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 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

Not that anyone should be treated with contempt but my experience of community rehab was not this! I had one good cop and two bad cops.

(also just to add that approach absolutely worked for me - I needed someone to tell me it straight!)

@consfusedandlookingforwine

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.

Agree 100%

Some of these posts are so sad to read, I had great midwifes with both of my babies! Im also a bit of a lard arse and they was going to let me in the pool fine second time round, first time the pool wasn’t available. Only thing that got in the way second time was the wireless monitor wouldn’t work, the midwife tried soo hard to get it going. It’s a good job I didn’t get in the pool as DC2 was an emergency section after they lost her heartbeat completely. My midwife stayed almost 3 hours after her shift had ended. I will forever be great full for her!
First birth I had a midwife and a student and both were fantastic, the student even more so.

I used to have these issues with medical staff when I was younger, I remember a nurse being cruel to me about my weight when I was 6, it was mortifying. But now I’m older, I don’t seem to attract the same wrath, and I’m obese. I do think you should stand your ground and make complaints when you’re treated unprofessionally.

I have had three kids and been very overweight for each of them and agree - the treatment is appalling. Each time I have had to have extra specialist appts with midwives and obstetricians just for being fat and each time I have got to the appt and they said why have you been sent to see me and I have said because I am fat and they were like "er, is that all, what a waste of my time and yours".

Then there was the midwife who said why are you here and I said because I am fat and she said 'oh don't say anything bad about yourself" and I said "I didn't" and she just did not understand.

And that constant reminding you that you and your baby are more like lt to die, that your epidural is less likely to work etc. I mean, it is not as if you are not going to go ahead with it.

And this was nothing compared to the contempt I got when trying to conceive.

I did get GD the third time and was gratified to see all seven of the other women in my GD group I had to attend at the hospital were 'normal' size.

OP have you seen the documentary about prejudice towards obesity within the NHS? It was done by Professor Rachel Batterham and was shown on BBC 2 it was very interesting, I had to wait 5years for knee replacements despite being told they needed doing straight away.

Not weight related, but when pregnant with my 2nd dc I decided I wanted a home birth. I had had a very straightforward pregnancy with my 1st, no issues, no problems at all aside from him being born 3wks early. I was told I was a geriatric mother as was 35 when he was born. My 2nd I was 37, again very healthy, normal weight, etc. Every time I saw a midwife they asked which hospital I was booked into for the birth, every time I said I was having a home birth. Every time their faces were a picture, explaining how risky they were. Every time I explained that I had done plenty of research on the matter and was convinced the baby and I would be fine. This was very tedious as my choice was clearly written in my notes, they just didn't read them. The final straw was when the midwife I was with looked shocked when I again said I wanted a home birth. She said I was being selfish, that if there was a problem I would have to go into hospital (I am totally aware of this ). But the humdinger was when she stated that the risk of home birth was that I would die and my baby would die. That my baby would die and it would be my fault! She was really nasty when she said this, it was with horror. Before anybody says I'm overreacting, she used those words, they are permanently in my memory. I was fuming but calmly explained that although I was an older mother, my previous pregnancy and birth went without a hitch (didn't need any intervention, no stitches either). This pregnancy was trotting along nicely, no health issues. I would consider myself fairly well educated, I had done ALL the research and was confident we would be fine. In an emergency we live 5 minutes away from the hospital (in a fast car my husband is a big man and would have no problem lifting me into it!) I went straight home, looked into and hired private midwives. Best thing ever. Spent time with me, discussed my wishes, really open. The home birth was amazing (not rainbows & butterflies amazing, but fab in that I was relaxed, in my own home (previous hospital birth experience is for another thread!), my other dc was asleep upstairs and got to meet his baby sister when he woke up the next day. The midwives stayed with me whilst the placenta came away on its own (didn't pummel my stomach and pull on it at the other end!) Very much different to the NHS experience. Saf but true

I’m an HCP (not a midwife) and I’d never be rude or unprofessional about weight.

I’d only refer to a patient’s weight if it was relevant to their treatment or condition. Eg if someone is pre-diabetic and overweight I have a duty of care to tell them their diet and weight could make them seriously ill.

There is sometimes judgement amongst HCPs about obese patients, especially nursing assistants as they’re the ones who risk injury turning the patient, transferring them, getting them on and off the commode safely etc.

HCPs are humans not robots. A stressed, busy charge nurse might be irritated at having to order expensive bariatric equipment for an incoming patient. Because she has 100 other jobs to do, and ringing round multiple equipment stores and departments takes time. And takes money away from the ward budget. But generally she wouldn’t show this irritation to the patient, it would be to other staff.

I can understand why a sonographer might be fed up if she can’t scan properly due to excess fat layers as they have to get certain measurements of the baby and are time limited.

And in a restraint situation (head injury/mental health issue etc) an obese patient is much harder to hold down so staff are more likely to get injured.

They shouldn’t show their irritation to the patient but sometimes the professional mask does slip.

it is a medical professionals job to tell you facts.

"X treatment/birth method isn't suitable for people over y bmi" and "technically difficult scan due to patient's body habitus", ok those are facts.

Eye rolling, rude comments, sneering and insults aren't facts. Saying "well if you didn't want to get sneered at you should have lost weight" is proving OPs point.

I can understand why a sonographer might be fed up if she can’t scan properly due to excess fat layers as they have to get certain measurements of the baby and are time limited.

