Experiences of obese women and hospital care

[Shinn]

I have actually had enough of the stigma surrounding being overweight and pregnant, i had my 20 week scan today and my first antenatal appointment. On exposing my stomach the midwife quickly asked me “oh was your first one a cesarian then?”, im sick of this presumption that overweight women are seen as incapable of naturally delivering their baby, i have been asked this so many times and my answer always seems to shock! I replied “no. I had my 9lb 1oz son naturally, 20minutes pushing no tears and no forceps.” I am sick to death of the reaction of shock i receive when delivering this information! Why is it so hard to believe that an overweight woman can be capable of delivering a healthy baby in a natural way!!!? The questions that we are asked as overweight expectant mothers are equally degrading, on meeting the second midwife i was asked a trove of questions including the like of “can you get on and off of the commode independently” “can you get on and off the bed independently” “can you move around independently”? How in Gods name are these questions relevant? I walked the full stretch of the hospital to get to the appointment, i got up from a chair when called in to attend my appointment, i provided a wee sample all by myself (sarcasm) within the appointment! The questions were apparently relevant assessment due to my BMI, i happily informed her that i was perfectly mobile and capable in the conception of baby number one and now baby number two to which she didnt have much to say 😂. As if it isnt degrading enough to be stigmatised as lazy and incapable of birthing when overweight, the new stigma attached to overweight expectant mothers is now that we are disabled and incompetent to complete menial tasks due to weight! I love the experience of being pregnant but I absolutely detest the stigma and maltreatment we receive due to weight. Its vile and needs to change. I experienced a healthy pregnancy at this same weight last year i am now pregnant again, i did not get gestational diabetes despite being told i would. I did not develop blood clots or pre-clampsia despite being told i would. I did not need help in delivering my baby despite being told i would. Please please overweight ladies share your experiences too so that i know i am not alone in this. On a side note this is in no way trying to discredit mothers who experienced complications in pregnancy due to whatever factor, the purpose of this post is to vent my frustration at the stigmatisation of weight in pregnancy and the perceptions and accusatory treatment us overweight women receive. Also please note i am in no way trying to discredit mothers who gave birth with c section, i understand that this way is by no means the “easy” way despite the stigma surrounding it! Ladies please feel free to share with me your experiences.

I don’t think you are unreasonable about the treatment of overweight women giving birth but your OP states Obese. Obese carries a big risk, like it or not. Glad you were ok but don’t dismiss the risks.

OP, there is a greatly increased risk of complications, needing emergency intervention, in obese pregnant women. If you are in a high risk group, you should be glad that the staff are giving you extra monitoring and care to mitigate that.
As for the questions about mobility, commodes etc - the nurse was just completing the standard obesity checklist for patients. She needs to know whether you need help with toileting etc, so it can be put in your care plan. She does not want to be sued if you get stuck on a toilet or fall while unsupervised.
We had several obese patients for whom we had to hire bariatric beds and specially reinforced commodes, as the patients would have broken or not fitted onto standard NHS ones. The nurse needs to determine whether you will need these, are they are very expensive and have to be hired in advance for a minimum period.

Obviously you feel that you have escaped the associated medical and functional morbidity of obesity in your first pregnancy, but it does not follow that you will be lucky twice, and you need appropriate care. Don’t be annoyed with NHS staff for simply doing their job properly!

I am quite aware of the risks associated with my BMI, it is abhorrent to suggest otherwise. My bmi does not facilitate the need for reinforced commodes and beds, that is insulting. My pregnancy had nothing to do with luck thankyou very much, it is possible to be obese and healthy. Preparation for birth and the exercises i did beforehand aided me in delivering my son safely and efficiently, the original post is regarding the stigmatisation and accusatory treatment obese women receive, you as a health care practitioner seem to be part of that problem. The assumptions based around BMI are simply prejudice, the assumption that i had a c-section for instance is yet another example of such stigmatisation. As a health care professional you have access to patient notes, therefore why on multiple occasions have i been asked about c-sections. Surely if the practitioner had been doing their job they would be aware that i did not have a c-section, making the accusatory questions irrelevant and unnecessary. Obese women are treated differently than women of a normal weight, we are stigmatised and disrespected by health care professionals many studies have revealed this. You as a health care professional outright denying this is indication to the problem.

You sound like you're in denial OP. People have give you reasonable and informed responses, yet you attack them.
You've been lucky. Others less so. The NHS staff are simply doing their job.
Maybe you're feeling got at because deep down you know they're right.
And no, I'm not fattist. I have been obese myself.

Thankyou for acknowledging the treatment of obese women, i understand the implications and the measures healthcare professionals need to take. My issue is more so with the stigmatisation associated with obese expectant mothers, the questions regarding mobility took me back as i am employed in an active role i didnt expect my mobility to be questioned hence my insult x

@unebaguettepastropcuite

You sound like you're in denial OP. People have give you reasonable and informed responses, yet you attack them. You've been lucky. Others less so. The NHS staff are simply doing their job. Maybe you're feeling got at because deep down you know they're right. And no, I'm not fattist. I have been obese myself.

Right about what? In denial about what? You seem confused, my initial post is regarding stigmatisation associated with bmi your post is irrelevant assumptions and goading. I haven’t attacked anyone....i am simply outlining my own experience of stigmatisation at the hands of staff and asked others to share their experiences, i did not ask for busy bodies to display their own accusations and assumptions regarding myself. Thankyou and have a nice day 😗

I don't think these questions are discriminatory tbh. You are less likely to be able to mobilise easily/unaided if you're obese. They need to know what you're capable of and if you're likely to need any help.
And I've been very overweight and obese myself in the past. Try not to take it personally would be my advice. They're not trying to say you're a shit person, just to find out what you need.
And referring to your active sex life is just 😬😬😬

Wow! Get your blood pressure checked! Or is this a wind up?

