Just told I can't birth at the birth center because of my weight (long) - Mothering Forums

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#1 of 42 Old 07-21-2008, 07:53 PM - Thread Starter
 
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A little background: I am 30.5 weeks pregnant. I weigh a little over 300 pounds, but am very active and mobile. I have no health complications. I switched to a practice of midwives/OBs a couple months ago because they have an alternative birthing center at the hospital they deliver out of. My meeting with the first midwife was very positive. We spoke of what I want for my birth at the birthing center and she was very encouraging about it. The next meeting with a second midwife was not so great. I posted a couple weeks ago about it. She said that, due to my size, I should have "strong labor support" in the birthing center to make me more comfortable. She also had trouble measuring my uterus. She really offended me by saying I need strong people to make me comfortable, but we spoke about it the next day and I assumed everything was okay and I'd still be in the birthing center.

In this practice, you have to see an OB once during the course of prenatal visits. Today I had my appt with an OB who I heard good things about. The meeting did not go well. She said that I am still considered low risk, but I cannot birth in the birthing center. I have to birth in regular labor & delivery because monitoring the baby will be very difficult since monitoring is not continuous. She said there was an incident recently involving a larger woman where the baby could not be monitored properly and the chairman of the department is now enforcing strict size requirements. I'm not sure what happened to the woman or the baby but something has them scared. Because of my height/weight (BMI), I am now risked out of the birthing center. The doctor kept saying that I should be thinking about the baby's best interest and that it's next to impossible to get intermittant monitoring on someone my size between 2 minute-apart contractions when it sometimes can take up to 5 minutes to find the heartbeat once the baby drops down lower during late labor. The doctor called the chairman and he said I cannot birth at the birthing center. I have no choice in the matter.

I feel really betrayed. I switched to this practice because I heard great things about the midwives and they birth out the birthing center. It would be one thing if I had been told UP FRONT about being risked out because of my weight. In fact, I asked UP FRONT on the phone about my weight being a factor. The receptionist asked my weight and I heard her ask the doctor (who happened to be the same doctor I saw today) who said it's not a problem. My meeting with the first midwife was great and she told me how great my birth would be at the birthing center. Then, bam, I get hit with this.

So, anyway, I am really upset. I wanted to be at the birthing center because it's right next to the hospital in the rare situation that I needed a transfer. I felt it's safer. Now I'm not so sure. If I go to regular labor & delivery, I feel more at risk of interventions, even though the doctor today said they have some of the lowest intervention rates of any practices in the area (20% c-section vs. 35% of the area average). She said the midwives c-section rates are only about 5% because their patients are lower risk. I can still have the midwives in regular labor & delivery. But I don't know what to do.

I was referred to a doctor (DO) who is also a midwife. She does home births. I know many people on this site have had home births. I know I don't want to have a regular hospital birth, but I'm still a little afraid of home births too. It's like I can't win. The last thing I need in the last couple months of pregnancy is to be stressed like this.

I don't even know why I posted. I think I just needed to vent. Thank you all for listening. I don't even know if this is coherent.

Shannon
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#2 of 42 Old 07-21-2008, 08:14 PM
 
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Shannon I'm so sorry, I responded to your previous post about your hurt from that midwife's comments and this is all so frustrating. I think venting is appropriate right now! How upsetting.

I think personally what I'd do is meet with the homebirth midwife and see how you feel, it might soothe your fears and make it feel "right" to birth at home, or it might solidify your feeling that you need to be at the hospital.

I don't understand why they thing continuous monitoring would be better though...the continuous monitor thing didn't work for me either when the baby dropped low and it never picks up my contractions. It sounds like they had a litigation scare and are now making foolish decisions as a result.
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#3 of 42 Old 07-21-2008, 08:15 PM
 
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I'm sorry to hear that. I am also over 300 pounds (just) but it has not been brought up as a risk factor.
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#4 of 42 Old 07-21-2008, 08:17 PM
 
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OMG< I am so sorry you are going through this!! I would get a lawyer because you are being discriminated against based on your size. I am livid for you.

Size discrimination is RAMPANT in this country, and it needs to change!

