act in front of someone. Most of the midwives I encountered were pretty fucking awful, why you would go into a caring profession when you seem to hate people is beyond me. I disagree about addicts getting treated better though, a lot get treated like scum. Water birth is fair enough to be honest.

That’s terrible, good for you for making a complaint. That is completely inappropriate from a healthcare professional.

Disgusting.

I’m not overweight so I haven’t experienced this directly but I think there’s a lot of misogyny in the medical profession, especially in maternity, and I’ve experienced that. And let’s face it, fat-shaming is generally just a form of misogyny - so I definitely believe you.

I flipping hate the NHS hero worship as well. Yes, there are some amazing people in the NHS and I’m really grateful to NHS staff for the work they’ve done during the pandemic. But it’s the fifth largest employer in the world I believe - so surprise surprise, just like with any other huge organisation, there are also lots of shit people. There are stupid people, incompetent people, nasty people, people plagued by unconscious or conscious bias, people with an agenda - and there are lots of problems with the system that means these people aren’t always managed appropriately. No clapping on a Thursday over here.

OP that is awful and I’m so very glad you’ve made a complaint. I wish some midwives would just stop being rude to pregnant women and new mothers. It’s a time when you feel so incredibly vulnerable, and it has such a powerfully negative effect.