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daviesjv

I feel victimised because I’m fat.

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daviesjv
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 retail services for larger Mums-to-be, such as this one. 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?

Edited by daviesjv
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kpingitquiet

Anon, if you're 40-or-under BMI, and healthy in all other ways FIGHT for midwife care and the choice to birth in a low-risk unit. I was in this group of first-timers and my first (major urban public) hospital classed me as High Risk. I moved houses in late pregnancy and was zoned into a different (major urban public) hospital. At my first meeting with the intake midwife, she looked at my stats and asked why I was "high risk"? I explained it was because of my weight. She said "Well, that's silly". I had flawless, even LOW blood pressure, perfect blood sugar, clear/easy-to-see ultrasounds, sensible pregnancy weight-gain, and an uncomplicated pregnancy at 32wks (aside from a nasty case of SPD). So, she got the head OB to sign off on moving me to the plush and fancy Low Risk Birth Unit (birthing centre) with access to bath tubs, a private courtyard etc in the birthing suites. If you are healthy, FIGHT for this option.

 

Also, to fetility and weight... eh...I think it's more likely that there is a tendency for women with medical conditions such as PCOS to be overweight, and this skews the data a bit. You may have had the exact same fertility status if you were 55kg. Many thin women have trouble conceiving, and many larger women (such as myself) get knocked up on the first try. I don't say this to brag, just to point out that you do NOT need to "blame" yourself for your fertility issues.

 

A note on birth for this obese mom: I had spontaneous membrane rupture at home, at 38wks + 1 day gestation, labored in the nice birthing suite with only gas for 2 days, was finally given syntocinon at hour-50, then eventually an epidural at hour-52 (no issues with weight + anesthesia, for me), got to the pushing stage and baby was not going to fit through my narrow (ahh, the irony) pelvic opening, so was sent for an emergency c-section. Baby was born at hour-56 weighing a petite and healthy 7lbs 1oz (3.2kg). According to the midwives and OB, my labor progressed much in the way ANY woman's does who has spontaneous membrane rupture prior to any contractions. Weight was not a factor.

 

Good luck with the rest of pregnancy, and with being a first-time mom!

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megsie76

Can't see why you can't access midwifery care if the only issue you have is you weight. I have a BMI of 34 and this will be my second baby through the local birth centre. First one went without a hitch. Did most of my labouring at home, arrived gave birth within 4hrs and was home 12 hrs after arriving in hospital. If you really want the care fight for it or find a hospital that will allow you to do it the way you wish. I think that being comfortable in your surroundings is going to relax you more and therefor allow for a smoother delivery than having care that you don't feel comfortable with.

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fooiesmum

Megsie76 - because this happens:

 

http://www.frasercoastchronicle.com.au/sto...wn-by-hospital/

 

 

I am unable to birth at either of my local public hospitals for the same reason, I am refereed to the OB's clinic at the tertiary hospital further from home and am not allowed to participate in the midwife program.

Edited by fooiesmum

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rose36

I think it all depends on the way you look at.

 

If you are obese (BMI > 30) and the statistics suggest that the risk to you and your unborn child is higher than normal weight women, then maybe being referred to a bigger, tertiary hospital is for the best.

 

Personally, I would rather have birth at a tertiary hospital where there is more expertise than a smaller hospital anyway. Many women require intervention to assist towards delivering a healthy baby.

 

To anon. This is not discrimination. This is the facts. Try to look at it positively; the best way of ensuring you and bub receive top quality care. It sounds like you're upset at being labelled 'obese' but as per the definition, if your BMI is > 30 then you are indeed classified as obese. The hospital staff are just doing their job.

 

Good luck!

 

 

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koiles

I think there's a perception that hospitals are just being mean and nasty - they are basing their decision on facts and statistics and making a decision that they feel is in YOUR and YOUR BABY'S best interests...it's also in their own best interests, but that's because they don't want to be responsible for losing or mismanaging a patient unnecessarily, how insensitive of them! I don't understand why anyone would even want to birth somewhere where they have openly said 'we're not confident we can handle you if things go pear shaped', it's like taking your car to get fixed and the mechanic saying 'the brakes won't work if you slam them on, but meh, how often does that happen anyway?'. Not everyone classed as high risk will have a high risk pregnancy/birth, but if you did wouldn't you want to be somewhere that dealt with these kinds of things regularly and could adequately care for you?

