Consultant has scared the crap of of me, am I being over sensitive?

[Welikethemoon]

First appointment with the consultant yesterday. I'm 13 weeks with my second. I have a high bmi, I'm 36 and I had a c section with my first because she was breech (she is now 3 1/2) pregnancy was uncomplicated apart from spd. I was keen on attempting a natural delivery this time.
I was expecting the consultant to say I needed to take asprin (I had to last time) and that I might need more scans to monitor growth. I did not expect to be told to sit down in a little room then have her literally stand over me and reel off the long list of horrible things I'm at risk of and what they expect me to do about it. Basically I'm at risk of dvt, bleeding, diabetes, splitting my scar, spitting down below, eoesiotomy, shoulder distosia, she told me there would be a high risk of them hitting the panic button in delivery and having hundreds of people come in to get the baby out in a hurry (her words) or emergency c section. So I asked if it would be better for me to have an elective section instead and she said "oh no! The risks are much greater if you do that!" I will need to take asprin from now, will need to do daily fragmin injections from 28 weeks, glucose tolerance test and she basically forced me to sign up to slimming World. She also wanted me to decide there and then if I went over due if I would consent to having an elective c section (after telling me the risks are even higher) as being induced would double the risk if my scar splitting. I refused. I don't have a clue which is better and she made no attempt to explain or reassure me further. Just said she would ask again at the next appointment. I also have a history of anxiety and depression (which she knew as she asked me about it) and this was a lot of information to take in! She then set about dictating a letter to my GP in front of me repeating all the risks and problems. Am I being over anxious or was this a really insensitive and unusual experience? I get I need to know the risks, but there are surely better ways of reassuring me that they are going to manage it and it will be OK in the end? Should I complain? My DH thinks I should. I'm not sure if I should suck it up as its my fault anyway.

sorry @Welikethemoon but why is it your fault??

Well, coz I'm over weight and chose to get pregnant over 35

She is probably required to make you aware of the potential risks/issues likely to come up, but it sounds like she was pretty blunt about it.

How high is your bmi?

To be fair you are the size you are due to what you eat so yes there is blame there, but, I think the consultant sounded like a total bitch. She might have been having a bad day, might have had a maternal or baby death recently or maybe just doesn't know how to talk to parents.

I would speak to your midwife and discuss your options and even ask to see a different consultant at your next appt.

The risks are high and things like DVT, diabetes and uterine rupture do happen but if you start now you can really reduce your risks. Losing weight while pregnant is safe for you and the baby. I've done it with all my pregnancies due to gestational diabetes. Each time I was lighter at 9 months pregnant then I was pre-pregnancy

Congratulations on your pregnancy

She sounds a bit brutal and I don’t blame you for freaking out a bit. You know how your first pregnancy went and there’s no reason this one will be harder.

My bmi is normal but I’ve been on aspirin and fragmin/clexane since bfp due to my history and neither is anything to worry about. I winced mentally over the first couple of jabs but these days I do it with my eyes pretty much closed, twice a day, and promise it’s no bother at all.

Try not to panic and enjoy your pregnancy.

Sounds awful. There's no way you need to make decisions like that on the spot at 13 weeks. You have every right to complain and change health care provider. Remember you can chose any maternity hospital. X

She doesn't know it will be OK in the end, though. Sadly, she deals with it not being OK in the end on a daily basis. Obstetricians can become quite traumatised themselves with some of the things they see at work (any of you who have read This is Going to Hurt will recognise that). I'm sorry you were left upset, but she does need to share the risks with you - if you are significantly obese they will need to manage a range of risks through your pregnancy and delivery.

High BMI and age do increase the risks of a VBAC, and high BMI raises the risks of C-section quite a bit too. A lot depends on how high your BMI is.

To be fair - aren't those risks in every pregnancy?? Probably a bit of both: her being too blunt and you being sensitive.

Slimming world sounds like a good idea though... why is it bad?

It also sounds like you have food for thought and should do research about vbac/ c section.

Okay... so I'm a tough love bitch. Take that as given. You want to minimise the risks, right?

You tell us. Will you try harder to reduce the risks because she tore a strip than if she had gently reassured you & said it will be ok in the end?

aren't those risks in every pregnancy??

Yes, but if the OP has a BMI over 35 they are much more significant risks. Rates of clotting, instrumental delivery, shoulder dystocia, and EMCS are much higher in obese women and rates of gestational diabetes are about 3x as high.

I had this kind of delightful experience.

Request and appointment with your supervisor of midwives and explain your experience.

Trust me when I tell you they’ll understand.

