Blog Delay Due to Family Illness

Dear Readers,

You may have noticed an increase in the time between posts. We are experiencing a personal and family health crisis, and it will be a while before we have regular posts again.

We welcome prayers and well wishes, and will keep you updated as we can. My Blog is not ceasing to exist, it just needs to take a backseat for a little while.  People have visited this blog over 5 million times, and I am sure that we will have many more to come.

I have many more posts planned, and will get to them as recovery allows.  Comments will remain open by approval, and we will check them periodically.  I appreciate all good wishes.

Peace, blessings and good health to all.

Kmom

Lipedema, self acceptance, and trolls

Image from this article

This is a really interesting article by Courtney Mina about dealing with the fat hate that often accompanies being open about lipedema or being body-positive in any way online.

She posted some pictures of herself in only undergarments on Instagram, Twitter (#biglegs), and Facebook to see if people would continue to be body-positive towards someone with large legs. She was open with people about having lipedema, what that meant, and how it has affected her life, all while still being body-positive.

Gratifyingly, many people were body-positive and supportive of her. This shows that body-positivity campaigns are making a difference and the message is being heard. 

However, there were also haters. Some of it was the open, in-your-face really vicious hate so common on the internet (yep, I get it too). Ugh. But that's such an obviously biased and obnoxious response that you mostly just have to let that roll off of you. Some people are just trying to stir up trouble and some people are just outright misogynists. None of us should be subject to such hatefulness, it's wrong wrong wrong for sexism like this to be so prevalent and our society needs to target this misogyny, but some individuals are so hateful they are simply lost causes. I refuse to lose sleep over them.

Of course there was also the poisonous "concern trolling" ─ I'm-just-worried-about-your-health stuff. This is the kind of stuff fat people get bombarded with by people we care about (because obviously you are simply in denial if you are fat and not trying to lose weight). They can't see how much they've bought into harmful untruths about weight and health, and they find it difficult to acknowledge that there really are medical conditions that can cause fatness. They think that since their bodies work a certain way, all bodies must therefore work that way, even when evidence for a disease process is presented to them. They mean well, but it's still hurtful.

And of course, sometimes the worst people of all are the "plus-size police," the women of size who so hate their own bodies that they try to police other fat women's bodies too. The self-hate they have is just palpable and so sad. The absolute worst are the ones who are in the honeymoon period during or just after weight loss before the regain begins, or the ones who are chronic dieters. They are in the "high" phase of the dieting addiction and they want everyone to join them on this drug. No one is allowed to rain on their parade, gainsay their experience, or present an alternative approach like Health At Every Size®. Anyone who approaches it differently is just "in denial."

Sadly, even some in the fat-acceptance movement have wanted to deny the medical reality of lipedema, a medical condition that often leads to heavier-than-average legs, hips, and arms. It's as if they think that any acknowledgement of a possible biological condition underlying weight means we are making excuses for it to appease the haters, rather than embracing our size with acceptance. [Nope, you can acknowledge the biological causes and still be part of fat acceptance.]

I thought this post had many thought-provoking things to say. Definitely check it out. I was encouraged that many people were supportive of her, but I have to wonder how many were supportive because she is young and beautiful. There's a heck of a lot less supportiveness out there for middle-aged and older fat women, but I have hopes that this, too, will improve with time. Body positivity should not be only for the young and beautiful but for people of all ages and looks.

http://www.bustle.com/articles/102550-i-have-lipedema-posted-a-photo-of-my-big-legs-on-instagram-to-see-if

Kiss Your Babies

My oldest son, age 1.5.
He left for college this week!

Sorry for the delay in posts. Don't worry, I will have new ones up again soon. I have several important ones in the works.

Why the delay? Well, we've been busy getting the school year going and getting my oldest son off to college. We moved him into his dorm this week. I did really well at holding it together and not being emotional until the car radio began to play "The Cat's in the Cradle." Uh-oh.

You know, it's trite what everyone says, but it's really true ─ they DO grow up so fast! It seems like only yesterday this boy was a newborn and we were getting used to life with more than one child. Here is a picture of him as a toddler, running as fast as his little legs would let him to keep up with his older sister and his cousins. He's always been a kid on the move, with things to do and people to see.

Now he is an adult, running away from us instead of towards us. He's an adult, starting the process of making his own way in life. [Say what?!?!?! He was a baby just a moment ago! Sob!]

Go, kiss your babies! Right now! Take time to spend it with them on the little things like playing games, making music, sitting around a campfire, having dinner as a family, reading books together, spending time in nature, and taking trips when you can. It's these small moments that you particularly remember and which really build the connections. Make precious memories and take lots of pictures! Enjoy every moment, for they will be grown up all too soon.

Well, he came from college just the other day, So much like a man I just had to say, "Son, I'm proud of you. Can you sit for a while?" He shook his head, and he said with a smile, "What I'd really like, dad, is to borrow the car keys. See you later. Can I have them please?"

And the cat's in the cradle and the silver spoon, Little boy blue and the man in the moon. "When you coming home, son?" "I don't know when, but we'll get together then, dad. You know we'll have a good time then."

See my Practice Variation Post at Science and Sensibility

My recent post on Practice Variation in Cesarean Rates went a bit viral. (Thank you to those of you who shared it on Facebook!)

The blog, Science and Sensibility (Lamaze International’s “Research Blog About Healthy Pregnancy, Birth & Beyond”), picked it up and asked to run it since it's very topical right now, what with the recent important study on Practice Variation.

I revised my very-quick original post and expanded on a few points, added some new research, reformatted it a bit, and generally prettified it up. (I spent all my time on that, so no new post here till next week.)

In the meantime, the revised post is now up on Science and Sensibility. You can go and read it here.

Looking for PCOS Stories

Happy holiday weekend everyone!

Just wanted to let you know that I'm working on continuing my series on PCOS (Polycystic Ovarian Syndrome) later this summer.

