Given the holiday, I thought I might do a quick post and share some opinions about the best classic toys for kids.
I was Christmas shopping yesterday and was appalled by many of the toys available. Call me old-fashioned, but I really think that kids do best with more of the "classic" toys. I urge you to consider more of these kinds of toys and only a few of the more modern toys in order to create a better balance for your kids.
Classic Toys That Promote Imaginary Play
I strongly prefer toys that actively promote imaginary play. I think this is an underexercised muscle in many children today and I see great benefits in kids when they get lots of time to indulge in imaginary play scenarios.
The best toys my kids have gotten over the years include (in no particular order):
Dress-Up Costumes - All of my kids have really enjoyed dressing up. I get dress-up clothes from garage sales, toy stores, Goodwill, theater costume clear-out sales, you name it. I keep a big bucket of them in a closet and have some hooks available around the closet to hang up the most commonly-used ones. I try to provide a wide variety of capes, hats, coats, ties, dresses, scarves, shirts, and shoes and let them decide what they want to wear, in whatever combo they put together. I do have some specialty clothes (princess dresses, pretend armor and crowns) but I also have lots of very generalized, every-day stuff. They love it. Even my teenaged girl still dresses up occasionally (she has Renaissance-y and witchy skirts, pants, vests, shirts, and hats) and my oh-so-cool teenaged boy will dress up on occasion if the little ones are putting on a play. I think dress-up clothes are some of the best toys for imagination around.
Train Tables and Train Sets - These promote lots of imagination and engineering; try the non-electronic trains for maximum imagination value. Thomas The Tank Engine has lots of fun characters (avoid the gag-worthy videos) but is more expensive; Brio has a lot of quality tracks for a much cheaper price. Wooden tracks are superior to the plastic ones if you can afford them; my sister-in-law was given a great set by a neighbor, so always look around before you buy. I found a good train table to be worthwhile because it contained more of the sprawling messy nature of the trains. Lots of matchbox cars and a good car-play rug are a good adjunct to train sets.
Pretend Kitchen Sets- Both boys and girls love imaginary kitchen sets and shopping accessories. I've had both plastic kitchens and wooden ones, and I have to say the wooden ones are better if you can afford them (check Craigslist for give-aways). Be sure to accessorize with wooden or plastic food, dishes, shopping baskets, etc. A good tea-party set (in tin or non-breakable materials) is a must and gets frequent usage in our house. Even my teenagers have been known to sometimes still take part in tea parties given by my little one (especially if actual food is served at the party). We've gotten a lot of mileage out of these toys, and they are well worth the investment.
Play Silks - These are just rectangular pieces of hemmed silk, tie-dyed into vibrant colors, like the ones shown in the picture accompanying this blog post. They are very cheap and easy to make yourself (see Dharma trading company); making your own is much cheaper than buying online (although you can get nice ones likes the ones above at magiccabin.com). Kids without much practice in imaginary play can be a little puzzled for what to do with playsilks at first, but in kids who have strong imaginary play skills, these become anything and everything, from superhero capes to rivers on the ground to skirts and veils to flags and fort-building materials. My kids have really come to love these and I now consider them to be one of the most indispensible childhood toys around.
Playhouses - I hesitate to call them dollhouses because that sounds like a "girl" toy and implies a house shape is mandatory, but most kids like some version of a playhouse. They can be traditional dollhouses, tree forts, castles, or gnome/fairy hutches, like ones found at Magic Cabin. You can make your own more cheaply than you can buy, but for those who are not crafty, I prefer the durability and look of the wooden ones over the plastic ones. Melissa and Doug have a cute "Fold and Go" dollhouse that is portable, and saves space if that is a consideration; not everyone has room for a giant dollhouse and this toy was really useful to us when we lived in a smaller home. But whatever size or shape it takes, be sure to have some sort of playhouse toy for your kids.