 

I am obese too, I understand how you're feeling and where you're coming from, I was knocked back from my original first choice of hospital and it feels like a slap in the face, it hurts your pride. Seriously though, going to a hospital that is equipped to handle anything that your pregnancy can possibly throw at them, is definitely not the worst thing in the world. The comfort I had knowing they could deal with anything was so reassuring. At a bigger hospital, you are just another obese woman - if you fight to get into midwife care at a smaller hospital, you are THE obese woman...I think you'd have to have a pretty thick skin to ever be comfortable with that. DS would not be here had I gone to a lesser hospital. DS2 on the other hand I could have birthed in my bath tub complication free. You don't know what kind of care you'll need until you need it.

 

Good luck for the rest of your pregnancy.

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la di dah

To me, discrimination is "we could give you the same level of care we give everyone, but your ethnicity/language/hair colour/sexuality peeves us, so we don't want you here" not "you have medical needs that we cannot address at this facility."

 

Discrimination is real. Distorting it to apply to someone who is over an objective medical standard who is being given care, just not where they want it, is pretty offensive to me.

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Aunt Annie

Anon, I would be interested to know how fit you (are as opposed to how fat you are, which is a controversial and often useless form of measurement).

 

My best GF is grossly obese in medical terms, but as a diabetic she keeps her blood sugars under control using daily strenuous exercise (long bike rides, walking, swimming), and so is extremely fit. She had no problems with either of her two boys' births (I oughta know, I was there :) ) which happened in hospital birthing suites rather than the sterile surrounds of a labour ward. (This was in Melbourne- don't know where you are.)

 

So if you are very fit and your other medical signs outside your raw weight are good, keep pushing for equity.

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lbj

Anon, you absolutely should NOT feel victimised because of your weight in this instance. I'm not sure where you are in Australia, but I am pretty surprised by the medical teams response. I am pregnant with my second bub. I am, technically 'obese' (BMI above 30). I weighed exactly the same at the beginning of my first pregnancy as I did at the beginning of my second.

 

For my first pregnancy, the GP I saw was a litle concerned about my weight. She would weigh me each appointment, and sent me for two (TWO!) 2 hour GTTs.

 

It was a trouble free pregnancy. I put on just 6kgs (not sure how I managed to keep it such a small amount, given the amount I ate!). I gave birth vaginally (with the help of a vacuum, thanks to bubs posterior presentation) to a healthy baby who weighed in just under 4 kgs.

 

This pregnancy I have a new GP. She has yet to weigh me. The midwife at the clinic at the hospital (RPA in Sydney) said that they don't want women to be overly concerned about their weight, and didn't weigh me either. She said that as long as I wasn't gaining lots of weight due to poor diet or over eating, I'd be fine. My GP has scheduled one standard 1hr GTT, as she has no concerns about gestational diabetes. Everyone i've spoken to seems to think that this will be a trouble free pregnancy.

 

There may be some risks for women who are overweight, Gestational diabetes among them, but by being sensible with what you eat, and regular monitoring by midwives/doctors, I think that any problems, should there be any, will be picked up, and I can see no reason why you shouldn't have the same likelyhood of a healthy pregnancy and vaginal delivery as the next woman

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Danno8475

I know this doesn't really help but...

 

I am also classed as obese 169cm and 90kg at the moment (so BMI 31.5) and worried that it would be an issue during my pregnancy, as the handbook my hospital gave me said they don't take women over 100kg. I put on 20 kg during my pregnancy (!!!) and was 115kg by the time I gave birth.

 

It never came up. They didn't mention it. Whenever I met with doctors they said baby was "right on for size" and she was born at a healthy, though not massive 8lb 5oz (3780g).

 

Uneventful birth in hospital birthing suite, though I had a retained placenta after the birth and had to go to theatre to have it manually removed (ironic that after making it through the birth with just gas, I needed a spinal block for that!!).

 

I would not have been surprised if they had suggested I couldn't birth there, but I would have asked exactly what the reasoning was and whether it was valid, considering I was healthy and fit. I also don't think I would have been insulted, as their policy is spelled out and it was my choice whether to birth there or not - it was also my choice to be the weight I was.

 

Good luck!

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shortnfat

Dear Anon, I am so sorry this is happening to you at one should be one of the happiest times of your life. Unfortunately, the reality is that not every hospital can cater to the special needs of larger Mums. I am a doctor who works with obstetric patients in 2 suburban public hospitals and have been in the sad position of turning some women away. I think this needs to be done very sensitively and I'm sorry if you were treated with disrespect. At the end of the day, the best thing is for you and your baby to be in a safe environment in the event that you need extra assistance with the delivery. And this can't be achieved in many suburban hospitals, where the obstetrician and anaesthetist may be some time away. Chances are you wont need them, but in the event that you do (and you are more likely to than many other Mums), you want them to be on site very quickly. Good luck, and I hope you are treated with more compassion than it sounds like you have been so far.