While, as always, I'll have lots of research and facts, I'd also like to add some stories from real women with PCOS. One of the difficult things about PCOS is that it's a syndrome, and that means it can present really differently in different people. Not everyone's experience is going to be the same, and not every treatment regimen is right for every person.

Thus it's important to represent a wide variety of experiences and treatment regimens, and it's really important to bring that personal voice of experience to the discussion, especially as we start to delve into some of the more personal aspects of PCOS.

In the past we've worked on discussing treatment choices for various aspects of PCOS, and I'd like to continue that. We've been focusing on treatment for menstrual irregularity and insulin resistance/blood sugar issues; now I'd like to focus on treatment for other common aspects of PCOS.

I'll be looking particularly for stories dealing with treatment choices for androgen excess, for hirsutism, for hair loss, and for infertility. Not all at once, of course...each one separately.

So, for example, if you are a person who has used The Pill to deal with androgen excess or menstrual irregularity, share which one was recommended to you and your experience in using it. Did it help? Did it make things worse in some ways but better in others? Did you have any complications with it? How did treatment recommendations for it change as you aged? What types are best for women with PCOS in your experience?

Or if you are a person who has dealt with hirsutism (excess hair on the face and body) or alopecia (hair loss on the head), summarize how you have dealt with it. Did you choose to do anti-androgen medications, cosmetic methods, or a combo of both? How successful were the treatments? Or did you opt out of treatment eventually? What information would you like to have read about treatment choices when you were first dealing with PCOS? What encouragement can you give to other women dealing with these challenges to their self-esteem?

Or if you are one of the many women with PCOS who have dealt with infertility, share your infertility journey and what has helped you. Did you use Clomid or other medications, did you use IVF, did you use alternative treatment like herbs or acupuncture, or something else? How long did you try? What was most effective for you? What was a waste of time and money? What would you like to have known about treatment choices ahead of time? If you were not able to have children, did you choose to remain childless or did you choose to adopt or go with surrogacy? If you were able to have children, what was most helpful in that process?

Obviously, some of these issues are very personal. Rest assured that your story will be shared anonymously or under a pseudonym (pen name). If you do have a story to share, please email a brief summary of your experiences to kmom AT plus-size-pregnancy DOT  org. Don't forget to give me specific permission to share your story, and please tell me what pseudonym you'd like to use (if you have a preference).

Because I may be sharing multiple stories, it's important that you keep your story brief. Focus on one or two aspects of your treatment or experience rather than trying to cover the whole thing. Ask yourself, what would you most like to get across to another woman with PCOS who is starting to deal with the same issues?

Keep in mind that I may not be able to use all entries, or I may choose to quote only part of your story. I may also edit for practical stuff like grammar, spelling, etc. Again, I will not be publishing under anyone's real name, so choose a pseudonym you are comfortable with.

Try not to give medical advice in your piece; none of us are healthcare providers, and we don't know the details of anyone else's case. It's okay to share what has worked for you or to advocate awareness of a particular treatment approach, but avoid telling people what they should do or getting preachy. We are all adults, we all make our own choices, and what's right for one person may not be right for another. Raise awareness, educate people about their options, but respect their right to make their own choices.

I'd also love for people to share their favorite PCOS resources....books, websites, blogs, and links. I'm aware of many of them but I'm sure there are many more out there I'm not familiar with. Tell me the resource, give its link, describe what it deals with, and tell me why you think it's helpful for women with PCOS.

Rest assured, this will be a continuing periodic series. In the future, we will be dealing with PCOS pregnancy, birth, breastfeeding, menopause issues, and many other things. But for now, it's time to continue posting about treatment options for some of the more common PCOS symptoms and health concerns, and it's time to add some personal voices to these discussions.

I look forward to reading your stories!

Blessings on Your New Year

Happy New Year to all my readers!

Thank you for reading, linking, and referring to this blog over the years. We are now approaching close to 2 million page views, which is simply stunning. Thank you so much; you humble me.

As a New Year's gift back to you, I'd like to share some special music. I love music, especially classical music, and this is one of my favorites.

In Japan, there is a lovely New Year's tradition of participating in a performance of Beethoven's Ninth Symphony (the choral symphony with the famous "Ode to Joy" tune, which was adapted into the church hymn, "Joyful Joyful We Adore Thee"). Supposedly this tradition began back in World War I when German prisoners-of-war played it at a concert for people in Japan. Over time (for many reasons), it developed into an annual tradition there, played all throughout December and culminating in massive New Year's Eve performances.

But while huge concerts are inspiring and impressive, there is something to be said for a slightly more intimate version too. This is an utterly charming video of a flash mob of musicians in Spain performing the best and most familiar bits of the famous last movement of Beethoven's Ninth.

It's not the most polished performance, but who cares? That's not the point. It's all about the exuberance of the music, the pleasure of making communal music together, and the sheer joy of the children and others watching as they are moved by this wonderful piece of music written long ago by a man who couldn't even hear the music out loud anymore but who continued to write for the sake of the beauty he could still hear inside his head.

Enjoy the beautiful music, count your blessings and your joys, and have a wonderful year. Many blessings upon you and yours.

*Want more? If you've got the time, check out the justly-famous 1989 Fall of the Berlin Wall Ode to Freedom concert of Beethoven's Ninth, conducted with transparent and overwhelming emotion by Leonard Bernstein. Part one of the 4th movement is here, and the second half of the movement is here. (If you don't have time for it all, my favorite part is the first four minutes or so of part one!)

Treasure This Time Together

Merry Christmas, everyone. Hope you are having a wonderful, happy holiday with your families!

Travel safely, and don't let the stress of travel or preparations impede the enjoyment of your time together. Focus on the important things in the season, not the passing unimportant ones.

Treasure every moment with your loved ones. Life changes quickly; savor your time with your family and friends now because you never know who won't be with you next year. Overlook their quirks where you can, humor or avoid the more challenging folks, forgive where you can, and appreciate people's good qualities as much as possible. Count your blessings and give thanks for the people you love.