Animals and Doll Figures - These are the best toys for kids! We get lots of small quality plastic or wooden animals of various kinds, and just let them have at it. There's tons of good imaginary play from these figures. I have more of a love-hate relationship with most dolls (I hate Barbie-type dolls) but the soft squishy cuddly dolls or stuffed animals seem to be wonderful for kids. They like to dress them, feed them, and take care of them like babies. Good for role-playing and working out sibling issues! Accessories like mini-strollers or mini-slings add a lot of fun and flexibility for minimal price.
An Army of Toy Soldiers - We're not talking violent or graphic stuff here, just your basic green or tan army guys, like the ones seen in Toy Story. I was pretty opposed to these at first, not wanting to promote violence, but I have to say that my kids love these. They spend lots of time setting up elaborate scenarios and can spend days on a "battle" in very imaginative ways, but I don't see them becoming more violent from playing with them. I think it channels a very natural instinct for them, in a more constructive way than might otherwise happen, so I've decided I'm okay with this toy after all. The bonus is that these are very inexpensive, so it's easy to get a giant set of them.
Action Figures - My kids have always loved action figures. Although I tend to favor classic wooden toys, I'm not above a good plastic action figure if it's well-made and not gimmicky. My kids play a lot with Star Wars action figures or the various superhero action figures. Although we discourage a lot of media-associated toys because we feel they tend to suppress imagination, we've found that our kids do a lot of good imaginary play with these particular figures so we have made an exception and invested in more than a few. And, well, it just feels good to the sci-fi nerds in us to have our kids playing elaborate Star Wars scenarios! (Another big favorite that promotes a lot of physical activity are plastic Jedi Lightsabers. Oh, the epic battles our yard has seen!)
Classic Games - I like classic games that promote thinking, interactive play, and fun. I tend to de-emphasize the really competitive games, although we do have some of those too. For little kids, we really like "Snail's Pace" and "Hi-Ho Cherry-O," "Penguin Pile-Up," "Hiss" and games like that. For medium-aged kids, we like "Uno," "Rat-a-Tat Cat," "Chutes and Ladders," "Trouble," "Sorry!" and "River Crossing." For older kids, "Risk," "Monopoly," "Blokus," "Break the Safe" and "Scrabble" etc. are good games. And of course, you can't forget the classic board games like checkers and chess.
Art Supplies - Kids love to do art, so it's handy to have a kitchen cabinet or toy chest dedicated to art supplies for them to access when needed. Tablets of cheap, recycled paper, colored pencils or block wax crayons, stamps and stickers, and playdough (you can make your own pretty cheaply) are classic things kids never tire of. (We let our kids paint too, but these supplies are kept in the parent-only cabinet so we control when and where the painting is done. I let kids make messes, but I'm happier about it when it's not a surprise.) Art supplies are generally cheap and the paper is recyclable when you're done. It's really helpful to have a child-sized table to do these activities on too. A kids' activity table was one of our best investments when they were younger.
Fort-Building Supplies - Kids love to play forts. A few big sheets, old blankets, silky curtains, sofa cushions, old giant boxes etc. can combine to make a great fort and keep kids occupied for hours on end. The advantage of forts is that they can be constructed from materials on hand or from inexpensive thrift store items and therefore are dirt cheap. This was one of our kids' favorite activities when they were young. Now that they are older, the forts have moved outside and gotten bigger (tree houses!), but they still love forts.
Blocks and Construction Sets - Kids love to play with blocks and similar toys. Wooden blocks, marble runs, Legos, Lincoln Logs, etc. are all great construction and engineering toys. These can be messy around the house so I like to have plastic bins to corral the mess between construction parties. I also liked the giant Lego-like blocks that snap into each other and store away under desks or counters and such; these often became part of the fort-building materials.
Outside Activity Toys - These seem obvious but I'll mention them anyhow. Soccer balls, basketball hoops, climbing/sliding toys, swings, mitts, frisbees, jumpropes etc. should be a part of every kid's toy options. Obviously your outside play area influences what you get but these things can always be taken to a park too. One option I was very leery of was a trampoline but I've found my kids love it. It really allows them to go burn off energy when they need to, and they play with it a lot more than they do the far-more expensive swing set right by it. Although I was hesitant to get one at first, the trampoline really has been one of our better buys for sheer exercise and excess energy-burning value.
