Too fat for vaginal birth? - Mothering Forums

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#1 of 33 Old 03-13-2006, 08:01 PM - Thread Starter
 
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can any mws please respond to this.

At first I couldn't stop laughing, the argument seems just plain stupid.

An obgyn told a women patient i know that since she was obese her chances of section are much higher. Not because of obesity related diseases, but because "sometimes the baby gets blocked by the fat". this woman is fairly tall, but around 270lbs. I don't think she's all that big, but thats beside the point.

Carrie, The Birthteacher CCE and Doula, real mom to five; and womb-mom to G. born at 23w by emergency C. 12/09
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#2 of 33 Old 03-13-2006, 08:03 PM
 
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I am not a midwife but just for your information I have a good friend who happens to be about 200 lbs (she's very short) and she had a homebirth so I think the logic in that ob's advice is lacking...
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#3 of 33 Old 03-13-2006, 08:05 PM
 
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umm... yeah... whatever...

tell her to check out www.plus-size-pregnancy.org

~claudia
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#4 of 33 Old 03-13-2006, 08:11 PM
 
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Not a midwife but I was just looking into this the other day.
I found this article/study. http://pregnancytoday.com/articles/3575.php?wcat=261

I found it interesting that women who had Class III obesity (BMI of >40 or roughly the equivalent of 5foot 4inch woman at 225 pounds) have an average increase in labor length (from 4cms dilated to 10cms) of 1 to 1.5 hours. Ob's not knowing of this tendancy of a longer labor, tend to csection then for FTP.

My dh's cousin recently had a csection as her "fat made it so that her pubic bone wouldn't open up." Sounds like a made up excuse to me - but then I'm the hippie homebirthing liberal of the family.
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#5 of 33 Old 03-13-2006, 08:16 PM
 
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Okay, I'm no midwife or doula, but COME ON!!!

I laughed when I read your post, then got a bit irked.

Ever seen the ancient goddess-worship statuettes? They're not of skinny little women (like me), they're of round, fat, LARGE women. If being fat were an impediment to healthy child-bearing, wouldn't ancient peoples have revered skinny women as the model of femininity?
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#6 of 33 Old 03-13-2006, 09:23 PM
 
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Well I'm only a doula, but I can respond.

I weighed about 270lbs when I gave birth (vaginally) to my dd. I'm 5'6" so I'm sure my BMI was over 40.

However, I have heard that larger women are more likely to be sectioned, and I have a primary para client coming up next month who is a very large woman -- very tall and also heavy -- and I've warned her that she may be really pushed to having a section. Sigh.

I believe the reason "they're" giving for larger women having c-s is that it's hard to get good fetal monitor readings because of all the layers of fat. So, if a baby shows even the tiniest amount of stress, or doesn't stay on the monitors like a "good" baby, they slice and dice. (ETA: They're likely to use fetal distress as the reason, from what I've read.)

God forbid we use dopplers or -- heavens! -- fetascopes!
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#7 of 33 Old 03-13-2006, 10:55 PM
 
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My dh's cousin recently had a csection as her "fat made it so that her pubic bone wouldn't open up."
What the heck does THAT mean?

Jamie, DW to Jeff, birth and postpartum doula and Hypnobabies instructor.
4 years and 5 IVF cycles in the making, Elliott was born at home in water on 2/2/11.
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#8 of 33 Old 03-13-2006, 11:19 PM
 
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Hi! I'm not a childbirth educator, but I'm popping in anyway! On another board I frequent, a woman had a baby vaginally this week, and she is close to 400 pounds. Her doc was really pushing for a planned c-section for inadequate pelvis, so I was happy to see she escaped that fate!

I am a big woman who was sectioned due to having an asynclitic baby, whose sideways head prevented me from dilating on the hospital timetable, and since my membranes had ruptured, I chickened out on waiting. From what I've read on ICAN and the plus-size-pregnancy website, it seems like bigger women may be more prone to malposition, which OBs aren't usually into fixing.

I have read this notion of fat vaginas, etc, and I think it's a ton of hooey!
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#9 of 33 Old 03-13-2006, 11:34 PM
 
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I am one of the women that have a 40 bmi....both kids were born vaginally, albeit my first was an induced labor. I didn't tear with either, and infact my second came so fast that the doctor in the other room didn't have time to even get into the room, the nurse caught her, and i scooped her up

Normally i am not one to be proud of my size, but for this instant I am a Fatty Mother Goddess!!!!

and poo poo on that Ob/gyn!!

Karin, Wife to Dear Sweet English Husband~Soon to be Legally American. Mom to Zach~13, Lily~9, Alex~2, and Izzy or Zeke arriving July 2010! Living a life full of LOVE!
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#10 of 33 Old 03-13-2006, 11:35 PM
 
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I think thats ridiculous!

But, I did learn the other day that clinically obese women have a much higher chance of having a baby with congenital defects, which I did not know. That wouldn't necessarily have anything to do with the birth itself.
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#11 of 33 Old 03-13-2006, 11:38 PM
 
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I'm another mama who gave birth vaginally, naturally, at 271 lbs. My labour was long (48 hours), and the traditional stirrups position didn't work for me. It wasn't comfy to put my legs in them. They mounted a squatting bar on the bed and I ended up laying on my back with my feet braced on the sides of the squatting bar for the pushing stage. Worked great!
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#12 of 33 Old 03-14-2006, 05:10 AM
 
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I thought it was supposed to the be other way around. More dangerous for a C-section if overweight. My 5'2" friend is 300lb and was told they would try everything they could for her to birth vaginally.