BTW, I'm large too, and I had a homebirth almost 19 months ago without any problems.

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#5 of 42 Old 07-21-2008, 08:41 PM
 
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I remember reading your other post. I'm so sorry you are going through this. It really sounds like discrimination.

It really sounds like a good idea to do a homebirth. Part of what brought me to MDC was when I was first learning about pregnancy I started to watch birthing videos. The hospital videos were often cold—sometimes horrible, but the homebirth videos always seemed so happy and peaceful...even during the intense painful moments.

One video that really stood out in my mind was of a large woman (250-300+ pounds) who was doing what looked like unassisted birth. She was laboring very calmly on her knees and stood up and caught her own baby. It was very beautiful to watch. If I can find the link, I'll PM it to you, if you'd like.

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#6 of 42 Old 07-21-2008, 08:48 PM
 
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Perhaps you need to figure out why you are afraid of homebirth and address those issues.

It doesn't seem like you will not get the birth you want in a regular hospital setting.

Homebirth is very safe despite what many people might think. There are lots of medical studies to confirm this so speak with a midwife, interview a few in fact, and get the information.

Mom of a 7 yr old, 4 yr old, and 1 yr old. Wow. How did that happen?
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#7 of 42 Old 07-21-2008, 08:52 PM - Thread Starter
 
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Originally Posted by Red_Lil_Mamma View Post
One video that really stood out in my mind was of a large woman (250-300+ pounds) who was doing what looked like unassisted birth. She was laboring very calmly on her knees and stood up and caught her own baby. It was very beautiful to watch. If I can find the link, I'll PM it to you, if you'd like.
I would definitely like to see that. Please PM me if you find the link!
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#8 of 42 Old 07-21-2008, 08:57 PM - Thread Starter
 
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Perhaps you need to figure out why you are afraid of homebirth and address those issues.

It doesn't seem like you will not get the birth you want in a regular hospital setting.

Homebirth is very safe despite what many people might think. There are lots of medical studies to confirm this so speak with a midwife, interview a few in fact, and get the information.
Megan,

I believe you are right. I do need to address the reasons that I am afraid of homebirth. I am now coming to realize this.

I have already emailed and left a message for a midwife/doctor (DO) that is highly specialized in homebirths. I have heard that she has even done VBA4C, which seems to be a much higher risk than I ever will be at this point in my life just because of my weight. I was referred to her from an assistant at my chiropractor's office who used her in her homebirth. I will also check out the other homebirth midwives in the area...all of whom seem great based on people's experiences on this site.
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#9 of 42 Old 07-21-2008, 09:00 PM
 
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mama.

i, too, am a bigger girl and have been yoyo'd around with promises of my desired birth then it snatched away. also was low risk until about 2 weeks ago when my bp went a little high *for the first time* and now i am scheduled to have my baby sectioned out on friday.

i wanted as natural of a hospital birth as i could get, and it looked like it would happen.. but not anymore so i am dealing with that. have you thought about another opinion? i too am not quite *there* as far as homebirth goes, i think it's beautiful don't get me wrong, just not for me at this time. maybe next go round. but maybe like another poster said you should figure out why you're not there with HB and see if you can get there.

theres always laboring at home until the last possible minute and going to really just push him/her out if that's what you're nerved about.

whatever happens i wish you the best and congrats on your baby and staying strong
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#10 of 42 Old 07-21-2008, 09:00 PM - Thread Starter
 
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OMG< I am so sorry you are going through this!! I would get a lawyer because you are being discriminated against based on your size. I am livid for you.

Size discrimination is RAMPANT in this country, and it needs to change!

BTW, I'm large too, and I had a homebirth almost 19 months ago without any problems.
I am so glad you had a positive homebirth experience. That makes me feel so much better.

At first I didn't want to feel like I was being discriminated against because of my size. I didn't want to believe that. I had lost 65 pounds or so before getting pregnant. I felt small compared to where I was! Anyway, after all this, I really feel like I'm being discriminated against. It is a miserable feeling.

