Wednesday, September 16, 2009

Pregnancy and a HAES Crisis of Confidence

Many fat-accepting women face a crisis of faith in their own self-acceptance and in HAES (Health At Every Size) when they become pregnant or consider becoming pregnant.

It's something that many of them don't want to admit out loud, especially in fat-acceptance circles, but I have observed it often in others over the years. I know it was certainly true in my own case.

Even though we still fully believe in fat acceptance and HAES, many of us guiltily go through a stage anyway where we start secretly obsessing over the possible complications of "obesity" in pregnancy, whether we could possibly have a safe pregnancy and birth at our weight, whether our babies could possibly end up healthy, etc.

It's a natural reaction to all the years of propaganda we have heard about how unhealthy being fat is, about how dangerous all that weight is, yadda yadda. Then you add in the natural insecurities that go along with being pregnant for the first time, the media onslaught of negative stories about being fat and pregnant.....and it's a potent recipe for doubts and worries, even in the most self-accepting, empowered woman.

We may or may not admit our fears to those around us, but I think many of us do experience them. But unlike other women of size, we may not feel "safe" to admit to those fears out loud for fear of what others in the HAES community may think. Or we may not even admit them to our partners, lest that cast doubt in their minds about us being pregnant and fat. So that can leave us incredibly alone, stewing in our own fears and letting them ferment.

We may not talk about it much out loud....but I'm convinced that many of us who have been pregnant (or considered pregnancy, or even just had a pregnancy scare) experience this fat-acceptance crisis of faith. I know I did, and I'm willing to take the chance to speak out about it in this forum in hopes that it helps others understand that this is a natural phase that many of us go through....BUT that it doesn't have to be a place where we stay emotionally, and that we don't have to let these fears impact our birthing choices.

If you didn't experience these fears, more power to you. I applaud your empoweredness, and I think it's important we hear from you too. But many others of us have felt these doubts, yet may feel a bit muzzled about talking about it because then it looks like we don't really believe what we've been saying all along.

I think it helps to discuss these fears openly, and to see them as a very normal part of plus-sized pregnancy in this fat-hating society.

I also think it's important to understand how these fears can sometimes influence our birth experiences and our decision-making in pregnancy, and to know that we have other choices besides the high-tech, high-intervention, high-fear model that most fat women experience.

Finally, I think it's vital that we acknowledge these fears and then find a way to move past them, so that it doesn't overshadow our entire experience of pregnancy and birth. We deserve to have happy, joyful pregnancies just like anyone else, and it's within our power to have that, regardless of size. Acknowledging the fears and talking about them is the first step to moving past them.

My Experience

When I was first pregnant, I experienced a huge uptick in fear levels about my size, despite having been part of the fat-acceptance movement for many years. Partly this was because it was an unplanned pregnancy and I hadn't sufficiently girded myself for all the worries of pregnancy, and partly it was because there was no information available then about being pregnant and fat.

What little information about it I could find in mainstream books had all kinds of scare tactics--and that was just for those who were a little bit "overweight." I was significantly "morbidly obese"----if things were that bad for overweight women, how bad would they be for me as a morbidly obese person? Gah!

So yeah, there was some panic on my part when I learned I was pregnant. I indulged that for a little while, then I took a bunch of deep breaths and tried to figure out what I could do to address my concerns and see what did and did not have merit.

I had been a member of NAAFA (National Association to Advance Fat Acceptance, http://www.naafa.org/) off and on for years before I became pregnant. So the first thing I did once I calmed down was to call NAAFA to see what kind of sensible size-friendly info I could get there. I hoped that they could provide an antidote to the fear I was experiencing.

Sadly, I got no help. They had no information about pregnancy at larger sizes. I said, "Surely someone in NAAFA has been pregnant in all these years it's been around?" The person I spoke to said probably, but she couldn't point me to anyone at that point. And she really didn't seem very concerned at all about finding me some reassurance or help either. So NAAFA, my best bet, was no help at all. That wasn't very reassuring, and I felt very alone.

So I thought, Well, I'll just have to find someone in real life who has done this. I went to some of the other fat women at my workplace who had kids and asked them what to expect. Alas, none of them had any help for me either; they said they really hadn't been fat when they had their kids and had only gained weight after having children. So I couldn't even find anyone in real life for inspiration.

