I am a 'plus-size' mum...or extra-morbidly obese as my paperwork says. I am British and living in the UK...We have free health care, which I have always been very grateful for and happy with. However, new government policies over the last few years have made being even over-weight and pregnant a problem, let alone as large as I am! (I'm a UK size 22/24.)
For example...anyone who is deemed overweight when they 'present as pregnant to their GP' is now offered a strict diet program overseen by weight watchers or slimmers world, or a termination 'until weight is acceptable'.
Those of us that go against GP advice are ostracised and treated as both unworthy and stupid. My current treatment includes being 'seen' by my GP in a corridor whilst people walk past, rather than in the privacy of an office; and being blatantly lied to about statistics (I was actually told it was physically impossible to give birth vaginally after a c-section, as the baby would 'go the wrong way'!).
My consultant told me I was so fat it made the radiographers sick to have to perform a scan on me...The same consultant insisted I have huge stitches after my C-section, and refused to allow me anything other than normal paracetamol [kmom note: Tylenol] as painkillers after the spinal block wore off to 'teach' me a lesson!
When I refused to have a coil fitted as contraception, I was told 'Well, you probably don't need anything, there can't be many men desperate enough to have sex with someone your size'...in a room with 3 other mums.
The alternative to that? Well, there isn't really one...I have 'opted out of care'...basically no-one sees me, so there isn't anyone to make the comments! I've had 3 antenatal appointments so far, and am under 'GP care', but as he won't see me in his office and I don't feel comfortable discussing my pregnancy or ailments in a corridor for all to hear, I basically don't see him either.
Now all this would be bad enough with a 'normal' pregnancy, but this is my 7th baby...of my last 3 pregnancies, one was a messy late miscarriage, the other two were c-sections (I'd managed normal births until then).
The first [c-section] was as my son was breech (obese women can't deliver breech babies naturally apparently!), the second c-section gave me one 7 week premature daughter and a still-born son...so not exactly 'perfect' births...then there's my BP (normally high, but I'm currently proud of the level I am managing to keep it at!)....and the added bonus, that if I step into the hospital prior to the baby actually crowning I will have to have another C-section, and likely a hysterectomy, as is hospital policy on third C-sections....
I spoke to an independent midwife over the phone at the beginning of my last pregnancy, and she told me that it was a load of rubbish about the 'too fat for a breech' and 'one c-section means always a c-section'. Without her encouragement I wouldn't have had the guts to stand up to the midwives and doctors as much as I have so far, and she also told me to demand a 30 week scan and to avoid induction as that can increase the chance of a scar rupture. Unfortunately, I couldn't afford a private midwife and as that pregnancy ended in a late miscarriage, I lost contact with the midwife who I'd spoken to over the phone.
My GP said after 2 C-sections I have a high risk of dying during labour. [Kmom note: This is totally bogus and not supported by the research at all.]
Aside from worrying about the labour going wrong, I have to admit this is a nice pregnancy---no rushing around for weekly antenatal appointments, no fortnightly blood tests to seen if my organs are failing, no monthly scans and far fewer lectures from 'professionals'!
I just wish people realised that just because I got this big my brain hasn't shrunk. I'm not stupid and I do have feelings. If belittling me or telling me obvious things like 'you need to lose weight' seriously helped the situation, I'd have been a size 0 years ago! I know I'm fat, I do have mirrors in my house and have to walk past shop windows during my week!
I have my scan for abnormal placenta (placenta previa and placenta [accreta], I believe) in 6 weeks, and then that's me back on my own until I give birth. We planned this pregnancy and it didn't seem so scary then, but now I have re-occuring nightmares.
Kmom's Follow-up Note: I was able to put this mother in touch with a couple of Independent Midwives in Britain so at least she has some better emotional support and a chance at other care. Thank you to those who have helped me find other resources for this mother.
As for British policy, I'm sure the attitude varies from consultant to consultant, but I'm hearing more and more stories of egregious size bias in the UK system. If you are a British woman of size and encounter this kind of treatment, I would remind you of the option of Independent Midwives. Yes, you'd have to pay out of pocket, but that's better than being subjected to crappy treatment and the risks of a cesarean you don't really need. And besides, many independent midwives will work with you to find a way to afford their care.
The same is true in the USA and Canada. Don't forget the choice of birth center or homebirth midwives. Yes, there are people who truly cannot afford that and have fewer choices, but too many people write it off as something they cannot possibly afford when there often ARE ways to make it work. Most midwives will find a way to help you afford it via sliding scale fees, payment plans, bartering, etc., and some insurances that say they "do not" cover homebirth actually do (mine did). Explore the possibilities thoroughly before you decide .
If at all possible, don't let cost keep you from having real childbirth choices and truly supportive care. It's priceless.