And the doctor kept saying, "It's not your size, it's the inability to properly monitor the baby later in labor." But it's because of my size! That is why! I told her I wished she could walk a mile in my shoes...to strive to have a healthy, natural pregnancy and to have all this stuff happen.
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#11 of 42 Old 07-21-2008, 09:25 PM
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Oh, I wish you lived in my city, I'd send you to the new midwife I just hired last week! She's awesome and 100% size positive. She doesn't weigh any of her clients because it's not medically necessary, for one thing. She showed me a photo albums of other births she or her partners have attended and one of the first photos I saw was of a woman probably around 350 lbs, totally naked, baby crowning! She said what's important to her is that you're healthy, whether you're 100 lbs or 400 lbs.

Well I can't refer you to her since it doesn't sound like you live in my city, but I just want to give you hope--people like that DO exist! I'm a big mama myself and have encountered my share of negativity about it and then some, but trust me, there ARE people who get it. Sometimes it's hard to find them.

I would really encourage you to look into homebirth. Maybe it will be right for you, maybe not, but there's no reason why you need to just accept the negativity that your current mws have laid on you! Reject it. Say "nope, I'm healthy and strong, I reject your appraisal of me because you're WRONG!"

Also, fwiw, I had a homebirth with my first baby, I weighed around 320 at term. And at no time did they have trouble finding heart tones with the doppler or any other difficulties related to my size.
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#12 of 42 Old 07-21-2008, 09:30 PM
 
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I would strongly encourage finding a size friendly hb midwife. I am 260 and had been seen by an OB's office that diagnosed me as high-risk from the first day I went in. While being overweight does increase some risk, i.e. Gestational Diabetes, Large Babies w/ possible shoulder dystocia's, etc.. there is no reason you can't be monitored for these things and make an informed decision when the time comes. I can say one thing, the chances of you having a c-section if you were to give birth in the hospital are high. Here is a good website that I have used a lot http://www.plus-size-pregnancy.org/firstindex.html

Good luck
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#13 of 42 Old 07-21-2008, 09:34 PM
 
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Oh mama, I'm so sorry.

I would follow your heart and if you're able and comfortable to go with a homebirth, do so. If you're just not comfortable, then see about hiring a doula to help with advocating for minimal intervention at the regular L&D.

And no matter what happens, I'm so sorry you're dealing with this.

SAHM to Guinevere (04/05/06) and Eowyn (02/13/09)
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#14 of 42 Old 07-21-2008, 09:47 PM - Thread Starter
 
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Thank you for ALL the wonderful support. I feel so much better after reading your replies. I am definitely going to look into homebirth.

My husband just got home. He is very angry. He even said, "We'll call a lawyer tomorrow and sue them for discrimination." I know he's just hurt to see me so hurt. I really don't want added stress of litigation. He knows how much I wanted to birth at the alternative birth center. He's not sold on homebirth, but I am definitely going to talk to a few homebirth midwives.

I love to hear all your stories. It makes me feel so much better.

Shannon
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#15 of 42 Old 07-21-2008, 10:04 PM
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Personally, and I'm not a lawyer or even close, but I'd advise against getting into litigation at this point. From what I know from fat activism, it's highly unlikely that a court would see this as discrimination. Socially it IS discrimination, but medically they'd blow a bunch of smoke up the court's behind about "high risk" and there's pretty much no way anyone would see through that, with the current media hysteria about obesity and all. But that aside, that's not the kind of thing you need to be focusing on right now. Right now you need to think about your baby, the changes your body is going through, and how best to take care of your pregnant self! I totally understand his anger, though.
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#16 of 42 Old 07-21-2008, 10:08 PM - Thread Starter
 
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Personally, and I'm not a lawyer or even close, but I'd advise against getting into litigation at this point. From what I know from fat activism, it's highly unlikely that a court would see this as discrimination. Socially it IS discrimination, but medically they'd blow a bunch of smoke up the court's behind about "high risk" and there's pretty much no way anyone would see through that, with the current media hysteria about obesity and all. But that aside, that's not the kind of thing you need to be focusing on right now. Right now you need to think about your baby, the changes your body is going through, and how best to take care of your pregnant self! I totally understand his anger, though.
Totally agree. This is also how I see it. I was just saying it to point out how angry he is. In fact, he's so upset that he's showering and just going to go to bed. He never does this. I know he's just angry to see me so hurt. It's like he doesn't know what to do to make me feel better. You know how most men are. They think they have to do something to make you feel better. I just want love and support...and to not feel like an enormous whale of a person because I want a beautiful, natural birth at 300 pounds.
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#17 of 42 Old 07-21-2008, 10:53 PM
 
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This makes me SO ANGRY. I'm sorry you're being treated like this. I've never heard this argument about monitoring before and it sounds like a load of hogwash to me. That's why they make hand-held dopplers.