My family was not supportive; my mother-in-law had already told me she didn't think I should get pregnant at my weight, that basically I should lose weight and "get healthy" first. My own mother (a thin woman) was very worried for me, and told me that my cousin the nurse said I should be seeing a "high-risk" OB, not just any old OB....because of my size.


On top of that, I couldn't find ANY maternity clothes above a size 16/18 in my area (a major metropolitan area in a large state). None, zero, zilch, nada. So I went through my entire pregnancy----still working until the last month, mind you----without any maternity clothes at all. That also just reinforced my perception that apparently, fat women just didn't get pregnant, and I must simply be an anomaly, a science experiment gone wrong.

The internet was around back then but hadn't really taken off yet. I was online more than most people at that time, but even the fat-acceptance bulletin boards back then had little to offer me in the way of reassurance. I thought, Surely some fat woman SOMEWHERE had been pregnant before---but you would never have known it. So basically, I was on my own, in seemingly uncharted territory.

I had no substantive information on being pregnant and fat...certainly no information that while there were risks to consider, outcomes could also be just fine in women of size. All the booga-booga scare tactics in the books made me terrified about what might happen, and the fact that I started bleeding and cramping in the first trimester only seemed to reinforce the thought that my body was broken, that somehow being fat made my pregnancy so incredibly high-risk that I'd be lucky to get out of this with a baby at all.

My OB and midwife tried to reassure me that other fat women had been pregnant before and that they'd get me through this, but while they meant well, they also filled our appointments with plenty of fear-inducing information and pressure for extra tests and monitoring.

They told me I had about a 50/50 chance to miscarry, that I might well have a baby with birth defects, that I had a very high chance of having problems with my blood sugar or my blood pressure, that it was good I wasn't gaining much weight and not to worry about eating if I felt nauseous, that we wouldn't want the baby to get "too big" so it was okay not to eat much. They tried to reassure me that even though I had all these risks, they'd take "good care" of me by ordering all kinds of extra tests to carefully watch over the baby and me.

That was supposed to reassure me, but all it did was make me feel like ticking time-bomb. Still, I was grateful they weren't yelling at me for my weight, so I sucked it up and never questioned what they were saying.

All of a sudden I went from being a take-no-prisoners fat-acceptance advocate and empowered health care consumer to being a meek little sheeple who didn't question anything her OB said. "Whatever you say, doctor; you must know best," became my mantra. I now know all those tests ended up actually causing more harm than good, but then I dared not question anything; I was just intent on getting through my pregnancy and having a live baby.

The truth is that I was paralyzed with fear that somehow my fatness was going to end up hurting my baby, and so I checked my brain at the OB clinic door. That directly led to many of the very negative experiences of that pregnancy and birth, and sadly, most of them were avoidable.

The Crime of Being Pregnant While Obese

It's one thing to be accepting of your size and body when the only person that might be harmed is you; it's a lot different to be so confident when a little baby is involved and when what you are, the very core of you, might be harming the baby.

It's very hard to stay body-accepting when everything and everyone around you is telling you that you are going to have problems because of your size, that you might actually kill your baby because of your size.

That is SUCH a powerful, guilt-inducing thought, and it makes many women of size become unquestioning sheeple in a quest to avoid any such scenario. I know it helped make me a sheeple.

Unfortunately, this situation often becomes a self-fulfilling prophecy, simply because you and your doctor expect problems to happen and therefore go looking for them. The more your doctors perceive you to be "high-risk," the more likely they are to submit you to multiple tests where a false-positive result is a real possibility, or to interventions (like early induction of labor) where the risk of harm is significant. The mere expectation of problems often results in those problems.

But when you are living in a state of fear that your body might harm your baby, you just assume that these tests and interventions are necessary to get you and your baby through pregnancy alive and well. And because you are fat, you may not question whether they might be causing more harm than good, whether the risks outweigh the benefits.

And in that rare situation when you do start to question your doctor about these things, out comes the "obesity ooogabooga" fear tactics and the "dead baby" trump card, which shuts down those kinds of inconvenient questions really fast.

On the one hand, we can't ignore that pregnancy at larger sizes does carry some risks. It's not wrong for us to be informed of these potential risks, or to be proactive about trying to minimize them. (More on that in the future.)

On the other hand, exaggerating these risks and using extreme interventions to manage even the slightest possibility of these risks has not been shown to improve outcome. In fact, no one has actually really studied whether the high-tech, high-intervention management of "obese" women improves outcome. They just assume it does.

