I'm a plus-size pregnancy specialist midwife: ask me anything!

[liftis44]

Hi, I've been a specialist plus-size UK registered midwife for 15 of my 20 year career. Nowadays I'm a PhD midwifery lecturer/researcher. I get lots of questions and worries from women on this topic, and I'm all up for myth-busting, information-giving and reassurance! ASK ME ANYTHING and I'll give you an evidence-based response ASAP!!

@Willbe2under2 @Matildahoney The guidelines changed in 2018. Advice is to take higher dose if your BMI is >30. This linke may be helpful:

www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/being-overweight-in-pregnancy-and-after-birth-patient-information-leaflet/

@Rainbowgoth always insist on a large BP cuff if your arms are big. You'll get an inaccurate reading (probably higher) if not.

Thanks once again @theheavyweightmidwife, I'll get in touch with my GP on Monday. Really appreciate this thread 😊

@Havehope21 No, you don't have to be weighed. The weighing is to calculate whether you'd have extra surveillance, possibly blood thinners etc. recommended but your mental well-being is so important in pregnancy. Are you in a position to have a chat to your midwife about it? I always favour openness and trying for a holistic discussion about your worries and preferences/needs rather than advising women to just refuse. As midwives, our conversations should really start with 'what's important to you? what are your concerns and priorities'. Good luck luck and stay in touch!

@ancienthouse You are correct - it is a blunt tool and an arbritrary cut off. There is some evidence that some risks increase (but it is really by much) as maternal weight increases, but most people really do have no problems! And we cannot predict who will and who will not have problems. We have these guidelines based on population-level data - because that's the best we've got, but discussions and recommendations at individual level based on this causes a lot of anxiety. I honestly think lots of women think complications are likely for them, which is not true, and really damaging (and may actually in itself make complications more likely!)

@Willbe2under2 it's an absolute pleasure to help!

Does a uterine prolapse cause a problem in pregnancy?

@theheavyweightmidwife thanks so much for your responses. So, so helpful!

@Room4onemore can you give more detail? A previous prolapse?

A prolapse that presented itself at about 8 weeks, 8 previous pregnancies, bmi just over 30 and 40 years old

@Room4onemore ah I see. It’s really hard to comment on that from afar. It’s also obstetrics really. Have you got a referral or been seen by an obstetrician?

No not yet I haven’t, I had a phone appointment with other the doctor and he said to wait until after the pregnancy, I asked if it was dangerous and he said no, but I’m worried about having a miscarriage or premature labour

This might not be a specific plus size pregnancy question but I have a telephone obstetrics appointment at 23+1 which was booked at least 4 weeks ago (15 weeks tomorrow) I have no idea what it could be for. Any ideas?

@theheavyweightmidwife Thanks for the work you do, and for this thread. It’s great that you’ve put so much thought into the language of this. I agree, the ‘o’ word is stigmatising to individuals who are often seen, also on mumsnet, to have failed on multiple levels when we all live in a world surrounded by industrialised food and have little time to move around. I love it when healthcare professionals are bold enough to address what’s wrong in the system.

@Room4onemore thats really beyond my scope of practice. You’ll have a slightly elevated risk and obviously act on anything outside of normal (bleeding for e.g)

@smooththecat It’s my pleasure. And my passion!

A tricky one @TeddyBeans Are you having a twenty week scan? Could just be a routine follow up? Sorry to not help
kore on that.,

Yes having a 20 week scan. It's thrown me because I didn't have an obstetrics appointment with my first pregnancy and the only difference I can think of is being 10kg heavier at booking than last time

Hi :) I’m obese which has been excacerbated by also having chronic fatigue syndrome- when things are bad, I’m hardly moving at all but still eating plenty! Recently I’ve been doing a lot better and the extra movement (and energy to cook better meals) has resulted in fairly steady weight loss. Im hoping to TTC soon and I’m a bit confused about the whole “no weight loss in pregnancy” thing if I’m still feeling well and eating better. Is it a case of “don’t do any silly diets but weight loss as a side effect of eating better is ok” or do I need to be actively trying to maintain my weight to avoid risks to baby?

Would you expect to see weight gain in the first 10 weeks?

@TeddyBeans i wish communication was better so you didn’t have to wonder and worry. Can you ask?

@riotlady good question! I’ve answered earlier about not having good evidence it’s safe to lose weight in pregnancy. People do for a variety of reasons and individually are fine but we just really don’t have evidence to say go ahead and cut back or whatever, as we can’t say it’s definitely safe. Frustrating! But yes, focus on healthy stuff, eating well, real food avoid sugar.

@Matildahoney for a lot of people yes, as appetite changes, pregnancy symptoms like nausea cause eating changes- using little snacky carbs to help nausea. But it is to do with this rather than the pregnancy per se. The baby is obviously tiny and placenta etc not developed yet.

So it's not a concern if someone hasn't?
Oddly my jeans no longer fit, but the scales have not moved, I think I'm naturally eating less as I fill up far quicker now, and also trying to eat the right things so I guess that would have an effect?

@theheavyweightmidwife I have a midwife appointment on the 12th so I'll ask then. Failing that I'll give the number a ring. Thanks anyway ❤️ I'm sure I'll be back with other questions if you're planning for this thread to be available for a while yet?