Reach out to family and friends you don't know that well so you can build those relationships if possible. Family can be trying sometimes, but they do matter. When they are gone, you never get them back. Make the extra effort to reach out and make connections. Take a chance; you never know what kind of special relationship or memories you might be missing.

Shower love and appreciation on those who matter most. Remember that this time in the children's development will never come again, so take lots of pictures of everyone (including yourself) and spend as much time as you can just being with them and having fun together. It's not about what you are doing, it's about doing it together and making those memories.

Treasure your time together, and cherish your loved ones. Honor the sacredness of the season. Find the joy and hold it close to your heart.

Have a wonderful holiday; the blog will resume after some holiday family time. Merry Christmas and Happy New Year!

Feedback on the PCOS Series: What Do You Want?

Before we get to the next post in the PCOS series, I'd like to get some feedback on it.

First, are you liking the PCOS series? Is it useful to you? If so, what's been most helpful? The comments have been pretty quiet on this series and I want to know if it's been useful to people. The series is a considerable amount of work and I want to make sure it's worth my time and research effort to put this out there for you. Do you want me to continue the series, or would you rather I focused on something else instead?

Second, if I continue the PCOS series, what would you most like to see in the near future? I have many posts in development (PCOS and hirsutism/acne, PCOS and fertility, PCOS and pregnancy, PCOS and breastfeeding, PCOS and menopause, PCOS and alopecia, PCOS and depression, PCOS and Lifestyle Tweaks, PCOS and alternative medicine, etc.), but it's a matter of prioritizing which ones to work on first. Some are more ready than others, of course, so not all will be ready anytime soon, but it would be nice to know what people are most wanting to explore.

Third, I'd love to have more personal stories of how you deal with PCOS (if you have it). Personal stories really anchor a series like this, especially when there are so many dry facts and stats in the posts. We need the personal stories for balance and perspective. But I can't put them in if I don't have them.

I'm especially looking for stories on how you deal with the challenges of hirsutism, acne, alopecia, and/or depression. Not every person experiences every PCOS symptom, so I think it's really important to share the experiences and wisdom of those who have struggled with those particularly tough symptoms and what has helped them. Women with those symptoms often feel especially isolated, so I really want personal stories on those particular posts.

I'm happy to share your stories without using names so you can speak very frankly about your experiences. In fact, the more honest, the better. Just be sure to give me formal permission to use your story and how you'd like to see it attributed.

I do have a couple of stories of how people use Health At Every Size® techniques to deal with PCOS, but I'd love more stories with that point of view too. I'd love stories on how women with PCOS try to get traditional providers to deal with PCOS in a more size-friendly (or at least weight-neutral) way. In my experience, women are really looking for strategies on that because the traditional approach to PCOS is so incredibly weight-centric.

So please give me your feedback on the PCOS series so far and what you'd like to see for the future. And if you have a story to share about your own experience with PCOS and how you deal with it, I'd love to have more personal voices in the series as well.

You can use the comments section below, or you can email me privately, using the email address in the column to the left.

As always, thanks for reading!

Google Reader Feed Changes

Here’s a message from the new administrator of Notes From The Fatosphere:

On 30th June, Google Reader will cease to exist. The Fatosphere feed has been moved to Feedly. Until the beginning of July, readers will be able to access NFTF via either Google Reader or Feedly, but from July 1st, you will need a Feedly account to continue to receive the feed.

All you need to do is go to Feedly.com, sign in with your google reader email and password, and follow the instructions to migrate your account from GR to Feedly.

If you don’t currently get the NFTF feed and want to do so, you can sign up at feedly.com for a new Feedly account. You will need either a gmail address, or a Google account for this. Then, once your account is set up, just type ‘notes from the fatosphere’ into the add content box and you’re done.

New Post at Science and Sensibility!

image from Wikimedia Commons

Just wanted to let you know about my latest publishing venture.

I have 2 new articles up on the childbirth blog, Science and Sensibility.

Part One is about helping birth professionals make their offerings more size-friendly. It can be found here.

Part Two is about helping women of size optimize their outcomes.  It can be found here.

Thank you to all the women who took time to comment here or by email when I asked for input for the articles.

Leave a comment on the Science and Sensibility blog if you are so inclined.  This is your chance to reach out to the greater healthcare community that is not very familiar with size acceptance or Health At Every Size®.  Help them understand what it's like to navigate healthcare (and especially maternity care) as a woman of size.  Tell them how you feel about current public health campaigns about obesity.  Share some of your experiences, suggest hints for improving care of women of size, or just make your voice heard as a woman of size.

Rarely do care providers hear the voices of "obese" women raised in advocacy for themselves; too often they talk about us instead of engaging in dialogue with us.  Many doctors, midwives, nurses, doulas, and childbirth educators read Science and Sensibility, so here's a prime chance to open up dialogue on improving care for people of size, and to raise some awareness about Health At Every Size®.

Check it out.  Then feel free to "like" it, "tweet" it, or "share" it elsewhere on social media.

*edited to add links to both Part One and Part Two

Thanks a Million!

Image from Wikimedia Commons

Just wanted to take a time-out from my normal posts to note that we just passed a MILLION page-views to the blog!  Wooo-hooo!!

I know, a pittance compared to some sites, and many hits are no doubt spam or quick searches with no real interest in the site. But even so, a million page views is pretty amazing to me.  Not bad for four years!

In the beginning, of course, I had very few visitors.  Slowly I built readership up to around 20,000 per month.  Then, two years ago, things really expanded.  Now I average around 1500 page views per day, and between 45,000 to 50,000 per month.  Unbelievable.  And I rarely even promote the site on other blogs or in social media!  The power of the internet, I guess.