Anecdotally, it does not seem to; it actually seems to worsen it. Certainly the cesarean rate has gone up drastically in "obese" women since the high-intervention management style has come into use with this group. But does that improve outcome? Where is the real, qualitative research on best practice care for "obese" women? It is stunningly absent, with doctors just going on the assumption of what's best.

The blame and the fear around being fat and pregnant is so intense that it's hard to avoid this high-tech, high-intervention model of care, and even empowered fat women often feel powerless in trying to avoid it, despite the alternatives available (the midwifery model of care).

And it's all motivated by our inner guilt, our secret inner fear, that our fat might hurt our baby.

Then and Now

Women of size having their babies now are lucky in some ways; at least today there is some information available about pregnancy at larger sizes, there are maternity clothes more widely available in plus sizes, and women of size can bond together in online communities regarding our experiences around pregnancy, birth, and parenting.

However, on the flip side, fat women having their babies today are bombarded with even more negative information and scare tactics than I was when I was first pregnant 15 years ago. Take the scare tactics I was told and multiply that by ten now; not only do you hear the negativity from your "scare provider" but also now constantly from the media. Furthermore, the sheer amplitude of the shaming and scaring has increased greatly too.

That's some pretty powerful stuff to try and counteract mentally, especially while in the emotionally vulnerable state of pregnancy.

Google "obesity and pregnancy" and you'll find a whole bunch o' scary stuff before you ever find this blog or my main website, http://www.plus-size-pregnancy.org/, which focuses on realistic information, reassurance, and proactive behavior instead of scare tactics. Most people won't continue searching long enough to find my websites; they'll only end up seeing the ooga-booga scare tactics. And that kind of negativity can't help but impact women who read it.

Honestly, I think it's those exaggerated fears of complications that leads so many fat women down the path into highly-interventive births and surgical outcomes. There are other causes too, of course, but I truly think that the exaggerated sense of fear---in ourselves, in our families, and especially in our caretakers---has the most to do with it.

But I also want to note that acknowledging these fears, then being proactive about dealing with them, becoming aware of how they can influence choices negatively and positively, can go a long way towards recapturing the joy we deserve to feel in pregnancy, towards making plus-sized pregnancy the positive and joyful experience it really should be.

It's normal and okay to have those fears.....but you don't have to let them paralyze you, and you don't have to let them dictate your pregnancy and birth experiences. You CAN have a beautiful and joyous pregnancy too.

What Were Your Experiences?

If you have had children, did you experience a crisis of faith in HAES principles? Did you feel suddenly less empowered as a health-care consumer? Do you feel the negativity and scare tactics helped convince you into interventions you might not otherwise have been so quick to accept? What kind of fears about pregnancy and birth did you experience related to your size?

Or were you already in such a secure place in your fat-acceptance journey that pregnancy didn't rattle you, not even a little bit? Am I the only one that had this giant crisis of faith?

Let's talk.

21 comments:

womantowomancbe said...

I began both my pregnancies at the same weight, with a BMI of 30, and gained 30lb with my first and 40lb with my second. To the credit of my midwives, I never knew I was at a higher risk of anything, nor was I counseled not to gain weight (they told me to eat healthily, but not to worry about portion sizes). Nor were there any problems. I've seen a couple of comments recently from nurses (primarily) , who say that they have never (or not recently, anyway) seen a vaginal birth of someone who weighed over 200 lb pregnant. Well, not only did I not have a C-section, but I had two home births!

However, I will say that I am putting off having another child until I drop some weight. While I lost 20 lb with the birth of each child, I gained it back the second time, so a couple of months ago (3 years after my younger son was born), I weighed as much non-pregnant as I did when I was about to give birth. I had a bit of a sore back with my first child, and became more uncomfortable, and earlier, when pregnant with my second child. I attribute that to the extra weight I gained. (And this wasn't "healthy" weight -- I was pregnant over Thanksgiving and Christmas and "ate for two" -- two cookies instead of one, lots of candy, etc. YUCK!) So, my goal is to get at least to my pre-pregnancy weight, if not lower, before I get pregnant again. Not so much because of any health issues or risks (they weren't a problem with either of my other two pregnancies, so I wouldn't expect them to be a problem in the future), but just because I don't want to start out pregnancy uncomfortable, and then gain more weight and get *really* uncomfortable.

