Justine Davies

Justine Davies

I am currently pregnant with my first child, after four years of trying. It was a natural conception, not IVF, but I was beginning to think that it would never happen so I was overjoyed late last year to find that – yay – it finally had!

But I’m having issues with my health carer and choice of hospital and (being a first-time Mum) I don’t know whether I’m being oversensitive. Short story: they think I’m “obese” and hence high-risk.

I am biggish – I have been for a number of years. It could have been a factor in me having difficulty falling pregnant (certainly that’s what everyone seemed oh-so-keen to tell me). But there are a lot of people out there who are more overweight that I am and I certainly wasn’t expecting to be made to feel like a second-class mother because of it.

It looks as though I won’t be able to have my baby in the hospital of my choice, which seems ridiculous because as I said, there are a lot of people bigger than me. I can’t really understand why the hospital has this viewpoint that I am somehow too great of a risk for them. Is this normal??

And how is it possibly fair?

(Anon)

First-off Anon, you absolutely shouldn’t feel victimised. I’m sure that your health professionals are not intending it as any type of judgement as to what sort of mother you’ll be!

However – and depending on where you live – you may well be limited in choice of hospital, due to your weight. To give you a little bit of insight as to why, I have asked Associate Professor Hannah Dahlen, a leading midwifery researcher with the University of Western Sydney, for some advice. Hannah was a contributor to the report: “Not waving but drowning': a study of the experiences and concerns of midwives and other health professionals caring for obese childbearing women.”

“The core finding of that report was that the dramatic increase in obesity in childbearing women has caught all of us by surprise and really, there’s an awful lot we’re not prepared for,” says Hannah. “Basically there’s a creeping normality around obesity, and what we would have once considered overweight is now considered normal. We’ve kind of adjusted out goal posts. So the health system is dealing with both the increasing costs related to that and also not always having the appropriate technologies. There’s a real feeling that health professionals are floundering, not sure whether or how to broach the issue of being overweight with the women, and then what the best model of care is for them.”

“Definitely we know that the risk factors are greater for women who are overweight. They’re more likely to have larger babies, to have caesarian sections, more likely to need inductions, more likely to have gestational diabetes. But whether we are currently giving women the best care is a question that I think we need to have a serious debate about.”

Anon, that may, of course, not be much help to you with your current pregnancy, however Hannah suggested that you speak with your local care provider to see whether there are any health support groups in your area that may be able to help you. One such model, at the St George hospital in Sydney, is the SSWingG group (which is a group-based model of antenatal care for larger women).

And it’s important for you to know that you’re not alone in your feelings. Hannah’s second research report, due for release soon, interviewed fourteen overweight women about their experiences and found that they often judge themselves more harshly than they are judged by others.

“Women told us very clearly: “Look, don’t judge us, get alongside us.” They hated us using terms about them like “high risk”. They didn’t like BMI – they found that a very user-unfriendly word. They didn’t want to be labelled,” says Hannah.

“What women said is that they really wanted to access midwifery care, and they wanted continuity. And they didn’t know why they had to be excluded from midwifery care; why couldn’t they have a combination. And I think that is what we need to address via debate; devise a system whereby women can gain the benefits of midwifery care, maximise “normal” but also provide them with access to specialised care if they need it.”

“Currently obesity in many hospitals has been highly medicalized, so if you’re over a certain weight then you get excluded from midwifery model and you get exclude from different places of birth, and you end up in a high risk clinic where you’re basically looked at for weight, blood pressure and whether or not you have diabetes, so it takes away all the other important psycho-social support and the ability to build up a relationship and have all the other benefits that women do well by. We do need to improve that and be more individual in our approach to the issue.”

In the meantime though Anon, see if your local area has a support group, such as the one mentioned above. And try some of the Essential Baby support groups. And rest assured that no matter where you end up having your Bub, you can be as great a Mother as you want to be!

EB Members: Do you have any advice for Anon?

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