Sensory Perception Activities- This category include things like water tables, sand boxes, seed trays, mud pies, etc. Kids love these. They can be kind of messy so they tend to be outside summer activities at our house, but I know pre-schools that have built indoor versions of water tables and seed trays out of cattle troughs or a little extra lumber and it works just fine. If you have the room and don't mind a little mess, these are great toys for kids.
These are a few of my favorite classic toys; what are yours? Please share them in the Comments section.
What About Electronic Toys?
I have to be honest; I am not a fan of electronic toys. I've observed for some time that kids' imagination abilities atrophy if given too much electronic stimulation or junky toys. They tend to inhhibit kids' abilities to entertain themselves; if my kids play too much electronics, I hear "I'm BORED; there's nothing to do!" comments a lot more because they can't remember how to entertain themselves. It overstimulates them too much and then they crave that same high level of stimulation constantly. Frankly, it overloads their systems and I feel it just isn't healthy for their brains.
For some kids, electronics can be addictive, and less time gets spent on more healthy play activities, like outside play, sports or just running around in nature. Some kids are more prone to this than others; my younger son tends to be far more addicted to electronics than my other kids, so we really have watch his use levels in particular. However, I notice that a high use of electronics negatively affects the behavior of all of my kids, which is the main reason we limit it. It's good that they all have limits, frankly.
We are not purists and do not forbid all electronics---this is part of the modern world and they have to learn how to deal with it constructively---but we really try to help them learn to use it in a healthy, gradual way. Therefore, we limit the amount of time and frequency that they spend on this kind of activity (computers, TV, electronic games), and it really does seem to improve behavior, academics, and general daily attitude.
Here's what we've done to find a reasonable balance; this is just our solution and doesn't have to be yours, please note. It's simply the best compromise for our situation and our particular kids. Your kids' needs may dictate a different solution.
We do have computer games and a Wii at our house, but they are not allowed to play with it during the school year (except on major school vacations, like now). On vacations when they are allowed access to it, play is generally only allowed after dark so that they are more likely to spend time getting plenty of exercise, imaginary play or reading. This allows them some electronic play but keeps them from sitting in front of it obsessively and never doing anything else.
Some parents we know allow more regular play but set specific time limits (a half-hour each day, an hour on weekends); we set the length of a session more by ear. A lot depends on your particular child's personality; some kids do better with regularly-scheduled but strictly-limited times, while others do better playing less frequently but more self-regulated.
Our kids seem to do better with the latter; we get less whining, more non-electronic play time, and less "jonesing" for electronic time. However, for some parents the other way works better. I think you have to experiment and see what works best for your own particular kids.
TV time is another part of the electronic picture. I know some parents who don't allow any TV at all, and others who allow it constantly. I'm not a fan of either approach. I prefer to allow it but limit what they watch and how much.
To be honest, we struggle more with limiting TV than with limiting computer and Wii time; we as parents like our TV-time so it's easy to let theirs get out of hand if we're not careful. However, we certainly allow far less TV than most of their peers get, and I know we are much more careful about what they watch than most parents. And they don't get TV in their bedrooms at our house; watching is a communal activity so we can monitor more of what they watch and how often. Still, the amount of TV watching is something we have to constantly remind ourselves to be aware of, especially in the cold winter months.
Most people don't think about TV as an electronics activity, but it takes up significant leisure time for kids, just as electronic games do. Too much of it inhibits their physical and imaginary play time. Generally speaking, many kids today suffer from electronic over-stimulation and an under-exercised imagination and could do with a lot less TV and electronics time.
Final Thoughts
I have to say that toy decisions and the struggle over how much and what TV/electronics to let them play have been some of the more unexpectedly-difficult parenting decisions we've faced.