Btw, I've dropped 15 pounds in one month on the Blood Type Diet. I'm finding it easy to stick to, and I feel great. I have another 20 lb or so to go, before I get to my pre-pregnancy weight, but for the first time in a few years, I can see it happening.

-Kathy

Aimee said...

Ohhh, I was SO glad when I found the Bmoms list when I was newly pregnant with my daughter, now 8. The internet wasn't *quite* what it is now, but it was pretty roaring. Having all those big women who were pregnant, who had children, it normalized things for me. I also had a good ob clinic who, I think, probably sees a lot of women of size, so I wasn't unusual for them and they NEVER ONCE talked to me about my weight, other than what they might say to any pregnant woman. My mother gave me some grief, but she's always giving me grief about something, it was just one more thing and I don't usually take her blah blah blah to heart. Your web site was the first genuine thing I found and and it led me to the bmoms list.

Nicole said...

In actuality, the only time that I feel like I have ever been able to be truly comfortable in my own fat skin--and confident in my body--have been the two times I have been pregnant and carried my babies to term.

I think part of this stemmed from my first pregnancy, which took place in the Czech Republic, where the fat panic is considerably less panicky. Also, my OB was a larger woman, and she did not have any reservations about my abilities to give birth to a healthy baby. She knew me as a person and about my health and knew that, beyond the fat, I was/am a very healthy person.

It turned out that I got very mild GD at about 36 weeks, but I could control it with diet and exercise. My baby was also breech, which was supposed to mean a C-section, but I ended up being able to deliver vaginally because of a very open-minded on-call doctor. And after having given birth to a breech baby without drugs in a foreign country, I wasn't about to accept that my second pregnancy was somehow high risk just because I was fat. I knew what my body could do, and I expected my doctor to believe in me just as much as I did.

I had zero issues in my second pregnancy, not even a GD repeat, and gave birth vaginally with a minimum of problems. And I didn't take any shit about my weight because I knew I was taking care of myself.

My big problem has come with NOT being pregnant. For whatever reason, my PCOS totally goes away while I'm pregnant and my whole system works better. It's about six months PP that things start to go haywire again, and now I'm 15 months PP and very deeply back into body hatred. It's like pregnancy is a shield that protects me from myself...

Thanks for the thought-provoking post.

Kimberley O. said...

I remember reading, "What to Expect When You're Expecting" and feeling like this huge monster - the authors were preaching orthorexia as a device to ensure the best pregnancy possible - and (I can't remember precisely)they were very down on the idea of even thinking about becoming pregnant without getting thin first. And, of course, the articles in the pregnancy magazines suggesting that fat pregnant women should focus on not gaining any weight through their pregnancy - I guess the idea was that the fetus would hoover up those delicious thigh-pockets, like liposuction!
My doctors, however, were great. I can't remember anyone expressing concerns about my weight as a factor, (I started out at a size 18-20 for both pregnancies)but I did have to go for ultrasounds earlier than many others because they couldn't hear the 11-week-old fetus' heartbeat through my tummy rolls.
That being said, I think there's a hell of a lot more fear tactics around now - fat pregnancy is treated as though it's crime both against the baby and society.

Holly said...

Hi. Long time lurker, first time commenter. My husband and I are keeping a blog about my pregnancy (our first), and I dealt with this issue--and continue dealing with this issue. If it's ok, I would like to just link to the post that most specifically deals with this.

http://thischangesnothing.blogspot.com/2009/08/weighty-matters.html

cileag said...

Very timely as I was starting to feel overwhelmed as a first time mom who's 35 weeks pregnant now. I'm planning a home birth, which I think has helped keep me significantly more grounded, but I'm also an L and D nurse and see a lot of negative commentary out there. Thanks for the information!

Anonymous said...

WOW!! You spoke the secrect depths of my guilt ridden heart. I started both of my pregnancies at about 220 lbs. Gained 15. I am still riddled with guilt that it was because of my weight that I was unable to have vaginal births. Even after a 35 hr VBAC attempt with my second one, I am still so terribly guilt ridden - 15 years later. I have never told anyone this before. (wipes tears) Thank you for helping me let this out.

Evan and Clover and Co. said...