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twotoddlers

you are not being victimized or being seen as a 2nd class citizen.. the health care providers are just trying to ensure that your birth won't have complications... which unfortunately may occur because of your weight.. and the fact that you have had difficulty in the past to conceive makes them want to take less chances..

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Mumma3

Please also consider that if you fight for the right to birth at a hospital which is not set up to handle larger women, and things do go pear-shaped during labour or after birth, you or baby may end up being transferred to the tertiary hospital anyway. Worst case scenario is that baby gets transferred and you don't - this can and does happen quite often. It may be a few days before you and baby can be in the same place.

 

I know that we talk a lot these days about the rights of women to birth how and where they want, but we are lucky to live in a country where we have the choice. Take note of the expertise of the medical professionals caring for you. They are very familiar with the statistics, and can sometimes let these facts have more bearing that the individual person they are dealing with, but they really do have your best interests at heart.

No-one wants a poor outcome in this field of medicine.

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shortone

Dear Anon

 

So sorry this as happened to you. Whilst I understand there are risks I think sometimes it is important to look at each individual rather than the 'numbers'

 

My BMI is in the 40s, I have delivered two beautiful babies without any problem. I am also a little older i was 36 yo for DS1 and 38 yo for DD1. I used an OB and he could have found a way not to have me on his list without any trouble. He put all the cards on the table at my first appointment in regards to weight related pregnancy issues.

 

Apart from my weight, my general health was/is great. My blood pressure remained the same from the first appointment for baby one to the day of delivery for baby two, I had no trouble with the glucose tests, no hint of pre-eclampsia (??) or any of the other things on the list.

 

I would ask the hospital to look at your individual case and fight for the right to birth where you want to.

 

Look after yourself and best of luck

 

S

 

 

 

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Pupalumps

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Edited by Pupalumps

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2goingon3

As a mother whose BMI was in the 40's with my first pregnancy I was devestated at 38 weeks to be told I had to change hospitals and couldn't access the midwife's services because of my weight. My blood pressure was perfect, I was diagnosed with GD but never threw a high reading after the initial test, didn't have swelling or any complications at all up to that point and had put on only 6 kilos. At the new hospital I was not allowed to access water because they couldn't have lifted me out of the tub/shower if the need arose and in the last two weeks of my care I was a number in a system, one hell of a shock after having had a single midwife/doctor looking after me for the rest. The outcome of this pregnancy was a perfect little girl weighing at a mere 7 pounds 3, with absolute no complications what so ever.

 

I agree that you need to birth in a hospital that caters to your physical needs but what I don't agree with is then having to have a pregnancy focussed around what could go wrong, rather than what is right. And to lose the support of a midwife was awful. High risk should not equate to lack of support. By all means flick obese women to hospitals that can cater to their needs but you still need to provide with good services.

 

By the way to those of you who are saying she shouldn't feel victimised that's not your call. I watched women who had put on 20-30kgs during their pregnancy, were heavy smokers, drug users or severly underweight allowed to birth where I wanted to. Yep I did feel picked on when the ONLY reason I was transferred was a number on the scales.

 

I have solved the problem this time, I am having no 2 at home and again am experiencing a trouble free pregnancy but at least I know who will be at my birth and I trust them!!

Edited by Charmamma

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Jenflea

You can still get GD even if you are a 'normal' weight so that's not necessarily an argument. I was overweight when I got pregnant, never put on a SINGLE kilo the whole pregnancy (94kg the day of my first OB appt, 93.8kg the day before my baby was born). the only way I know my weight at the birth was because I weighed myself a few times over the course of the pregnancy. my Ob never did, it was never raised as a concern either. I only weighed myself because I wanted to know how my weight was going. I did get GD which was diet controlled and my baby was only a touch over 3kg, so certainly not a big baby by any stretch of the imagination!

Perhaps it might have been different at a public hospital rather than the private one, but my weight wasn't brought up at my diabetes education meetings or appointments which were run out of the local public hospital.