Before I was a parent, I really didn't think this would be difficult. I would have agreed that limiting TV somewhat and avoiding the more obnoxious and violent toys was a good idea, but I would have pooh-poohed the idea of limiting computer time so strictly or promoting classic imaginary play toys so strongly.
But now, in the reality of raising kids and seeing the effects of various playtime choices, I have to say that some of my opinions and choices have changed.
I can watch how my kids respond to various toys and activities and see how changing those activities changes their behavior. For example, I notice how much better-behaved my kids are when they have regular time for intensive physical play, every day. I notice that my kids behave very passively when they are in front of the idiot box, which in theory can be useful.....until the TV goes off and they have to work off the overstimulation their brains have been experiencing. I also notice how much more whining there is about filling down-time when there is a lot of electronic play going on, and how much more in-fighting among siblings there is when they are trying to share computer time.
On the flip side, when we restricted electronic play to school vacations, the kids were noticeably more even-tempered and happy (after the initial whining) and more able to self-regulate their play. And I noticed that the kids did better in schoolwork and got along better with each other when they engaged in more imaginary play and less electronic play.
Now, of course there are barriers to more classic toys. If you clicked on any of the toy links provided above, you may have noticed how expensive many of these classic imagination toys are. Yeah, it's true, some of them are not cheap. However, I'd note that electronic toys are just as expensive, if not more, but the classic toys last longer. And not all of the classic toys were expensive; some can be gotten pretty cheaply, or made for very little money at home. Furthermore, you don't always have to pay full price for the expensive items. Many can be gotten through secondary sources like thrift stores, Craigslist, or eBay.
So don't let pricetag shock keep you from investing in some of these classic toys for your own kids (or nieces, nephews, grandkids, whatever). They really are worth the price.
In my opinion, it's okay to buy some electronics and let your kids have some TV time. It's part of our modern world and kids have to learn to deal with it sooner or later. Just please emphasize the classic toys that promote imagination more, make sure your kids get plenty of opportunity for fun physical activity, and please, please don't let electronic devices (including iPods and texting) be your kids' constant companion. Find a reasonable compromise of these activities that works for your family.
Remember, kids need meaningful human interaction, plenty of fun and healthy movement, and lots of free-play imagination time. It's up to us as parents to make sure they have it.
*Illustration is of play silks from the Magic Cabin online catalogue.
Thursday, December 24, 2009
Wednesday, December 2, 2009
Reply turned post: Ghettoizing Fat Pregnant Women
Kathy at Woman to Woman Childbirth Education has a good post on a recent article from the UK, discussing the banning of "obese" women from birthing in certain "low-risk" hospital birth units because of their weight.
I commented on her blog, but the more I think about it, the more I think it deserves its own post here on my blog too. So I'm going to hijack the discussion over to here.
This is part of a new trend towards "bariatric obstetrics." The idea is that the "obese" mother is at SUCH INCREDIBLY HIGH RISK that she is better off delivering at a hospital that is specially equipped for her needs and where doctors can specialize in such "high-risk" deliveries.
Although some folks setting up these policies may have good intentions, what they are actually doing is "ghettoizing" fat women.
By taking away low-risk care options for fat women, they virtually guarantee a high-risk, high-intervention, high-complication delivery for them.
But no one is actually studying whether switching to special "bariatric obestetrics" practices and hospitals actually improves outcomes among "obese" women. They just assume it does.
And it assumes a level of extreme risk for all fat women when many don't experience that at all.
Yes, pregnancy in women of size has more risks of some things, like gestational diabetes, pre-eclampsia, macrosomia, etc. Yes, some women of size have complications. You'll never hear me pretending otherwise. And sometimes a woman of size does have complications that needs a higher-intervention approach or a higher-risk hospital or practice.
But many women of size have healthy pregnancies and births, and many more probably could if they access to proactive, low-intervention care via the midwifery model of care.