Excellent post, as usual! I did pretty well my first pregnancy, even though I did seethe when well-meaning (I hope!) people would tell me "You don't even look pregnant!" when I was eight months along. Way to make me feel like I'm so grotesquely huge that you can't even see the healthy eight-pound baby and her enormous amniotic sac swelling my belly! Anyway, with my second baby, my water broke at 19 months, and I was sent home from the hospital with the expectation that I would be miscarrying soon. I spent the next 6 weeks on bedrest, reading about Premature Rupture of Membranes, hoping desperately it wasn't because I was fat. I have to say, though, that the midwives/doctors I've had for my three kids have never bugged me about the weight.

nopinkhere said...

Having just finished my second pregnancy a month ago, this is still very much in my thoughts. Before my first pregnancy I was a little concerned about finding good medical care. Trying to find a size-friendly OB was not a fun prospect and leaving in tears the office of the first one I tried cemented that feeling. But rather than go along with the scare tactics and consent to being considered "high risk" just because of my weight I ended up finding a free standing birthing center (for both pregnancies and births). The midwives there have a much friendlier attitude about being pregnant. I even had GD with both and had to naturally induce with the first due to high blood pressure and worries about pre-eclampsia. Despite that, they never hassled me about my weight. There were some comments, but they were matter-of-fact rather than fear-inducing. In fact they made sure to tell me that women of any size can have those problems. I do have to say that with the first pregnancy I was under my starting weight for the first half and only went over by 15 lbs and was under my starting weight the entire time for my second pregnancy (from being on the diet for GD). With both births I had fast, simple vaginal deliveries with no drugs and healthy, normal-weight babies. I think if I had been at a hospital I would have been much more likely to end up pushed into having some sort of medical intervention. I'm very happy with my experiences with the midwives at the birthing center and would recommend them for any women, plus-sized or not.

deeleigh said...

My BMI is around 35, and I've been told to lose weight before trying to become pregnant. However, it seems like a really bad idea to me. Weight loss achieved by dieting is normally followed by either long-term restrained eating and lots of exercise (to maintain it) or by rapid regain. It seems to me that undereating and overexercising while pregnant could be dangerous, and that combining diet-related weight regain and pregnancy-related weight gain would be really hard on the body. Isn't that obvious?

I really don't understand why they give women that advice.

Anonymous said...

Thank you very much for posting this. I struggle with accepting my body every day and the guilt that somehow I am the reason that my husband doesn't have a child yet. I have PCOS and my gyn. has been supportive so far about helping us with infertility treatments without focusing strictly on weight loss (like a lot do), so I am lucky in that area.
I hope if I do get pregnant someday that I can stay positive and enjoy pregnancy without being subjected to scare tactics by doctors, media, and the world around us!

Jen Anderson said...

I just have to say that the comments to this post have been extremely comforting to me. I'm trying to get pregnant now and my greatest fear is that I'll be pushed into a c-section by a fat-phobic doctor. The only midwives and birth centers in my area are out of my insurance network, so I don't have those more comforting options. I'm considering either hiring a doula just to have someone to advocate for me.

But it's a relief to hear about doctors who don't use scare tactics and bullying.

Orodemniades said...

My OB's were effing brilliant with weight things. Although I got weighed everytime I went in, they consistently told me they were worried about pre-eclampsia, not weight gain. In fact, they both told me that most fat women gained little weight, and that they weren't going to worry unless there was very sudden weight gain *or* loss, or a gain of more than 35lbs. Considering I started my pregnancy with a week in the hospital due to late-onset Ovarian Hyper-Stimulation Syndrome, I was really happy to be considered normal if 'high-risk' (ivf, ohss, "old", fat). They wanted to make sure I was eating good fresh food, and honestly, that was it. If you live in Southern Vermont, I'd be happy to share the name of the practice!

I desperately want another baby, but having to go through a FET or another IVF at my current, slightly higher weight (I think I'm around 280) makes me paranoid. I really don't want to end up in the hospital again.

Also, I am amused by the word verification, which ends in 'napy' (like nappie)

Orodemniades said...

Forgot to add that I gained 17lbs during my pregnancy, which I started at 270lbs.

Tami said...