I've taken a little break recently from pregnancy-related stuff, focusing more on some parenting-related issues and fun stuff.  However, don't worry, I have many pregnancy-related items and weight-related things in the works, plus a return to the PCOS series soon.  These are the things closest to my heart, but they do take a lot of research and time to complete, so I fit in some easier stuff now and then. Plus, sometimes I just like to vary my focus anyhow! Keeps things fresh.

But now's your chance to give a little feedback to the blog.  What do you like best, and what do you hope to see more of?  In your opinion, what's the most important stuff to cover?  I can't promise I'll change my posting habits too much, but it is helpful to hear what folks need/want most.  Helps me prioritize my time.

Thank you, readers, for all your pageviews, recommendations, links to the blog and links my other website, www.plus-size-pregnancy.org.  I appreciate you all.  I don't get to reply to all my emails anymore (one of the downsides of a well-read blog is having too many emails to answer each one personally), but I absolutely read every single email.  I try to fit in what I can, but as a working mom with four children, I can't always get to every one.  My apologies.

Still, I hope the blog has been useful to you.  It's certainly been a pleasure and an honor for me to write this blog and interact with my readers.

Thanks a MILLION, y'all!  See you after the next million!

The Well-Rounded Mama

Gardening Rainbows

A recent double rainbow in my back yard at twilight.
Light at the end of the tunnel for this stressful year!

I finally got out to my garden this week after an intensely busy and high-pressured winter and spring. What a stressful year I had at work!  I'm always busy, but this year I was busy with a capital "B", and stress arrived in an economy-sized package.  Alas, that limited many of the other projects I had going (including my writing); so frustrating.  Apologies for some minimalist blogging content this spring.

I had so many things I wanted to try in the garden this year, but getting such a late late start meant that some of them just aren't going to get done this year. Feh.

However, once in a while I managed to steal a moment here and there to plant something this spring, so I do have carrots and peas going in various stages.  I had some garlic and onions overwinter, so that's helpful.  Surprisingly, I had some brussel sprouts overwinter too, so we'll see if that turns into anything. Of course I have my perennial fruits and veggies, like asaparagus, raspberries, strawberries, cherries, etc.  These form the core of my garden this year.

Asparagus Ferns to the left,
and the Rhubarb of Doom to the right

We were able to harvest asparagus this year. I planted it last year and you don't harvest the first year, so this was the first time we got to eat our own home-grown asparagus.  You harvest only minimally the second year, so we were sparing in our harvest, but I can see this is going to be a source of much delight to us. We love asparagus at our house!  Served al dente with a little garlic aeoli, or grilled with a little olive oil....Oh, sooo sooo good.  I'm just sad asparagus season is over now. But that's okay...they are busy building roots so they can give us lots of yummies next year. You can see the ferns that asparagus spears turn into in the picture above on the left.

I also planted rhubarb plants last fall, but that was a bit of a fail. I've never grown rhubarb before, so I didn't realize just how HUGE they get.  But you can see the Rhubarb of Doom in the picture above.  Uh, a little large for a raised bed planter, ya think? Obviously, it doesn't need the babying of being in a raised bed, based on its dinosaur-sized leaves.  So we're going to have to dig this puppy up and move it to a better spot.  I'm not looking forward to that job.

You can see the first strawberries of the season above. We're harvesting strawberries like crazy now. I will have enough to make a large batch of freezer jam that's just from our garden; in the past, I've had to supplement with berries from various Farmer's Markets.  I probably will again for later batches, but it's very satisfying to be able to do a few batches that are just from our garden.  I love strawberry freezer jam the best because you can use minimal sugar and the freezer jam keeps more of the fresh strawberry flavor. It's like a eating a little burst of summer in the middle of the winter. Flippin' awesome.

We also just started harvesting the first raspberries.  OMG, is there anything better than the first raspberries of the season???  Usually we just eat these fresh, but I put in a whole bunch more raspberries last year and so will need to put some up somehow...especially since we'll be harvesting raspberries into October.  Made some raspberry muffins yesterday, may try some raspberry sauce, some white chocolate raspberry bark, some raspberry chipotle sauce, and will also just freeze some straight up.  Any other great raspberry suggestions?  I'm going to have a lot.

We are knee-deep in cherries from our trees right now. I have to figure out what to do with them before they go bad. I don't much care for cooked cherries (so canning them is out) but love the fresh ones. I think we are going to freeze them raw.  Just wash them, pit them, put them on some parchment paper on a cookie tray and stick them in the freezer to freeze individually, and then bag them for later in the year.  I've heard that eating fresh-frozen cherries (no sugar, no additives) right out of the freezer is a real treat.  I'll let you know!

I have lots of plums starting to ripen, and many apples have set, so I'm looking forward to canning some plum chutney and applesauce later in the summer.  Looks like we'll have a few fresh pears too. However, my pluots (mix of an apricot and a plum) are total duds so far.  Maybe next year.

We did finally get some other stuff planted.  I was so late that I mostly used starts from the store, but that's okay; I'm not a gardening snob.  I have broccoli that's almost ready; the head has gotten a lot bigger than when I took the above picture.  We love fresh broccoli, which is good because we'll be having a lot in the next few weeks before we get slammed by hot weather.

I planted eggplant for the first time this year.  I'm not a big eggplant fan, but thought we'd give it a try. If all else fails, my MIL will eat them. Also put in a zillion tomatoes (for my special homemade spaghetti sauce, yummm), potatoes, pumpkins, green beans, swiss chard, zucchini, and cukes.

As some of you know, I have some knee issues from a bad car accident a few years ago.  This is why I mostly garden in raised beds.  But of course, raised beds are not cheap to build.  So this year, I'm contemplating trying straw bale gardening to expand my raised beds inexpensively.

Image from WSU Master Garden blog, wsumgtc.wordpress.com 

You condition a straw bale, then plant certain types of garden plants in the straw bales, like pumpkins or cukes or tomatoes (with staking).  It's raised bed gardening on the cheap. Then you use the decomposing straw left over for your potato beds next year, or put it in your compost pile. It's late to start this process, but what the heck.  I'm going to give it a shot anyhow.