If fat women don't have any complications, do they really need a high-risk practice or location, based on weight alone? Do they really benefit from it? Or does it cause more harm than benefit?
And even those who experience mild complications, can't they usually still be cared under the midwifery model of care and benefit from that model?
Research shows that when comparing clients of the same level of risk, midwifery clients experience fewer inductions, fewer augmentations, fewer epidurals, fewer episiotomies, and fewer cesareans, yet their outcome is just as good or better.
Some research suggests that women of moderate risk also benefit from the midwifery model of care. Although not specifically addressing obesity alone, Cragin and Kennedy 2006 concluded,
And I think that's the thing that has me most enraged....the paternalistic, condescending attitude of making my decisions for me, for my own "good"....because I'm fat. Taking away my best chance of having a safe, unintervened-in birth....because I'm fat.
As Susan Hodges of Citizens For Midwifery states, "How much 'risk' does it take to supercede the mother's right to bodily integrity?" Or self-determination?
I've got news for these folks. My weight does not give you the right to make my choices for me or to dictate whom I can see or what kind of birth I am "allowed" to have. This is my body, and *I* get to decide.
Unable To Access Low-Tech Care?
Unfortunately, I think that more and more in the next few years, we will see fat women denied the right to obtain low-risk maternity care, the right to see midwives, and the right to have homebirths or birthing center births.
It's already happening. Some birth centers already deny access to women above a certain BMI or weight limit. Some homebirth midwives/doctors turn away "obese" women, even those without complications, simply based on their weight.
Some homebirth midwives want to serve women of size but know that if there is a transfer or anything goes wrong, the authorities in their area will skewer them for daring to care for an obese woman at home.
(It's already happened; a friend of mine recently planned a homebirth and her midwife backed out on her for this very reason. She eventually found another midwife but it was not easy to find one so late in pregnancy. Fortunately, the birth went fine and no one got taken to task for serving a fat woman at home....but the fact remains that the fear of this caused her first midwife to desert her, and near the end of pregnancy too.)
So more and more fat women---even those who want alternative, low-tech care---are being forced into the high-tech medical model, one in which "morbidly obese" women often end up with a nearly 50% c-section rate---or more.
In fact, even being forced to be in the hospital with an OB isn't enough now. Some hospitals (like this one above in the UK or this one in Australia) are forcing fat women into specialized centers, so that they can't even access the low-risk, low-intervention hospitals.
And some regular OB practices refuse to care for obese women, requiring them to instead see high-risk OBs....regardless of whether they actually have any complications or not.
To these providers, the mere fact of being "obese" is complication enough, even without any actual complications to inconveniently complicate their biases, so to speak.
In other words, the hyperbole of risk around fat mothers is so out of control now that we are ghettoizing them. And it's only going to get worse.
Show Me The Money, Baby
The real question here is whether the centralizing of "obese" women together into specialized centers and under the "high-risk" umbrella improves outcomes or not.
My bet is that it simply leads to an atmosphere of unchecked and unquestioned intervention, and many many unnecessary cesareans.
But we don't know that because no one is documenting the outcomes. As far as I can tell, no one is even asking the questions.
Where is the proof that these bariatric specialties improve outcome?
Where is the publication of the protocols routine to these bariatric obstetrics practices? Are all these women being told to diet during pregnancy? Are they all being induced early for fear of a big baby? If they go outside the approved protocols of xxx pounds of weight gain or xxx pounds of expected baby size, are they just automatically sectioned?
Where is the documentation of the intervention rates of these practices? What is the induction rate, what is the c-section rate, what is the VBAC rate, what are the complication rates?
Where is the prospective study of high-tech, high-intervention specialized bariatric care for obese women, compared to a control group of women of similar size and complications who instead are exposed to the low-tech, low-intervention midwifery model of care?
Show me the money, people. Ah, but that's the problem right there. This is a new cash cow in obstetrics these days....the specialized practice of "bariatric obstetrics."