I've had 4 pregnancies, and in all of them I was around 230-240lbs when the baby was born. 1st was a c/s, the other 3 were VBAC's, 2 of them at home. In my 4th pregnancy I actually lost quite a bit of weight without really trying, and my post-baby weight was 40 lbs under my pre-baby weight. Only in my 4th pregnancy was my weight really an issue, and that's when my midwife decided I had too high a risk of SD because of my weight and the weight of my previous baby. But this was after the state BoM had reamed another midwife for allowing an "obese" woman to attempt a homebirth (I believe the "obese" woman weighed 165 lbs). My real concern here is that states are legislating away birth choices for fat women--and if it's not technically illegal, you can still end up with situations like mine where midwives are afraid to assist fat women because they know the BoM will rip their heads off if there's a problem during the birth.

Many fat women and other "high risk" women find themselves with few options. I know a woman who submitted to a repeat c/s for the birth of her twins because she could NOT find any doctors who were willing to provide prenatal care without first requiring that she agree to a c/s regardless of her health or the health of her babies. She could have done a homebirth, but she wasn't comfortable with that idea. But I find it appalling that EVERY doctor she contacted refused to even consider a VBAC, without even meeting her or speaking to her. It was just a given that she would have a repeat c/s, and when she did ask about VBAC as her pregnancy progressed, the doctors just shot her down immediately, nobody would even consider it.

charming gardener said...

Thanks to this blog, I had the courage and a bit info to quit my patronizing and scare tactic consultant and hospital here in the UK. I am 38 weeks pregnant now with a BMI of 43 and excellent health! I've had an extremely easy and no issue pregnancy. No GD, no high blood pressure,no swollen ankles. I have continued exercise and my already normally good diet - just stocky n short. Oh, AND I am 41! Old too! After my consultant told me ONE TOO MANY TIMES I was high risk and shouldn't I just schedule my C section to avoid any issue... I lost it with her. Stress, crying, fear, self loathing. All really not good stuff when you are housing a new life. (or ever!)

Have since switched (um at 36 weeks!) to a different hospital with a friendly, can-do, we-don't think it is medically necessary for you to have a c section doctor. Hurrah! Sure, I may end up needing one -- like many people, but not pre determined. And I feel like they are on my side!

That was the best, most relaxing news I could have heard. I am not an emergency. And I have been able to return to relaxing and enjoying this healthy pregnancy.

Thanks for creating a place to get some real info and quell panic.

Angie said...

Individually we can be fat positive or fight fatphobia, but over lifetime of fatness there are going to be shifts in confidence or even faith in our own experiences.

As fat people, as a group and as individuals we face real everyday oppressions and those take a toll on our mental and physical health - so even if you are fit and confident in your fat body - it is not your fault as an individual if you have a "crisis of confidence." Pregnant women are already pathologized, add to that fatness, and you are likely going to be the target of some ugly negativity.

As a first time mom I was determined to have a home birth, my sister had a vbac waterbirth at home and I was inspired by her, even hired one of her midwives. But the midwife, although she was great and supportive, was also fatphobic and that came out later in my pregnancy, when she said she wanted an ultrasound because she wasn't convinced of the position of the baby, although I told her where the butt and feet and head were and two other midwives palpated and told her the same. She said she couldn't feel through my fat. It became a thing, her wanting me to get tests, her not trusting herself or me and it was focused on my fat.

When I hired her I was maybe 200 lbs, working out seven days a week, I dieted down from 350 and loved my 200 lb body (I'm also under 5'2") and at our first meeting I told her, I'm fat and healthy and I want a homebirth and midwife because I'm not going to be pathologized for being fat and she nodded of course of course.

Then I went past dates almost two weeks and she was freaking out and I was freaking out but I wouldn't be induced so they made me write a letter saying if my baby died it wasn't their fault. Oh the joy of natural homebirth!

I did have my son at home and all was well and I gained probably 50+ lbs I think and it was not a problem. But our struggles did suck some of the joy out of the last month & avoiding doctors and being up front and absolutely direct about my expectations did not protect me.

Melissa said...

Thank you for writing this! I found your blog through fatshionista on livejournal, and at some point in the past had bookmarked your blog without ever reading it. I came across it again today, and wow what great timing it was. Because I am sitting at my computer, procrastinating about writing a letter to fire my horrible fatphobic obgyn.

I had a c-section 16 months ago with my first (breech presentation) and am determined to VBAC. Due to a move, I have to switch doctors, so I used my annual pap as a way to check on my office choice shortly before we try to conceive. Boy, am I glad I did...I'll never go back there. So many of the things you talked about here happened during that appointment, and I feel the responsibility of writing to her and her practice in the hope that no one else will receive the negative treatment that I did. However, I am having trouble organizing my thoughts and emotions. Would you mind if I used bits of your writing in my letter? I could possibly credit you there somehow, or post the letter here for you.

