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??.

That was so unprofessional of her. Plus there’s no straight correlation between weight and gestational diabetes - my underweight, size 6 friend had GD and met the opposite reaction. Apparently midwives she’s not met before would look at her, look at her notes (which mentioned GD) look confused and then ask her if she’s sure there’s not been a mistake in her notes.

Surely it’s not beyond the understanding if trained medical professional that a higher risk of something does not always correlate with that that thing actually occurring!

There is no excuse for being unpleasant, especially when patients are feeling vulnerable. I have Crohn’s disease and put on 3 stone through medication. The consultant never believed how ill I was because I wasn’t a stick insect. I lost all the weight but have tanked it on again after surgery, inactivity and lockdown. And now I’m pregnant and concerned I’ll get lectured for my terrible diet and weight (can’t help the diet). I have given up smoking recently, so would rather be fat than smoking in pregnancy. Midwives probably deal with the ‘eating for 2’ brigade and those who can’t be arsed, but the majority of women want to be as healthy as they can be for their baby

Midwives are the most heartless healthcare “professionals” in the system. After 3 babies and 5 pregnancies I’m convinced they have whole units during training on how to be uncaring, heartless and dismissive on the mothers concerns or feelings. Just ignore her op.

When I was a chubby (13 stone at 5 foot 7 size 16) 17 year old I had an abortion. It was highly traumatic and not made any better by the doctor saying that I ‘obviously liked eating’ and as I left - ‘lose some weight, OK’. It was a dedicated abortion clinic so this twat had free range to behave like this to vulnerable women at their lowest ebb. I have never forgotten it. I still have intrusive thoughts about the way he spoke to me. My weight didn’t effect my health (I certainly wasn’t big enough to stop me getting pregnant, obviously) so it was his own little campaign. I disgusted him and he wanted to make sure that I knew it.

Sorry I meant to say he said that I must ‘liked my food’ said in the most condescending manner possible.

That is appalling OP. I can relate as I was obese when pregnant... I am aware that I am obese and appreciate it might come up in my appointments but I still feel I should be treated with respect and dignity. I have never felt so bad about myself as I did walking away from my booking in appointment, trying to hide my tears from my husband after the humiliating lecture I received from my midwife. Also as some other posters have mentioned, my blood pressure etc was perfect throughout and that seemed to almost be a disappointment to everyone!

I was “allowed” a water birth but did have to go into the hospital for the head midwife to have a chat with me... as it turned out my baby had other plans so I didn’t even put one toe into the water!

Oh OP that is horrific, do follow up your complaint and ask what action was taken. You can also request that midwife isn't involved in your care from now on.

I'm overweight and was for both pregnancies, one doctor made an issue of it but I never saw him again. The midwives and nurses were all great, none made an issue or comment, at a glucose test one even asked why I'd been referred as she didn't think there was any need.

Midwives are the most heartless healthcare “professionals” in the system.
This is a bit unnecessary, of course there are some in any profession who let the side down but you can't tar them everyone with the same brush! Midwives are right in there at the hardest most emotional time of our lives, every single word, look, movement from them is taken to heart by expectant and new parents, it's a hard and endless job with huge demands on them physically and emotionally. I'm not saying everyone of them is a saint, but I take issue with anyone saying every single midwife is a monster.
I spent a week with dc2 in scbu and me on post natal after a traumatic EMCS, the nurses and midwives were so lovely to me during that time, one sat with me while I cried one day at 2am unable to even speak and just hugged me until I calmed down then helped me shuffle to see my baby.

I’ve not read through all the comments, but I must say that aside from the usual extra measures, my obesity wasn’t really brought up through either of my pregnancies. My midwife was bigger than me, lol, and very frankly said that aside from having to note my weight, we weren’t going to discuss it. I would have liked a water birth but my first was back-to-back (not a chance!) and my second came to fast for any time to think about anything but who was catching the baby! I remember seeing the anaesthetist a couple of months before my due date, and at the end of the appointment he exclaimed he saw no reason why I should have been there, I was perfectly healthy and my pregnancy was going swimmingly and the only reason I was with him was due to a number on a page!

30 years ago when pregnant with my first, I came across a report in my notes from my GP. In it she had said it was going to be difficult to determine the age of my pregnancy as I was significantly obese. I was 17, under 8 stone and a size 8.
I was so convinced that I must be fat so I stopped eating and ended up in a maternity ward hooked up to a drip.
I just goes to show attitudes haven’t changed🙁

I was treated the same with my last pregnancy. Given a bariatric bed and a bariatric chair, which were both far too large for me and as I'd had a c-section I ended up sleeping on the edge of the bed for a week as it was so large I couldn't wriggle to the middle. When I asked if I could have a normal sized hospital bed like the one I had slept on a week previous when having steroids injection on the same ward, I was told no I was too overweight for a normal bed!