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Pupalumps

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Edited by Pupalumps

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klme

I appreciate that women with a high BMI are at higher risk of a range of complications during pregnancy and birth but the manner in which many hospital staff, in particular the obstricians dealt with me during my second pregnancy was appalling. I very much felt that I was seen firstly as a woman with a high BMI, and secondly as a woman who was pregnant when I strongly believe that it should be the other way around. I left numerous appointments in tears, mostly after yet another obstetrician felt that they needed to point out YET AGAIN that my BMI = higher risk. Apparently because I'm fat they thought I was an idiot incapable of remembering from one week to the next. I felt very much as if I were being railroaded into having a caesar just to "minimise risk" (or more likely to make their jobs more predictable).

 

Like many obese women I experience varying degrees of shame, guilt and awkwardness about my size. These feelings prevented me from speaking up about my ill-treatment and my own desires for my birth until towards the end of my pregnancy when a friend spoke to me about the need for me to be an advocate for my birth and ultimately my baby. After discussion with a supportive midwife I felt I actually got to have the birth I wanted, though the hospital still produced the commode mid labour, declaring I was too heavy for the hospital toilets that I had been using throughout my pregnancy on every visit. And people wonder why 14 hours after giving birth to a healthy baby I headed home, if only to pee with dignity!

 

Dear Anon, what you're going through is crappy and is a blight on your pregnancy. Research what your options are but most of all advocate for yourself and your baby. Recognise that these people are professionals but demand that you be treated with humanity, even if it involves having to appeal higher up the system (exploit the hospital heirarchy). Even contact your local member of parliament, or the health minister for your state or territory if you feel your concerns aren't being taken on board. Most importantly good luck, I hope all goes well for you and that this becomes a mere blip on your path to parenthood.

 

 

 

 

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la di dah

Do they calculate BMI off a regular chart even while you're pregnant, or are people who are saying they had 30 plus BMIs using their pre-pregnancy weight?

 

I'm just trying to figure out what I'm likely to be.

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Linda6

Anon. I know exactly how you feel as I'm going through the same thing. For those people who say the way overweight people are being treated is for their own health you obviously haven't been in this situation so don't fully understand exactly how you are treated in this situation.

I went for my first hospital appointment at 11 weeks and had a great reception by the midwives they were lovely then I saw the trainee doctor. He had no bedside manner and after leaving me alone in the room for 20-30 minutes while he spoke to his consultant came back told me that they couldn't see me at that hospital any more because of my weight and write out a referral for an early GTT.

It wasn't what he said but the way he said it.

That's where my aloneness started. This was in September and when the new hospital called me to make an appointment it wasn't made until mid November.

It took me weeks to find out where I would go to get the results of the GTT because as it turns out my new hospital will only deal withe for the birth and not for any appointments prior to that. After weeks of calling to find out what was going on I eventually got an appointment with my original hospital at 20 weeks.

My only issue is my weight I don't have GD, high blood pressure or any other medical complication and my baby's growth is in the mid range for growth.

Yet at my appointments the first thing mentioned is my weight and this is mentioned at a minimum of 5 times per appointment. At no time do they discuss the positive outcome of a labor.

I live over 1 hours drive from the new hospital when I asked how I get to the hospital when I go into labour as my husband would most likely be at work I was told that I wouldn't go to that hospital first I would go to my local hospital and if there were no risks in my labour I would birth there.

I don't understand why I am going through all this crap when the most likely outcome is that I will birth at the original hospital.

Seriously tell us the risks, let us know that if we present for labour and there are complications on the day we will be transferred to x hospital (just like any other woman) but don't put us through this crap to start with. Treat us like pregnant women as that is what we are and most of all please treat us with respect. We have that right just like anyone else.

Linda

 

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Pooks_
To me, discrimination is "we could give you the same level of care we give everyone, but your ethnicity/language/hair colour/sexuality peeves us, so we don't want you here" not "you have medical needs that we cannot address at this facility."

 

Discrimination is real. Distorting it to apply to someone who is over an objective medical standard who is being given care, just not where they want it, is pretty offensive to me.

I think it depends on whether that medical standard is based on good information, or on bad information or bias. For instance, my grandfather was not given anesthetic once when getting dental work because as a wog, he was not deemed to need it because they are more used to the pain. It was standard practice for other 'wogs' he knew at the time. Not a great analogy, but my point is that the medical world is as open to bias as anyone else.

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BetteBoop

 

 

Run for your lives, it's a

 

 

 

zombie thread

 

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Pooks_
Run for your lives, it's a

 

 

 

zombie thread

Oh sh*t, fo' shizzle? I got stung. I needs sleeps.

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Linda6

What's a zombie thread?

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