Thing is though, if you can't get it, you can't get it. Just write down "scan difficult/impossible due to pt body habitus". There is no point insulting the patient.

As for lifting, I know that's a problem, but it's not really to do with the patient. Staff really shouldn't be lifting patients unsafely, the hospital should have enough staff to assist and equipment such as hoists. The fact that there isn't equipment nor enough time to use it, and there is also a lack of staff, isn't really the patients fault.

I work in a hospital and I see staff making comments on weight, and yes some of the ones commenting are overweight themselves. Sometimes more overweight than the patient!

interesting mix of comments on here i think theres a bit of a bullying mentality in the nhs tbh. I think underfunding is a huge issue, i think masks are slipping as a result definitely. but judging from certain comments its always been bad so im unsure.

The 'take some responsibility for your weight' comments are always interesting, so a midwife making an error in HER work, being pulled up on it by another colleague, proving i dont have GD (ive never had it) my BP is fine (never had raised BP) and choosing, not to apologise for the error but get defensive, launch a notepad and gesturing something rude at me and leave a mortified looking colleague, is erm yeah?? a deeply inspiring intervention not all heros wear capes eh!?

TBH i dont just think its midwives. i feel from a previous serious terminal experience with a top medical so called professional , that a lot of staff need to go back on care and compassion courses. I feel its sadly lacking.

Most of my life I have been fat, but because I was struggling to conceive I lost weight (about 10 stone) over 2 years on my doctors advice... well I say advice, his exact words were “a fat cow isn’t a fertile cow”!

When I visited my doctor at a healthy weight, that I had maintained for a year, but still wasn’t falling pregnant he told me it was due to my “dramatic and sudden weight loss”

So even at a perfect bmi and weight, my obesity was still being blamed and no real medical help was offered.

I don’t know how but it’s normal

I too read this as ' I don't know how it hasn't been recorded on the system but its normal.'

I ready the Midwife as being annoyed because she felt she was being called out on an error. You don't know what back history there is.

Thing is though, if you can't get it, you can't get it. Just write down "scan difficult/impossible due to pt body habitus". There is no point insulting the patient

I agree, of course you shouldn’t insult the patient. But I also understand why the sonographer might look irritated or sigh or make some other involuntary sign of frustration. Especially if she’s scanned 10 obese women in a row and half of them had a go at her for not being able to get a clear picture of the baby. She SHOULD be always professional but she’s human too!

As for lifting heavy patients, even if you have a hoist on hand you still have to find a big enough sling, roll them side to side to get the sling under them, which is hard on the teams’ backs. Then move the hoist into position while the patient’s in it, which is much harder on your back if the patient’s obese. Even moving a heavy patient up the bed on a glide sheet involves rolling and physical effort (and you need a bigger team to make it safer so you have to pull other staff off the ward). You can make manoeuvres safer but not completely safe. Back injuries are very common in the NHS even with correct manual handling.

Likewise, wheeling an overweight patient from ward to ward is much harder. And I guess it’s harder for a surgeon to operate too.

IVF requires a certain BMI as being overweight during pregnancy has so many risks to mother and baby.

But weight isn’t the only thing HPCs might look irritated by. I have small veins and they often moan about getting a cannula in (which I understand because they’re under pressure and not being able to find a vein quickly IS frustrating). I don’t take it personally.

If you’re over-sensitive about your weight I think it’s easy to think cryptic comments or looks relate to your BMI rather than the nurse just made an error or is tired!

Sorry, I've read your post a few times and still don't understand what she meant by "I don't know how but it's normal" - is she referring to you as 'it' or your GD results?

this is a sad thread to read.
i am a midwife and care passionately for the women and families in my care.
my job involves lots of grief ,emotional,physical pain surrounding pregnancy loss.
we do have to ask v private,distressing personal questions but should never allow a woman to feel hurt, betrayed,not listened or care / advice to lack empathy.
if difficult,restricted choices are offered ,full explanation must be given explaining why.
i am so very sorry you have such sad/ cruel stories to tell.

The 'it' refers to my results, me being fat as she pointed at me and suprised i didn't have GD.

@epac, please don't feel disheartened the women you care for well will be forever grateful. i worked in care for years my very jaded but down to earth senior often said, theres nothing worse than a group of women!! i wonder if theres an element of that in midwifery too.

I’m a 14-16 and am overweight but was made to feel I should have my own special show on Sky due to my hugeness last time I saw a consultant.

Tbf my consultant isnt too bad, but every appointment is like,, other
Cons: than your BMI your a very low risk pregnancy.

Me : Yup........

Cons:Yep,...............

Me: Yepp,.................😐............

When I was pregnant I was put on a tracer and the midwife was struggling to find the heart beat but was in a completely different place to where everyone else found it, she commented 'its just because there's so much of you to get through' I was stunned and showed her where the heart beat was usually found, and where it was found straight away. I should have complained.

@simiisme

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.

Those people definitely don’t get treated with respect

If it makes you feel any better OP I was treated badly by loads of midwives who very often spoke about me as if I wasn't in the room and one spectacularly rude consultant who I complained about - and I'm well within normal BMI.

So possibly just general unprofessionalism/forgetting that we are pregnant, not deaf.

My friend is a very slim doctor and when she was in hospital with pre-eclampsia she was treated appallingly by the medical team (ignoring her symptoms, snappy remarks, ‘we know best’ attitude). So it’s not just you OP and it’s often nothing to do with BMI.