Consultants are generally scaremongering bastards.

@CountessVonBoobs that's scary!

Why shouldn't the op be told this?? She weighs approx 50% more than 'healthy' - it's not like she doesn't know this, but sometimes burying your head in the sand about risks isn't helpful... her manner might have been off, but her message spot on.

She sounds brutal, nobody can force you into slimming world surly that's advertising of a particular brand/company after all it's just healthy eating and exercise it's not rocket science.

Slimming World have a plan specifically adapted for pregnancy, which other diet companies generally don't. The NHS often specifically recommend it for this reason - because it's safe, sensible and supportive in pregnancy.

My BMI is also over 35 I got no lecture from any HCP to date. I'm shared care and have had nothing but support from the consultants and midwives. I'm the one asking them "oh I suppose with my bmi I'm at risk of another complicated delivery after DC1?" They said no my pregnancy has been low risk to date, baby's growth is measuring spot on, GTT normal, barely any weight gain and attending a 'weigh to a healthy pregnancy' program with a dietician.

No one has belittled me due to my size but discussed kindly the increased risks so I'm fully aware.

That consultant was being unreasonable speaking to you about the risks in that manner!!

There are plenty of women choosing to get pregnant into late 40s which has increased risks and no one would dare say "you made the choice to get pregnant over 40 so YES IT IS YOUR FAULT"

When it comes to weight certain people get a kick out of telling those with high bmi "it's your fault you're fat".

The consultant doesn't have to tiptoe around her but could've had a normal chat about risks and not lecturing OP into feeling so guilty.

Congratulations wishing you a happy pregnancy OP!!

her manner might have been off

And that’s the issue.

Consultants have all got valid points to make; their duty is to inform us of the risks and consequences of decisions in pregnancy.

But too often women are scared or feel bullied into making decisions where they may not realise choice exists because of bullish consultants acting like drill sergeants and not discussing the patient with - well - the patient.

Isn't 'over 35' OP's age? She hasn't said what her BMI is.

I'm 36 years old and my bmi is 44. For context I'm 5' 1" and a size 18. So I get I'm over weight, but it's not like I need to get special clothes made. I'm otherwise healthy.

@Welikethemoon

definitely get in touch with the supervisor of midwives and please research VBAC and your BMI a bit on the Internet (Mayo Clinic, Babycenter, The Bump, academic papers) as it could give you some pointers to narrow down the focus of what will probably end up being your birth choices chat.

All due respect OP but that's well into morbidly obese. That is certainly going to increase risks a lot.

There are calculators online where you can enter your statistics and get a calculation of your chance of a successful VBAC. It looks like about 42%.

@Welikethemoon being overweight and in you mid 30's isn't a reason to not have a baby nor should they be seen as a negative. she sounds a bit too blunt IMO. I feel like a PP is correct, consultants seem to scare the shit out of you, I appreciate they want you to be prepared for the worst but putting the fear of god into you just adds more stress.

I had my 28 week scan last week and I had ONE sugar reading the whole week that was over what it should be and she was hell bent on putting me on the insulin and telling me how its too dangerous ect ect. luckily a senior consultant came in and totally disagreed with her

definitely get in touch with the supervisor of midwives- I agree!

Getting in touch with the supervisor of midwives is easier said than done, as (like a previous poster suggested) I am already going outside my area to have the baby, as for various reasons I don't want to use my local hospital. So my midwife care is through my GP surgery and the midwives are attached to my local hospital but my consultant is based at the hospital a bit further away that I will have the baby at. Different county, different primary care Trust. I don't have any contact with midwives at that hospital until I actually go in to have the baby. I did the same last pregnancy and given that I never saw the same midwife or consultant twice in either pregnancy it makes little difference to me but does make getting any complaint through more difficult. I also found last time that I seemed to slip through the cracks of responsibility as neither trust (my home or the one I was going to) would allow me to do any antenatal classes because of this. So it's all very well saying you have a choice about where you give birth, but it does come with conditions that they don't tell you about.

Darling, I just put in “supervisor of midwives” + [hospital name] into google, her email came up so
I emailed her, and cc’d the “maternity@toytownhospital” email.

I said I’d had an appointment and that I felt shaken up and confused about my choices, stated how far along I was, age, NHS no etc and they responded in a week.

Try it x

Thanks for the tip, I will try that. X

She was harsh OP, but everything she was telling you was correct. A BMI of 44 is double the "healthy" BMI range, and of course does increase the risk.

She could have been gentler, which would have been nice. But her job is to give you informed medical advice, which she did.