Sitting here hoping to get a positive pregnancy test when I test 2 weeks from now...I believe in my body, and I know I am ready for another pregnancy...but the idea of my secret fear is so dead on...thank you for writing what you did.

Kim Larson said...

I love this write up and your other website plus size pregnancy! I wish I had found this when I was pregnant 3 years ago for the first time. When I first found out I was pregnant I felt good and confident about my body's ability to be pregnant and give birth naturally. I soon didn't though. Sadly my GP gave up doing births in 2001 and I didn't think of getting a midwife so I went to a maternity clinic with 12 different doctors. I ended up seeing 7 of them and ALL of them scared me- telling me I am high risk for: GD, high blood pressure, C-section, hemorraghing in C-section, large baby, etc (and I heard this every appointment)...
I ended up having a great pregnancy- no high blood pressure, no GD, I walked everyday and I ate well. But two weeks before I was due they thought I had a large baby and that I might need a c-section (this due to my fundus height measurement which in the best cases of ONE doctor measuring them can be inaccurate- I believe this was size bias).
I had an ultra-sound but I never got the results my water broke two days later! My labour was hard- I knew my baby was sunny-side up (posterior) but I was told she would 'flip'. She never did (no room with my waters broke) but I now believe there were interventions along the way based on my size that led to this: continual fetal monitoring (they screwed a monitor into my baby's scalp- she has a scar); epidural (I could only labour on my back then- next to impossible to get out a posterior baby that way!!); induction(because she was posterior my contractions weren't regular so I received pitocin to speed them up- althoug I was never told that this is normal for a posterior baby- abnormal contractions); and (this was the worst!) after two hours of pushing the obstetrician came in asked me to push and told me I wasn't pushing! Also that I would probably have a c-section but to keep pushing anyways (who does that?!).
Soon we will be TTC for number two and I am super-excited! Not only because of the new life we will be creating but also to get some of my power back I lost during my first prenancy labour. I will talk with my GP to see if I am a good candidate for VBAC. As well I want to see if a midwife will take me on.
Just to throw this out there here's my 'numbers: 5'4", 235 with first- gained 23 lbs; still 235 and hoping to conceive- no helth problems still :D

Well-Rounded Mama said...

Thanks everyone for so many great comments. It was great to hear everyone sharing their experiences.

Anyone hoping for a VBAC should get into contact with ICAN, www.ican-online.org. There are local chapters in many cities and there are also online support options.

I had a c/s (2 in fact) with posterior babies. Although there can be many causes of this, I think one distinct possibility can be because the back and pelvis are out of alignment. My 3rd baby was also posterior throughout pregnancy, till at 36 weeks, desperate to increase my chances for a VBAC, I tried seeing a chiropractor. He turned anterior within an hour after the adjustment and stayed put. I had a VBAC 2 weeks later.

I really think that a lot of women with malpositioned babies have pelvic and back alignment issues. I think being heavy is a stress on the body in some ways, and especially if you've had a bad fall, a car accident, sports injuries, etc.

So I'd suggest that anyone experiencing a lot of back or pelvic pain in pregnancy, anyone who has a history of falls or car accidents etc., or anyone with a persistently malpositioned baby consider going to see a chiropractor that's trained in pregnancy.

You can find a FAQ on my regular website, www.plus-size-pregnancy.org, about finding a chiropractor in pregnancy.

womantowomancbe said...

WRMama,

I know you're going to be blogging about the UK hospital who will be turning away women who have a BMI of 34 or more. Here is another article about it, including the tidbit that 18% of Britons are "obese". I'm not sure if that means that 18% are 34+ BMI or just 30+ (which is the standard definition for obesity, based on the BMI). Assuming 18% are sooooo overweight as to be risked out of giving birth at this particular hospital, then the rate of complications would have to be 4.5x that of women whose BMI is less than 34, for them to have the same number of risk incidences (hemorrhage, dystocia, whatever else they can throw in) as "normal" weight women.

Assuming only about 10% of British women would have a BMI of 34+, then they would have to have 9x the rate of normal-weight women for complications in order to have the same number of complications as normal-risk women.

Somehow I doubt that any risk or complication based strictly on weight would be this much higher!

-Kathy