Just think of all the money they can charge insurance companies to force these women to see bariatric specialists! Just think of all the money they can charge for "specialized" bariatric equipment! Just think of all the billable services they'll "need" in the hospital! And just think of all the extra money from all the extra c-sections!
Sorry, I don't care if you have no financial incentive to study this or not. You have to SHOW ME that this high-tech, high-intervention, high-risk attitude towards birth in "obese" women actually improves outcomes before you dictate where I "have" to give birth in order to birth "safely."
PROVE IT. In a good study, with a good control group of similar fat women being treated in a true low-intervention midwifery model to compare it with.
Until then, stop taking away the rights of women of size to birth where they want to, to have equal access to low-tech birth, to have equal access to "alternative" techniques like waterbirth and full mobility in labor.
Stop forcing fat women to have early epidurals "just in case," mandatory internal monitoring, and automatic confinement to bed. Stop pushing fat women to induce labor early "before the baby gets too big." Stop sectioning fat women whose weight gains or whose baby size fall outside your definition of "desirable." And stop forcing women into bariatric obstetrics practices and high-risk hospital wards if they don't want it or need it.
Stop ghettoizing fat women, damn it. And stop telling us how and where we are "allowed" to give birth. These are our bodies and our babies, and we are the ones who get to have the final say.
I commented on her blog, but the more I think about it, the more I think it deserves its own post here on my blog too. So I'm going to hijack the discussion over to here.
This is part of a new trend towards "bariatric obstetrics." The idea is that the "obese" mother is at SUCH INCREDIBLY HIGH RISK that she is better off delivering at a hospital that is specially equipped for her needs and where doctors can specialize in such "high-risk" deliveries.
Although some folks setting up these policies may have good intentions, what they are actually doing is "ghettoizing" fat women.
By taking away low-risk care options for fat women, they virtually guarantee a high-risk, high-intervention, high-complication delivery for them.
But no one is actually studying whether switching to special "bariatric obestetrics" practices and hospitals actually improves outcomes among "obese" women. They just assume it does.
And it assumes a level of extreme risk for all fat women when many don't experience that at all.
Yes, pregnancy in women of size has more risks of some things, like gestational diabetes, pre-eclampsia, macrosomia, etc. Yes, some women of size have complications. You'll never hear me pretending otherwise. And sometimes a woman of size does have complications that needs a higher-intervention approach or a higher-risk hospital or practice.
But many women of size have healthy pregnancies and births, and many more probably could if they access to proactive, low-intervention care via the midwifery model of care.
If fat women don't have any complications, do they really need a high-risk practice or location, based on weight alone? Do they really benefit from it? Or does it cause more harm than benefit?
And even those who experience mild complications, can't they usually still be cared under the midwifery model of care and benefit from that model?
Research shows that when comparing clients of the same level of risk, midwifery clients experience fewer inductions, fewer augmentations, fewer epidurals, fewer episiotomies, and fewer cesareans, yet their outcome is just as good or better.
Some research suggests that women of moderate risk also benefit from the midwifery model of care. Although not specifically addressing obesity alone, Cragin and Kennedy 2006 concluded,
Even among moderate-risk patients, the midwifery model of care with its limited use of interventions can produce outcomes equivalent to or better than those of the biomedical model.To take away the choice for that low-intervention model across the board based only on size, regardless of actual complications, is a total miscarriage of justice.
And I think that's the thing that has me most enraged....the paternalistic, condescending attitude of making my decisions for me, for my own "good"....because I'm fat. Taking away my best chance of having a safe, unintervened-in birth....because I'm fat.
As Susan Hodges of Citizens For Midwifery states, "How much 'risk' does it take to supercede the mother's right to bodily integrity?" Or self-determination?
I've got news for these folks. My weight does not give you the right to make my choices for me or to dictate whom I can see or what kind of birth I am "allowed" to have. This is my body, and *I* get to decide.
Unable To Access Low-Tech Care?
Unfortunately, I think that more and more in the next few years, we will see fat women denied the right to obtain low-risk maternity care, the right to see midwives, and the right to have homebirths or birthing center births.