I'm also looking at creating some sort of adapted portable cold frame/hoop house for my garden. I want to be able to cover the tomatoes to extend their season in the fall, and I want to be able to grow some cold-weather crops in the winter but be able to protect them from the very coldest weather.  So we'll be experimenting with that this summer.  Updates next fall.

So that's what's up with me right now.  I'm trying to get the kids' summer schedule organized (one's in Alaska with Scouts right now), I'm trying to get the garden established and weeded, I'm trying to start canning, and I've got to get my office cleaned before the cameras from the Hoarding shows arrive.  Oh yeah, and work on some writing projects.

What are you up to this summer? Got any big plans? If you garden, tell me what's going in in your garden!  Anybody got any great recipes for raspberries?

Shameless Plug

So, this blog recently got nominated by readers of about.com as one of the Top Five Pregnancy Blogs this year.

I never quite know how to take something like this; I'm flattered, I'm embarrassed, and I have no idea whether or not to mention it on the blog.  Sounds too much like tooting your own horn to me, so I had decided I wasn't going to mention it.  If folks wanted to vote for me, I wasn't going to object, but I wasn't going to actively solicit votes either.  It's just a little uncomfortable.

I don't do a lot of self-promotion, and I constantly have people telling me that I need to be doing more social networking.  I'm a product of my baby-boomer generation, I guess, and I just find the whole Facebook and Twitter thing annoying and egotistical, not to mention being way too much of a time drain. I'd rather spend my all-too-minimal computer time doing something more substantive. Plus, these contests are often just a way to drive more visitors to the sponsoring organization's webpages.  It's very clever viral marketing, so I'm a bit cynical about participating in that.

And yet, I do feel it's an honor.  I know the author who runs about.com's pregnancy content, and she has consistently worked for women's best interests for years. She's not just out there trying to buy her way into more hits; she really cares about supporting women and giving them good information so they can make informed choices about their care.  This is one way of doing that.

So I got to thinking about this contest as a way to spread the word about the relatively unknown concept of Health At Every Size®, about the need for dignified and respectful treatment for women of size, and about important pregnancy and birthing issues we discuss here that apply to all women, regardless of size.  It's great to work on substantive issues, but it's even better when people actually read your messages about those issues.  It's the difference between preaching to the choir and reaching out to a whole new audience, some of whom may really need to hear those messages.

So it's with some embarrassment but also some grit-your-teeth-and-just-do-it determination that I'm letting folks know about the contest.  If you've found this blog useful at all and are so inclined, just click on the link below and go vote. You can vote now through March 21st. You can only vote once each day, but you can vote more than once.  Don't feel you have to vote, but if you want to, I thank you for helping to raise awareness of these issues to a whole new audience.  Here's the voting link:

http://pregnancy.about.com/od/readerschoiceaward/tp/Readers-Choice-Awards-2012-Blog-Finalists.htm

I really don't expect the blog to win, as we're up against some really outstanding and social-media-savvy blogs (personally, I voted for The Unnecesarean!). However, if we have a good showing, then perhaps more people who don't know my blog will come and check it out. That's all I'm aiming for.

Thanks for thinking about it.  Shameless-and-embarrassing plug over now.  We return you to our regular programming.

(And yes, I'm still holding my nose and considering the whole Facebook thing. I know you young whipper-snappers don't understand resistance to Facebook, but us old geezers just have a great distaste for the whole concept. Or at least this old geezer does! But I suppose it has its uses. I'll think about it....)

Blogiversary #2: State of the Blog

♫  Happy Blogiversary to me, Happy Blogiversary to me.....!  ♫

Yes, it's been 2 years since I started this blog.  I can hardly believe it.  Feels like I've been doing it a lot longer!

So in honor of the blog's birthday, let's take a moment to do a State of the Blog assessment, eh?

Purpose of the Blog

2 years ago, I started the blog to raise awareness about the issues of "obesity" and pregnancy. 

I found little awareness or comment about pregnancy issues in the fat-acceptance world and wanted to raise the fatosphere's awareness of the discrimination and mistreatment many women of size face during their pregnancies and births.  Size discrimination often starts in the womb, yet this has been a very overlooked area in the discussion about size bias.

I particularly wanted to reach out to pregnant women of size who might be looking for information on how weight could affect their pregnancy and care.  I wanted to make sure they had in-depth information about their choices, risks, common care protocols, the pros and cons of interventions, etc., and that they had information about proactive things they could do to improve outcome.  And I wanted to make sure they had a place to share their concerns and questions, and a space where they could see other pregnant women who looked like them so they would know that they are not alone. 

I also wanted to reach out to the birth world and further its awareness of how pregnant women of size are often mistreated, ask birth workers to question the assumptions often made about women of size, to analyze the quality of the research on obesity and pregnancy, and to open a discussion of how to improve outcomes in women of size. 

Whew. That's quite a wide-ranging mission and target audience.  This means that sometimes my posts will appeal only to one segment of my readership.  Some will really want the pregnancy pictures and birth stories, others really want the nuts-and-bolts research analysis, and still others are most interested in discussions of size bias or Health At Every Size instead.  But hopefully, even when the posts don't appeal to your particular needs, they're still interesting enough to learn something new or to be diverted by for a few minutes.

Thank you to those of you who have linked to my blog or specific posts on your sites, or who have "liked" or tweeted about them on social media networks.  It really helps increase the visibility of my blog, increase the readership, and get my message out.  Keep linking, "liking" and tweeting!

My birth friends are pushing me (kicking and screaming all the way) towards the social media world, and I have been informed that I must get a Facebook page soon.  I'm no fan of social media but I recognize its importance in getting out advocacy messages, so I'll probably be looking into this soon.  Keep your eyes peeled for it.

Blog Stats

Alas, Blogger has only had stats available for my site for the last year, so I have no data on how many readers I had in the first year or what they read the most.  But now that I have these stats available, it's been fun keeping track of them.  It feeds my inner geek and my ego too, which is always nice!