I hope you are able to find a birth place where you feel comfortable.
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#18 of 42 Old 07-22-2008, 01:45 AM - Thread Starter
 
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This makes me SO ANGRY. I'm sorry you're being treated like this. I've never heard this argument about monitoring before and it sounds like a load of hogwash to me. That's why they make hand-held dopplers.

I hope you are able to find a birth place where you feel comfortable.
Thank you all again for your support.

Well, I spoke with the midwife/doctor (Dr. Kathy Kleinert for anyone interested) this evening and she sounds awesome. I told her what they told me and she said she's never heard of such an argument and that it's pure size discrimination. She said that she believes that if I am healthy enough to get pregnant and carry a baby, I'm healthy enough to have a normal, natural delivery. I also told her they couldn't properly measure my uterus because of my size and she basically scoffed saying, "Don't worry; I'll measure your uterus on Thursday when we meet, even if you decide not to go with me. Just to put your mind at ease."

So, I'm meeting with her Thursday. Her rates don't appear to be high. I think my insurance will reimburse at least half.

My husband is still angry. He just doesn't want to see me hurting. I have had so much loss and grief in my life. Both of my parents and all four grandparents are gone, many of whom died in a hospital. That is why I don't want a hospital birth. The smell of hospitals remind me of my mom being in hospice care and my father dying just a year ago. Dr. Kleinert said that my body size if of absolutely no concern and that, if anything, it's easier to monitor a fetus when she is lower than higher (I believe her exact comment was, "I don't know about you, but most women don't have extra fat on their vulva" ).

I still have lots of questions for her. I am mostly worried about cost because we had not planned for this at all. She doesn't really charge much (at least I don't think so). And if I can get some insurance reimbursement, it might be doable. She put me at ease immediately after speaking with her. It's rare I feel that sort of connection with anyone immediately.

Maybe things happen for a reason....

Shannon
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#19 of 42 Old 07-22-2008, 01:56 AM
 
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I just wanted to tell you. I was 290 with my first and 304 with my second when I delivered. I had wonderful labors. Please don't let them scare you! The last thing you need is doubts when you're having a baby. You are NOT a risk just because of your weight. I can't have homebirths because none of the midwives would take me, because I deliver early. But the birthing centers all would. I'm so sorry Mama!
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#20 of 42 Old 07-22-2008, 01:57 AM
 
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I already know I'll face size discrimination at some point in my pg. I always ask the obs if i'm considered high risk due to my weight. They always say no, but I know my care will NOT be the same. My ob tried to feel my uterus at my last point, I asked her if she felt anything and she sheepishly admitted that she couldn't.

I also looked into a birthing center, but read about weight being a reason for not being accepted. I'm sorry no one thought to mention at least the possibility to you earlier.

I am hoping to just go in to the hospital late to avoid alot of interventions, but ob said, due to some pelvic issues I might have to have a c-sect anyway, which is still supposedly extra dangerous for people of size.

I thought I was infertile and so went to an RE and basically, she didn't want to treat me because of my size, fortunately, I soon discovered that I COULD get pg without assistance, but that was MAJOR size discrimination.