It's already happening. Some birth centers already deny access to women above a certain BMI or weight limit. Some homebirth midwives/doctors turn away "obese" women, even those without complications, simply based on their weight.
Some homebirth midwives want to serve women of size but know that if there is a transfer or anything goes wrong, the authorities in their area will skewer them for daring to care for an obese woman at home.
(It's already happened; a friend of mine recently planned a homebirth and her midwife backed out on her for this very reason. She eventually found another midwife but it was not easy to find one so late in pregnancy. Fortunately, the birth went fine and no one got taken to task for serving a fat woman at home....but the fact remains that the fear of this caused her first midwife to desert her, and near the end of pregnancy too.)
So more and more fat women---even those who want alternative, low-tech care---are being forced into the high-tech medical model, one in which "morbidly obese" women often end up with a nearly 50% c-section rate---or more.
In fact, even being forced to be in the hospital with an OB isn't enough now. Some hospitals (like this one above in the UK or this one in Australia) are forcing fat women into specialized centers, so that they can't even access the low-risk, low-intervention hospitals.
And some regular OB practices refuse to care for obese women, requiring them to instead see high-risk OBs....regardless of whether they actually have any complications or not.
To these providers, the mere fact of being "obese" is complication enough, even without any actual complications to inconveniently complicate their biases, so to speak.
In other words, the hyperbole of risk around fat mothers is so out of control now that we are ghettoizing them. And it's only going to get worse.
Show Me The Money, Baby
The real question here is whether the centralizing of "obese" women together into specialized centers and under the "high-risk" umbrella improves outcomes or not.
My bet is that it simply leads to an atmosphere of unchecked and unquestioned intervention, and many many unnecessary cesareans.
But we don't know that because no one is documenting the outcomes. As far as I can tell, no one is even asking the questions.
Where is the proof that these bariatric specialties improve outcome?
Where is the publication of the protocols routine to these bariatric obstetrics practices? Are all these women being told to diet during pregnancy? Are they all being induced early for fear of a big baby? If they go outside the approved protocols of xxx pounds of weight gain or xxx pounds of expected baby size, are they just automatically sectioned?
Where is the documentation of the intervention rates of these practices? What is the induction rate, what is the c-section rate, what is the VBAC rate, what are the complication rates?
Where is the prospective study of high-tech, high-intervention specialized bariatric care for obese women, compared to a control group of women of similar size and complications who instead are exposed to the low-tech, low-intervention midwifery model of care?
Show me the money, people. Ah, but that's the problem right there. This is a new cash cow in obstetrics these days....the specialized practice of "bariatric obstetrics."
Just think of all the money they can charge insurance companies to force these women to see bariatric specialists! Just think of all the money they can charge for "specialized" bariatric equipment! Just think of all the billable services they'll "need" in the hospital! And just think of all the extra money from all the extra c-sections!
Sorry, I don't care if you have no financial incentive to study this or not. You have to SHOW ME that this high-tech, high-intervention, high-risk attitude towards birth in "obese" women actually improves outcomes before you dictate where I "have" to give birth in order to birth "safely."
PROVE IT. In a good study, with a good control group of similar fat women being treated in a true low-intervention midwifery model to compare it with.
Until then, stop taking away the rights of women of size to birth where they want to, to have equal access to low-tech birth, to have equal access to "alternative" techniques like waterbirth and full mobility in labor.
Stop forcing fat women to have early epidurals "just in case," mandatory internal monitoring, and automatic confinement to bed. Stop pushing fat women to induce labor early "before the baby gets too big." Stop sectioning fat women whose weight gains or whose baby size fall outside your definition of "desirable." And stop forcing women into bariatric obstetrics practices and high-risk hospital wards if they don't want it or need it.
Stop ghettoizing fat women, damn it. And stop telling us how and where we are "allowed" to give birth. These are our bodies and our babies, and we are the ones who get to have the final say.
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