Generally I average about 20,000-25,000 hits per month these days.  That's up from the beginning of the year when it was more like 17,000-20,000 per month.  So that's encouraging.

Here's the part that boggles my mind. All together, I've had nearly 275,000 hits in the last year alone.  Whoa.  Pretty amazing!

Yeah, okay, peanuts compared to some sites, but still pretty dang impressive to me!  Starting this blog has been a big boost for getting out my message, even beyond my regular website, www.plus-size-pregnancy.org.  I'm sure if I ever drag my reluctant backside over to Facebook, that would help boost readership even more.

Popularity-wise, my Top Five Posts of all time are:

• Plus-Size Pregnancy Photo Gallery
• Will I Feel My Baby Move If I'm Fat?
• Belly Shape and Fetal Position
• The Fat Vagina Theory: Soft Tissue Dystocia
• Healthy Birth Practices: Get Upright and Follow Urge to Push

 Of these, the Plus-Size Pregnancy Photo Gallery is by far the most-viewed post.  It has had nearly 70,000 views all on its own, compared to about 12,000 for the next most-viewed post. 

Apparently there is just a tremendous need out there for images of women of size in pregnancy and birth, because nearly all the search terms commonly used to find my blog involve some variation of "overweight" or "obese" or "plus-size" and "pregnancy" or "photo" or "belly."  So obviously, one of the most important things I've done is to try and meet that need for images and reassurance.

This is one reason why I hold my nose and still use the "o" words ("obesity" and "overweight") at times; I know those are the search terms used by people not familiar with fat acceptance.  Frankly, those odious "o" terms are how most people find my blog.  It helps me preach not just to the choir but to a lot of people unfamiliar with fat-acceptance and Health At Every Size.  It helps me reach more of my most-desired target audience ─ people unfamiliar with size acceptance and new to the concept, whether those are people in the birth world or are people of size themselves.

So while I've had many approaches to the terminology issue over the 16 years I've been writing about this topic, in the end I've decided that getting the message out to those who need it most takes priority. As a result, I use a mix of terms on the blog, from the repulsive "o" words at times, to "fat" (which is my preferred term but which alienates some), to euphemisms that tend to be a bit more neutral. This makes my blog more likely to be found by a variety of people, not all of whom are on board with fat-acceptance yet.  You can agree or disagree with that approach, but it's the compromise that seems to work best for me after many years of trying different ways of handling the terminology.

Geeky Stuff

I get a real charge out of my little "world" widget on the top right-hand side of my blog. It's always so much fun to look and see who's reading my blog right now and where they are from.   I love that!

Not surprisingly, most of my readership comes from English-speaking countries, especially the U.S., the U.K., Australia, Canada, and New Zealand, but I get a fair amount of hits from Germany and the Netherlands. I also get quite a few hits from places I wouldn't have expected, like India, Russia, South Africa, and Iran.  Very cool!

One thing I am working on for the future are reference pages with links to research studies....sort of a quick reference link page, as it were.  I think some of my readers might find that useful; I know I find it useful on other people's blogs. (Thank you Fat Nutritionist!)

I also have a major series planned on the risks of pregnancy in women of size coming soon.  We'll take each one of the risks, look at the research on it, dissect the quality of the research, and figure out the lessons to be learned from it (if any).  This will be a major series, and it takes a huge amount of time to research and write each risk category, so it will definitely be a periodic series over a long period of time instead of a continuous short series.  Still, even though it will be spread out over time, hopefully it will be of use to women of size as they try to sift through all the scare tactics and rhetoric around fatness and pregnancy.

Conclusion

So that's the State of the Blog─where we are right now, and some directions we plan to go in the future.

Thank you for reading the blog, for sharing links to it with others, and for spreading the message about it.  Keep doing spreading the word, please!

Thank you to the Fatosphere for being open to this unique message about pregnancy in fat women.  I know it can be hard to care about this topic if you are not personally planning to have children, but size discrimination matters, even if it doesn't personally affect you.  Thank you to those who continue to read even with no personal investment in the topic, and thanks to those of you who are affected by the topic and who share your stories and concerns.

Thanks to the many gutsy maternity care providers and birth workers who have embraced the cause of better treatment for women of size too.  It is so important that this message not be limited to this blog or to the size-acceptance world, but that it be actively discussed and pursued by those in the birth field.  Special thanks to those birth workers who have done their best to help and advocate for women of size as clients.

Finally, special SPECIAL thanks to the many brave mamas of size who have shared their pictures, their thoughts, their comments, and their stories with the blog or my other website.  Your experiences are the heart of why I do this; thank you so much for sharing.  YOU ROCK.  You'll never know what a difference you make in the lives of future women of size.

Happy Blogiversary, and I look forward to sharing many more blogiversaries with  you!

Third Post at Science and Sensibility is up!

Okay, my third and final post at Science and Sensibility is up!

You can access it here.

This one is about lowering the risks for complications in women of size, and exploring ALL the possibilities for doing that. 

It's about not relying on weight loss, restricted weight gain, and/or a high-intervention model of care as the only ways to prevent complications in women of size.  It's about the need to explore other options as well, and what some of those options might be.

Check it out!  And give it some more link love, eh?

Second Post at Science and Sensibility Now Up!

My next post, second in the series on obesity and pregnancy, is up now at the Science and Sensibility blog.  You can find it here.

This one takes a critical look at the research for confounding factors that rarely get accounted for in the research, and suggests directions for more meaningful research in the future.

Go forth and give it some link love, "likes" and tweets!

Belly Blog Carnival Deadline Extended

I've gotten a number of submissions for my Belly Blog Carnival, which is great!  I'm thrilled. 

However, the original due date was tomorrow, and I've decided to extend it a couple more weeks.  I'm prepping right now for a big trip and presentation, and I'm realizing that I don't have the time to give the Belly Blog Carnival the attention it deserves before the trip.  I also want to give folks time to send further submissions.