In the long term obesity is never healthy, I think your anger is perhaps because you don’t want to be reminded of your weight. They are not there to offend you but offer you the best care.

I'm not obese, got asked all these questions on admission for appendicitis. Standard questions...

There isn’t any stigmatisation. As others have said, your care reflects the very real risk factors associated with obesity. It’s a major major cause of morbidity in pregnancy and throughout life. Would you expect to be tiptoed around if you were a 40 a day smoker?

Hmm... I was classed as morbidly obese when carrying my DC and I just assumed that the questions are asked of every pregnant woman.
If they’re not, I assumed that they were asking questions tailored specifically to my situation and were just doing their job.

I obviously missed the perfect opportunity to be offended 🤣

I don’t get people insulting me. Maybe I’ve got a ‘don’t bother’ face or maybe the majority of people just want to be kind and helpful?

Research and studies have shown being obese does increase certain risks during pregnancy and birth, and checking mobility is fair enough so that they can ensure the right support/equipment is available if needed. Sorry if you feel offended by the fact that they have a duty of care to point these out.

To me it sounds like the questions are just standard procedure, not a personal attack. I understand it must make you feel horribly self conscious though.

I’m sure risk assessment drove the majority of those questions. Being oversight and pregnant does increase the level of risk unfortunately and medical professionals need to assess it.

My pregnancy had nothing to do with luck thankyou very much

Of course it did. Most women who have successfully pregnancies and natural births are very fucking luckily.

To suggest otherwise is to suggest that women who have difficult pregnancies or births could have done something to prevent it.

You actually sound quite naïve and ignorant.

You were lucky. Not all women are, obesity or no obesity.

I experienced a healthy pregnancy at this same weight last year i am now pregnant again, i did not get gestational diabetes despite being told i would. I did not develop blood clots or pre-clampsia despite being told i would. I did not need help in delivering my baby despite being told i would. Please please overweight ladies share your experiences too so that i know i am not alone in this. On a side note this is in no way trying to discredit mothers who experienced complications in pregnancy due to whatever factor, the purpose of this post is to vent my frustration at the stigmatisation of weight in pregnancy and the perceptions and accusatory treatment us overweight women receive.

It’s great that you had a smooth pregnancy and delivery.
Not all smokers get cancer but health professionals have a duty of care to point out the risks based of years of scientific research.
Same goes with me being morbidly obese and pregnant. I’d be a bit worried if they didn’t point out potential problems.

Fat-phobia definitely exists but I’m not sure the examples you’ve provided are to be honest. A lot of those questions seem to be about being able to get the best case for somebody who is obese. Would you prefer that weight was completely ignored and risk not giving appropriate care?

A friend told me an example of an obese woman who went for a smear and the nurse who did it made a fuss about not being able to get the sample. The appointment ended with the patient agreeing to lose weight and come back. Said patient then ended up with stage 4 incurable. Surely that’s the issue with fat-phobia in medical care?

I think that being fat is still seen as ‘fair game’ to belittle, patronise and devalue people (especially women) in our society and that needs to change. Everyone is deserving of respect.

That said, it sounds like you’re an active and healthy obese woman but that’s not the case for all. The questions asked were relevant but I i magazine the HCP asking them could have done so with more respect.

I think all pregnancies are luck. I became pregnant in my late 20s with a healthy BMI, I did yoga and exercise every day, I felt very well in my self. I had problem after problem in pregnancy from high downs risk and CVS to low placenta, massive baby with risky proportions 3x diabetes tests, and I had such severe pelvic pain I was housebound by the end.

That was all pure unluck. I thought I'd be a pregnant goddess and I was just a mess!

Wow, defensive much!

Definitely in denial, obese is different to overweight.

Obese mothers have more risks during pregnancy than healthy weighted ones. That's a fact. Only 2 women in my NCT had big complications, both were the only larger ladies, one is still struggling to get her C-section to heal a year later, infection after infection.

The NHS staff are just trying to do their jobs and prevent issues later on. Imagine if you have a bad 2nd labour and end up with complications? Your choice to get pregnant whilst obese, I'm sure they don't love the extra paperwork. Of course there are different questions, you are in a different risk category, no different to if you had other additional needs.

Good luck with your labour, I hope all goes well.

This is about elevated risk factors. Would you prefer they ignore the risks and don’t ask so you don’t feel upset about it?

I had my first child in the early 90s. On my notes from the dr to my gp was the wording " This rather fat lady of 25 " ......... Cheeky fucker !

The questions around mobility are standard for obese patients, they're to protect both you and the NHS staff responsible for your care. If you were to need help moving around in labour (which many women do, whether they are obese or not) the staff will have difficulty moving you due to your weight - they could seriously injure themselves, so they will need special equipment on standby. If you had mobility issues (no, not all obese people do, but pregnancy can cause these and they are much more likely to occur in obese patients, hence the checklist).

Nobody is trying to insult you, they are trying to protect you and the midwives and HCAs involved in your care.

I was asked all those questions and I’m not obese. Maybe a little overweight.
I laughed and asked if I should have trouble and she said it was routine questions encase of surgery and to make sure you i any help you need.
It sounds more like you’ve taken that personally because you are obese.