I'm sorry you are going through this, I hope you do get the kind of birth you want. I think "strong labor support" just means you need people who will be able to help you move around, lift you, hold you up, etc. They are assuming that it would take alot of manpower. It's understandable because I know I'm not as light as a feather, but still it's discrimination.
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#21 of 42 Old 07-22-2008, 02:22 AM
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That doctor sounds like a keeper! I hope your meeting goes well and the insurance all works out. IMHO it's worth it to pay a little extra for that kind of confident support.
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#22 of 42 Old 07-22-2008, 03:30 AM - Thread Starter
 
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I just wanted to tell you. I was 290 with my first and 304 with my second when I delivered. I had wonderful labors. Please don't let them scare you! The last thing you need is doubts when you're having a baby. You are NOT a risk just because of your weight. I can't have homebirths because none of the midwives would take me, because I deliver early. But the birthing centers all would. I'm so sorry Mama!
Aimee,

I am so glad to hear your story. I'm glad to hear your positive experience in birthing centers. That is what I wanted, but for now it's not working out. There are a couple of freestanding birth centers in the area also. I may contact them to see if they would take me. After I meet with this doctor on Thursday, I will then decide. I just want a safe, healthy, natural, intervention-free birth. Is that too much to ask?
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#23 of 42 Old 07-22-2008, 03:39 AM - Thread Starter
 
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I already know I'll face size discrimination at some point in my pg. I always ask the obs if i'm considered high risk due to my weight. They always say no, but I know my care will NOT be the same. My ob tried to feel my uterus at my last point, I asked her if she felt anything and she sheepishly admitted that she couldn't.

I also looked into a birthing center, but read about weight being a reason for not being accepted. I'm sorry no one thought to mention at least the possibility to you earlier.

I am hoping to just go in to the hospital late to avoid alot of interventions, but ob said, due to some pelvic issues I might have to have a c-sect anyway, which is still supposedly extra dangerous for people of size.

I thought I was infertile and so went to an RE and basically, she didn't want to treat me because of my size, fortunately, I soon discovered that I COULD get pg without assistance, but that was MAJOR size discrimination.

I'm sorry you are going through this, I hope you do get the kind of birth you want. I think "strong labor support" just means you need people who will be able to help you move around, lift you, hold you up, etc. They are assuming that it would take alot of manpower. It's understandable because I know I'm not as light as a feather, but still it's discrimination.
My goodness, you have had a rough time of it too. I'm sorry to hear about your experiences. I am so happy you conceived, though.

I asked up front whether my size would risk me out of the birth center and they said NO. Now it does? How can one not feel betrayed? I am self-conscious about my weight and I wanted to put that out there right away. So I did. I am always expecting to get rejected because of my weight. When I was told my size didn't risk me out TWICE, I assumed I was good to go. Now, suddenly, it does? How disheartening. And the doctor looked at me like I was crazy to be so upset. I was crying my eyes out and she acted like it wasn't a big deal ... that it's all for the baby. I don't think she gets it that I hate hospitals and all the needless interventions they stand for.

Anyway...I just hope your pregnancy progresses smoothly and that your OBs treat you with respect. There is no reason you cannot have a healthy pregnancy because of your size. I would get a second opinion regarding the pelvic issues, by the way. It seems like they're already "preparing" for interventions.

Hugs to you and wishes for a healthy, happy, natural pregnancy.

Shannon
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#24 of 42 Old 07-22-2008, 04:05 AM
 
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Wow, what an awful experience I'm so worried this will be an issue for me too when we finally get pg, altho I've been told so far I couldn't homebirth because of my weight

I really hope things work out and you get the birthing experience you want and deserve.

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#25 of 42 Old 07-22-2008, 04:25 AM
 
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just adding my two cents.
dd1 was a hospital induction leading to c-sec. i was 310 at delivery. i was bullied into the induction by a not so great cnm. it failed miserably because neither my baby nor my body was ready to birth.
dd2 i was 310 when i had her at home, wonderful 4 hour labor, mostly in the birthtub, dd2 was born at home in the water 3 years and 2 weeks after my first horrific birth.
as a woman of size i would NEVER subject myself to ACOG again, never ever.
we have rights too.
and really, i'm fat but i dont have a 50lb vagina

treehugger.gif )O( unschooling, witchy mum to Addy(7) and Niamh(4)
Living with an invisible chronic illness.
Fat and hairy. And happy with both *( o Y o )*
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#26 of 42 Old 07-22-2008, 09:57 AM
 