So therefore I'm extending the deadline till after I get back from my trip, at which point I'll take time to collate all the submissions and write my own entry.

Let's make the new deadline April 15th.  Keep those submissions coming!

p.s. Don't you just love the picture above?  It's one of my all-time favorites.

The Best of 2010 on WRM

Recently, I saw someone post "The Best of 2010" from her blog ─ what she thought were the best or most interesting posts that she wrote during 2010.  I thought, what a great idea.........I need to steal it! 

So here are some of my favorite or what I think were the most important posts of 2010 from my Well-Rounded Mama blog, just in case you missed some along the way. 

Enjoy, and I look forward to seeing what comes out in 2011!

January 

Second Annual Turkey Awards: Scare-mongering and Shaming Tactics - A condemnation of an opinion piece blasting women of size for the crime of Being Pregnant While Fat, and an examination of the scare tactics and shaming being used in the media to distort the risks around "obesity" and pregnancy.

Healthy Birth Practices: Avoid Unnecessary Interventions - 4th in a series on the Lamaze Healthy Birth Practices.  This one discusses the risks of common routine interventions in labor, why women of size experience these interventions at higher rates, and suggestions for avoiding them.

February

Not much this month because I was in Hawaii for my 25th wedding anniversary!

Eat, Drink, and Be Merry, For Tomorrow We Diet - Research abstract summarizing what we in the fat-acceptance community have known for years ─ that restrained eating (a.k.a. dieting) tends to lead to or exacerbate overeating behaviors.

March

Choosing a Birth Care Provider: Which Type? - Between 80-90% of women in the U.S. choose an OB to attend their births, yet outcomes are just as good (and often better) with family docs and midwives.  This article by guest authors outlines the different type of birth providers available and the pros and cons of each.

You Have The Right To Decline To Be Weighed - Rehash of the debate over whether it's necessary to weigh people at every doctor appointment, when it might be important and useful, and when it's not. 

Why VBAC Bans Are A Violation Of Human Rights - Discussion of the epic fail of ethics in doctors and hospitals that "ban" VBAC, either officially or de facto. 

April

Variability of Uterine Efficiency - One of my favorites of the year, this post for Cesarean Awareness Month challenges the common perception that virtually all cesareans are "necessary" and shouldn't be questioned.  It shows the variation of cesarean rates from state to state, year to year, hospital to hospital, even doctor to doctor, and points out that oftentimes, factors unrelated to the characteristics of the mother herself are the strongest drivers of cesarean rates.

Healthy Birth Practices: Get Upright and Follow Urges to Push - 5th in a series on the Lamaze Healthy Birth Practice, this entry discusses the reasons not to use the "stranded beetle" pushing position so many hospitals use, gives illustrations and examples of alternative birth positions, and discusses the benefits of these positions (especially for women of size). 

May

You're Killing Your Baby - Another in a sadly long series of posts documenting the abusive treatment of women of size in pregnancy.  This was the case of a woman, just over 200 lbs., whose doctor told her that she was "killing her baby" because she "couldn't control" her appetite.  (Her baby was fine and is now almost grown.)

June

Ultrasounds in Women of Size, Part 1 - Doing an ultrasound during pregnancy in a woman of size can be more difficult, but there are techniques to help improve imaging and accuracy, and techniques (like pressing too hard) that can actually result in data distortion.  (Part 2 of this series is in the "to-do" queue and will get done eventually!)

Distoring the Risks Again - Once more addressing the way that the risks of "obesity" and pregnancy are distorted in mainstream media (like this particular article in the New York Times) by using risk ratios instead of real-life numbers, promoting simplistic views of fat people and their habits, ignoring the fact that correlation does not equal causation and that extreme intervention also introduces risks, and by citing worst-case scenario stories of specific fat women.

Healthy Birth Practices: Keep Baby With You - Examines the influence of post-delivery practices in hospitals on breastfeeding and bonding, and discusses how common interventions particularly impact women of size and their breastfeeding rates.

July

Will I Feel My Baby Move If I'm Fat? - One of the most-viewed blog posts on this site ever, this discusses the common myth that fat women won't feel their babies move "because of all that fat in the way."  Poppycock!

About Damn Time: Good News For Vaginal Birth After Multiple Cesarean - A review of ACOG's change of guidelines about VBACs, and in particular "allowing" VBAC after 2 cesareans again.  A celebration of the changes but also a condemnation of the (non evidence-based) decision to disallow VBA2C in 2004 and the chilling effect that has had on women and birth worldwide. 

Limiting Fertility Treatment Access For Fat Women - Excellent article abstract and brief discussion of the current British policy denying access to fertility treatment for "morbidly obese" women across the pond. 

You Will Probably Just Die Anyway - Another in the series of posts, documenting mistreatment of women of size in pregnancy.  This woman was told that she would no doubt get GD, high BP, and probably just die during pregnancy.  The story sparked a number of people to share their stories of mistreatment and scare tactics too.

August

Breastfeeding in Women of Size: Sensationalism Vs. Meaningful Research - Another common theme in articles on "obesity" and pregnancy is that breastfeeding rates are lower in "obese" women.  This article examines the research, notes its shortcomings (particularly the lack of consideration of the impact of PCOS on milk supply), and discusses other possible influences (hypothyroidism, anemia, interventions in labor and postpartum) and how these might also impact women of size disproportionately.  A call to arms for better and more meaningful research on breastfeeding in women of size.

Is Weighing Necessary During Pregnancy? - Part 2 of the series on whether "obese" people need to be weighed at doctor appointments, this installment examines the arguments (and research) for and against weighing during pregnancy. 

Please Document Your Stories of Mistreatment - Notes the importance of documenting examples of size/weight bias, tells some of women's stories, and gives resources for documenting these stories.