I made a complaint when I left but never heard back and I didn't have the strength to chase it. It was a miserable week of being more uncomfortable that necessary because of the bed

I've put on loads of weight in the past 18 months and had some really embarrassing experiences with the practice nurse at our surgery in particular. I get it that I'm too big and I need to lose weight, but that doesn't mean I'm happy to be patronised or to have assumptions made about me. The last time I saw her, she was going on and on about having "too many potatoes and extra parsnips with my Sunday dinner", when I never eat Sunday roasts. I'd be all ears if she had listened and given me some advice that actually related to my situation.

I'm really sorry OP that you were spoken to this way. I too have had that experience so your not alone and it's not in your mind.

I was size 14 and in the 'overweight' BMI category when I fell pregnant so considered low risk. At around 20 something weeks my community midwife told me that I was 'too fat' to be examined and sent me into the hospital for further monitoring. I broke down in tears in the hospital worried about my baby and feeling so much guilt. Luckily I had a kind midwife who told me I was totally normal and not to fat to be examine. My community midwife was also obsessed with me having GD. Due to my age I had a test and she kept saying how , shocked she was that my results were normal. I could go on further but all I'd say is good for you for putting in a complaint. I suffered from terrible anxiety during pregnancy and my awful community midwife did nothing but make it worse.

Im pregnant with dc 3. I have put on weight due to a slipped disk in my neck (lots of pain, unable to exercise etc) i used to run & be really fit. At my booking appointment my bmi was 30.4. I was wearing a size 12 pair of jeans (i am only 5ft). I was told gruffly that as im an older mother & obese i am considered high risk.

Thats fine tell me i can accept these things. But if you had actually taken the time to read my notes (done over the phone due to covid) you will actually see im high risk first & foremost due to dc1 birth!

Another moan. I also take duloxitine for nerve pain (slipped disk as above) which i informed them about. On my paperwork in the psychiatric section they had put duloxitine? For other use. This used to be a drug to treat depression & mental health problems but as research has advanced they now know it is better used to treat nerve pain.

Im not happy about the insinuation that i am lying about the use of this medication, but havent seen the same midwife since to comment on it!!

What makes it worse i work in the nhs. Never would i make horrible comments to someone about their weight!

How about you take responsibility for being over weight?

How about you take responsibility for your empathy deficit?

The clinical difference in risk between say BMI 29 and BMI 31 is minute but the difference in treatment is vast depending on your location. Remember it's just a tick box, they don't actually look at your individual risk. I understand they have to have a cut off somewhere but for all the posters parroting how 'being obese is an increased risk so they're only being factual' the actual increase risk for anyone under BMI 40 is tiny. They'd have you believe the difference is huge but it's not, and the vast majority of obese patients have BMIs under 40 and go on to have perfectly healthy pregnancies and deliveries. All obese patients are lumped into the same category whether they have mobility issues, good fitness , excellent blood sugars and blood pressure, or not - and BMI categories are not actually based on science and health outcomes - they were originally defined based on how people looked. I am not saying for a moment that there is no health issue with being very overweight, but the issue for most women who have been healthy enough to fall pregnant has been vastly overstated and the treatment in some parts of the medical profession is a cultural that is not backed up by evidence.

Yep! Fatties are fair game. And I'm saying that as a fatty.
Yet the alcoholics, drug addicts, people with STDs - all to a degree things that start due to lifestyle choices - get treated with respect.
My blood pressure got lower and lower throughout both my pregnancies - despite me gaining 4 stone each time. The midwife kept checking the bp cuff & said I was a medical anomaly, but she wasn't outright rude.
However, years ago when I was a couple of stone lighter than now, I winced in pain during a gynae exam. Doctor saw my face & said, 'Well I wouldn't have to push so hard if you weren't so fat'. Which was nice. Nothing to do with my retroverted uterus.

Yet the alcoholics, drug addicts, people with STDs - all to a degree things that start due to lifestyle choices - get treated with respect

Do they?

Perhaps (and no offence meant) you are aware of your weight and the complications it can cause. You need to look at the bigger picture and not just think of your feelings. Fact is fact! it is a medical professionals job to tell you facts. I mean imagine trying to tell a patient that they have cancer but you can’t say you have cancer because it might offend them? It just doesn’t work they have a duty to tell you what’s wrong and If you are overweight then you should be told to make healthier choices if not for you then for your children. you are overweight and it should be noted on your records. If you don’t like people stating the fact that you are too heavy then you should try and rectify that.