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thats terrible. i seriously think you should write a stern letter of complaint re them going back on whether your size is an issue. you changed practices on the basis of that they said, so i think you are perfectly entitled to an explanation.

glad to hear this new doc is better for you tho!
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#27 of 42 Old 07-22-2008, 01:28 PM
 
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Hi,

Just wanted to empathize. I was rejected by the freestanding birth center in my town because of my weight. Keep in mind that I've never had a miscarriage, high blood pressure, diabetes, or ANY major health problem. They looked at my BMI *ONLY* and risked me out simply because of it. I am about 20 pounds over their limit - I weighed 198 just prior to pregnancy and am 5 foot 1. Their BMI limit is 35.

Also, my first visit to an OB/GYN was horrible. She told me I should gain no more than ten pounds, would be considered high risk because of my BMI, and she was "really concerned." Really, really wanted to tell her to go f- herself.

I have no tolerance for fat phobia. There are many other factors involved in having a healthy pregnancy besides weight. We have to demand non-discriminatory treatment.

Oh, and I should mention - most of my weight is in my thighs. Seriously. So...I mean, are my thighs gonna get in the way of the baby coming out? ;-) Oh well...gotta laugh at something.
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#28 of 42 Old 07-23-2008, 12:18 AM - Thread Starter
 
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Originally Posted by AddysMama View Post
as a woman of size i would NEVER subject myself to ACOG again, never ever.
we have rights too.
and really, i'm fat but i dont have a 50lb vagina
:

I am so glad to hear you had a good experience with home birth. That last sentence made me crack up.

I am leaning toward homebirth now. The cost is more than I anticipated birthing to be, but in the long run, it's important to me to have a birth that I'm at peace with. And I don't see myself being at peace in the hospital.
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#29 of 42 Old 07-23-2008, 12:27 AM - Thread Starter
 
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Originally Posted by HeddyBee View Post
Hi,

Just wanted to empathize. I was rejected by the freestanding birth center in my town because of my weight. Keep in mind that I've never had a miscarriage, high blood pressure, diabetes, or ANY major health problem. They looked at my BMI *ONLY* and risked me out simply because of it. I am about 20 pounds over their limit - I weighed 198 just prior to pregnancy and am 5 foot 1. Their BMI limit is 35.

Also, my first visit to an OB/GYN was horrible. She told me I should gain no more than ten pounds, would be considered high risk because of my BMI, and she was "really concerned." Really, really wanted to tell her to go f- herself.

I have no tolerance for fat phobia. There are many other factors involved in having a healthy pregnancy besides weight. We have to demand non-discriminatory treatment.

Oh, and I should mention - most of my weight is in my thighs. Seriously. So...I mean, are my thighs gonna get in the way of the baby coming out? ;-) Oh well...gotta laugh at something.
HeddyBee,

Wow! A cutoff of a BMI of 35! Since when does BMI alone determine a mama's or baby's health? You were clearly healthy since you had no outstanding health problems -- nor do I, by the way. None. Never a miscarriage, diabetes, or hypertension (although, funny enough, my BP goes up when I step into this particular doctor's office...hmmm...I wonder why).

I also have no tolerance for fat phobia. It's amazing to me that I have lost 65 pounds and still have to justify my health. I told a couple of friends at work today what happened yesterday. They are in shock. They said, "You are one of the healthiest, most active pregnant moms I know." Yeah, I know. That doesn't matter, though. I spend all day standing and walking, do yoga, and eat very well. But that doesn't matter. Supposedly, they can't monitor the baby properly in the birth center...yet the midwife/doctor I'm meeting with on Thursday says it's a bunch of b.s. I guess we just have to find supportive, caring providers on our own. It's super hard to do. You'd think with so many people being overweight that providers could find it in their hearts to be compassionate and empathetic. Apparently not.
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thats terrible. i seriously think you should write a stern letter of complaint re them going back on whether your size is an issue. you changed practices on the basis of that they said, so i think you are perfectly entitled to an explanation.

glad to hear this new doc is better for you tho!
Thank you Ninnifer! I am definitely going to write a letter of complaint once I gather all my thoughts. I am still a little about it all.
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