Antibiotic Underdosing in "Obesity" - One of the most important entries this year (in my opinion) even though it has nothing to do with pregnancy.  This entry discussed the fact that many "obese" people are underdosed with antibiotics, i.e., are given  ineffective, subtherapeutic levels, and this may cause a lot of our poorer outcomes after surgery etc.  A lot depends on the type of antibiotics (some need weight-based dosing, some do not, depending on the mechanism of action) but research clearly shows that more study is needed into the best dosages for "obese" people ─ yet little of this research is being done. 

September

Delaying Routine GYN Care - Research review of 23 studies documenting the fact that "severely obese" women often delay or avoid routine gynecological tests like Pap Smears and Mammograms because of issues like weight stigma, lack of appropriately-sized equipment, and communication issues with providers.

Nice Is Not Enough: Questions for Interviewing a Maternity Care Provider - Sparked by a blog entry from a midwifery blog, discussion of important questions to ask when choosing a birth attendant for your birth.  Some discussion of special issues for women of size too.

Prenatal Weight Gain: When the Conclusion is Made Ahead of the Results - First in a series of posts about prenatal weight gain politics and how they are impacting women of size.  Discusses a new Kaiser study which promotes ZERO weight gain for "obese" women in pregnancy.

October

Prenatal Weight Gain: Ignoring Possible Harms - Second in the series on prenatal weight gain politics for women of size.  Discusses the possible risks associated with very low weight gains (and even weight loss) in "obese" women and the possible implications for the baby's future health. 

Prenatal Weight Gain: The Importance of Study Design - Third in the series on weight gain in women of size.  Discusses how the studies on restricted weight gain in "obese" women often are poorly designed, with critical concerns about sample size, controlling for iatrogenic factors, lack of long-term follow-up, and confusion of correlation vs. causation.

Gaining Weight In Pregnancy Means a Cesarean? - Documents a concrete example of one of the ramifications of restricted weight gain for women of size, which is penalizing women who "gain too much" by requiring them to have an "elective" cesarean.   

Too Out Of Shape for Birth? - Documents another example of size bias, the perception that fat women are "too out of shape" to push out a baby. 

November

Breastfeeding Lowers the Risk for Diabetes and Other Maternal Disease Later in Life - Review of new and old research that shows that extended breastfeeding significantly lowers the risk for diabetes, heart disease, and other issues later in life. 

Failure to Wait Cesareans - Discussion of a new study which shows that many cesareans for "failure to progress" are actually cesareans for "failure to wait."  This particularly impacts first-time moms, women who are being induced, and women of size. 

Third Annual Turkey Awards: Jumping To Conclusions - Documents incidences of science-challenged doctors who ramp up the risk perception around "obesity" and pregnancy to conclude that if a fat woman is somewhat at risk for complication, then she WILL get it, and she or her baby will probably DIE as a result.  (See also, "You Will Probably Just Die Anyway" above.)

December

Contemporary Cesarean Patterns in the USA - Discusses recent study on cesarean patterns in 19 hospitals across the country and its implications.  Nearly half of the women were induced, many had "failure to wait" cesareans, primary cesareans were up sharply (which bodes ill for the future), and VBAC access is limited.  Calls for changes, but is anyone listening?

VBAC After 2 Cesareans - Distorted Risk Perception - Distorted risk perception is especially egregious in "obesity" and pregnancy, but many doctors also have distorted risk perceptions with breeches, VBAC, and especially about VBAC after more than 1 cesarean.  Documents a study in which French OBs underestimate the risks associated with multiple repeat cesareans and overestimated the risk for rupture in VBA2C as 7-15x what it really was.

The Fat Vagina Theory: "Soft Tissue Dystocia" - Documents the commonly-taught but completely unproven theory of "soft tissue dystocia" ─ that extra adipose tissue in the pelvis and vaginas of "obese" women obstruct the baby's path out and is a big part of the high cesarean rate in women of size.  Documents the lack of research supporting this theory and discusses the research and anecdotal evidence which seem to contradict it. 

Year-End Summary

All in all, a productive year, I think!  Which of my 2010 entries were your favorites, dear readers?

Yeah, there were a lot of research-heavy entries, but then I'm a bit of a numbers geek.  Plus I just think it's important to document the research that challenges common perceptions about "obesity" and highlight further research that's needed.  There's plenty of research on "obesity" out there; the problem is that much of it is CRAP or is not very insightful.  The bottom line is that we need better and more meaningful research. 

Next year, we start a periodic series addressing the risks of pregnancy in women of size, discussed in realistic terms but without scare tactics or hyperbole, and ways in which women of size can be proactive about lessening these risks.  Stay tuned!

Happy New Year to all my readers. Have a wonderful 2011!

*If you have specific requests for topics for the next year, feel free to leave them in the comments.  I may not get to them immediately, but I do like idea suggestions.

Happy Birthday to Me!

Happy birthday to me!!  Or at least, happy birthday to my blog. 

2 years ago this month I started this blog to try and reach out to more people in the fat acceptance community and in the birth community.  Although a number already knew about my http://www.plus-size-pregnancy.org/ website, many did not, so it was a good way to raise awareness about pregnancy in women of size, birth politics in general, and size acceptance issues in general as well. 

To celebrate my blog's birthday, I have redesigned its template a bit.  Tell me what you think.  And thank you all for coming and reading my thoughts and for sharing yours!

On Vacation

Just wanted to let readers know there will be a short hiatus of a week or two on this blog. 

This year is our 25th wedding anniversary. To celebrate, we are going to Hawaii! 

Sunshine and warm weather.....I can't wait to replenish my vitamin D stores.  I'm going to sit on the beach or by the pool, and I'm going to read books of pure fluff with nary a medical study in sight. Ah, bliss!!

Be patient, gentle readers.  I have plenty more to say and any number of big posts in the works.  They're just going to have to wait till I recharge my batteries a little bit!

In the meantime, all you snowed-in folks can envy me all you want. I'm not sharing my rays.