Ah I’m sorry OP, I can well believe that.
I was a high BMI in my first pregnancy. At my booking in appt my midwife slapped a sticker on my file saying the anaesthetist has to be informed when I was admitted to hosp in labour. She didn’t explain at all why she had done that. She then also told me I would have to be on the Labour ward, no pool, needed consultant-led care and gd test. All this was fine except she didn’t explain any of it to me or discuss any of my options. And made it abundantly clear that she thought I was too fat to be pregnant. Thankfully my sis who is a gp forwarded me the guidance for high bmi pregnancies, and, as I was under bmi of 40, the different options in care choices. I read up on all the research and went to my first consultant appointment prepared to have to argue my case.
Thankfully I walked into the consultant appt and he took one look at me, and said “oh, you’re fine, you clearly carry it all on your bum and legs” !! He explained bmi was pretty arbitrary, and that I was fine for birthing suite, pool etc and he was discharging me. Thankfully I made him write that down in my notes as at every single subsequent midwife appt I was told I would have to be Labour ward etc, and I was able to just direct them to my notes.
I also got the usual great surprise at my bp, sugar, negative gd etc.
As other pp have said, if COURSE you need to discuss the medical risks with your patients and make informed decisions. But you can do that with both clinical care and compassion.
And OP, I had a lovely water birth in the end. All the best for the rest of your pregnancy

I hope all goes well with the actual birth. You could always ask the midwife what she meant and explain how you understood it, next time you see her. I know its not the same, but I have four children and when I went to a new doctor with them with chicken pox, the receptionist said in front of the whole waiting room... what four children, you should learn to say no.!!!!!!!!!!!!! I wanted four. Also when first was a week old, on New Year eve a midwife who I didn't know came for the visit and said there was something wrong, I had to get a lift to hospital, quite worried, and after a long wait a doctor told me there was nothing wrong and accused me of over reacting. I think it was because she thought my house looked like a slum to her, various forms of heating (30 yrs ago) no central heating, a workshop in the front room with tools, no stairs banister and a very large wood fire. She saw my house made and made assumptions.

How about hcps, midwives in this instance, actually bother to do their job properly including learning up to date information?

All obese patients are lumped into the same category whether they have mobility issues, good fitness , excellent blood sugars and blood pressure, or not

Exactly

And CLINICALLY to do this is LAZY PRACTICE!

Patients are individuals not a homogeneous group of people with all the same CLINICAL FACTORS.

is a cultural that is not backed up by evidence.

Totally agree!

Weight/size is but ONE factor of a patient’s clinical history it does not and should not be the defining characteristic a GOOD hcp focuses on.

I’ve plenty of addicts in my family, they’re generally treated better yes, the ones who are now recovering addicts but are now obese (I would argue having swapped one addiction for another and they would say so themselves, it’s actually very common for a variety of reasons) have said themselves on numerous occasions that they were treated better as active addicts than they are now.

@Getskinnyordietrying (maybe choose a less offensive username too, or was that deliberate for this thread?! “No offence meant” my fat arse!)

Fact - being obese is ONE risk factor for certain conditions and circumstances, it’s NEVER the only one

Fact - recent research is showing that genetics have a far greater part to play in diabetes of all types than was previously thought.

Fact - berating, “telling off”, being “blunt” with patients regarding their unhealthy habits has repeatedly been shown through in depth research not only NOT to work, but indeed to make it MORE likely they will maintain those unhealthy habits

Fact - by focusing too much on the “bad” patients, patients with significant other risk factors for eg gestational diabetes (family history, ethnicity, age, previous medical history) may well be MISSED and that neglect can lead to tragedy! I had to really push as a very slim, fit and healthy pregnant mother under 30 to get tested for gd DESPITE several other risk factors AND symptoms because several hcps didn’t believe it was possible in someone who was slim!

Fact - not all hcps are good practitioners, compassionate practitioners or even non neglectful practitioners

Fact - pregnancy and childbirth is a worrying and difficult time, unnecessarily stressing a mother could actually increase their risk of certain gestational conditions due to stress - any decent hcp knows better!

Fact - if simply telling someone they’re fat and they should lose weight well fuck me! You must have a miracle fucking cure for obesity!

Fucks sake!

I definitely felt shamed like this when I was pregnant and I was told I couldn't have a water birth when i was in labour (wouldn't have had time anyway!) I was a size 16 at the start, I lost weight during the pregnancy but absolutely no one mentioned that at the hospital despite friends and family being concerned, I was just on the list as high BMI and had growth scans which was a complete waste of time and I had a very healthy and straightforward pregnancy as I did the first time, they just don't look at you as an individual

I was fine during pregnancy. Nothing much was said.

But trying to get help with other issues had been... long.
Mainly it’s because I’m overweight which means anything wrong is because I’m fat. (Ie: if you hadn’t been so fat, you would have dislocated your ankle when you fell over.)

Nothing to do with the fact it turns out I have Ehlers Danlos syndrome picked up a physio during a discussion about injuries and when I started listing off all of the joint dislocations he looked shocked and said it wasn’t normal.