Missionary, birth-worker, midwifery student
Mama to love.gif DD (9yr), DS luxlove.gif (3yr), & 2twins.gif UC twin DDs (5yr)

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#13 of 33 Old 03-14-2006, 10:32 AM
 
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: Absolutely!!!!! Have any of these OB's disclosed the risks of MAJOR ABDOMINAL SURGERY, which is what C sec is afterall, for an obese woman helLO!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! These docs have too much fat in their HEADS, grrr!!

My cousin was over 300lbs when she gave birth to her third boy vaginally, describes this as her best birth of all of them (b/c it was #3, not due to her weight at all, but her weight was not a hinderance really). I agree with other posters here, it is doctor fear at play rather than reality. I would also hazard that it is partially our screwed up society's uncomfortability with overweight women... I have several friends who were well over 200lbs when they delivered their babies, naturally and joyfully... Pregnant Fatty Goddesses indeed, you go mamas!
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#14 of 33 Old 03-14-2006, 11:56 AM
 
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Proud to be a Preggo Fatty Goddess! (And, when not preggo, a Regular Fatty Goddess!)
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#15 of 33 Old 03-14-2006, 12:14 PM
 
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This makes me furious! It's like fatphobia expressed through medical violence. Grrrr....

Amy: Certified Professional Midwife and mom to Max (11) and Stella (6).
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#16 of 33 Old 03-14-2006, 02:25 PM
 
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My dh's cousin recently had a csection as her "fat made it so that her pubic bone wouldn't open up."
I feel sorry for this woman, that now she's given yet another reason by society to deem herself "less than" a thinner woman : And how embarrassing that everyone is hearing that as a reason! Some docs just plain suck...

Anyway...wanted to add with my last homebirth I was pushing 300 at the birth and all went wonderfully. I'm 5'8" but still, pretty heavy! I'm in the same boat this time and looking forward to another amazing homebirth! I love my body when pg and I don't feel incapable of birthing at all ~ as a matter of fact, I think I'm pretty darned good at it If 11.5 lbs of posterior baby didnt' get "blocked by the fat" then I'm not worried!!

It bugs me that fat women are just given reason after reason, from so many different directions, to think less of themselves. We rock!!

C ~ mama to (16), (13), (9) (5)

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#17 of 33 Old 03-14-2006, 02:30 PM
 
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Here's my two cents. If she's not too fat to make a baby she's not too fat to have it vaginally. SOmebody found the opening otherwise the babe wouldn't be in there in the first place. Sorry I HATE OB stupidity. UGH>
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#18 of 33 Old 03-15-2006, 12:52 PM
 
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: : : : :

too fat
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#19 of 33 Old 03-15-2006, 01:19 PM
 
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RIGHT ON, afishwithabike, love that phrase. It comes up a lot when I am doing CBE. I would say to any ANY woman no matter how big or small, if you got that baby in there, you can certainly get him/her out, we are just built for it. And it is all meant to be beautiful, pleasurable, meaningful. This is life!
The day after I had my 10lb 2 oz son naturally an OB came in to check me and chat. He said, like a stupid ass, "you have a body that is well suited for having babies" (I had been pressed by an OB to do a c sec just b/c the baby was big, no way!!). I said in reply "Yeah, I'm a woman". Isn't that telling? The OB's really see a lot of us as not well suited for having babies, INSANITY! It is their purpose to somehow interfere and rescue mothers and children from their experiences... so so sad how it undermines the confidence of capable mamas.
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#20 of 33 Old 03-15-2006, 01:19 PM
 
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Originally Posted by jlpetitte
But, I did learn the other day that clinically obese women have a much higher chance of having a baby with congenital defects, which I did not know. That wouldn't necessarily have anything to do with the birth itself.
Ah, but "clinically obese" according the the standards of a couple of years ago or to today's far more stringent standards? The neat little revised numbers that let the gov't tell us how more than half of us are fat?
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#21 of 33 Old 03-15-2006, 01:24 PM
 
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there is a belief that if you're overweight, you're for sure gonna end up with a cesarean because you'll either have diabetes or hypertension.

I think that belief is totally bunk.

My worst blood sugar and blood pressure issues have been with women who are not clinically obese. Of course, that's only anecdotal, but the idea that a thin woman will escape any congenital anomolies or birth issues because of her weight is just as ridiculous.

Just one more thing to make women feel bad.

I hope if a woman hears a doc say that she runs far, far away.
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#22 of 33 Old 03-15-2006, 06:25 PM
 
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Originally Posted by jlpetitte
But, I did learn the other day that clinically obese women have a much higher chance of having a baby with congenital defects, which I did not know.
I've heard of a slightly higher risk of neural tube defects but *much* higher? I doubt it. Where'd you learn it?
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#23 of 33 Old 03-16-2006, 08:41 AM
 
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Can you quote the study that suggests that fat women have a higher proportion of babies with clinical defects?
I was treated as high risk this last pregnancy because in the last 5 years the NHS have added obesity as a risk issue. . After reading everything I can on the subject, the only conclusive risks I've found are
1) Fat women have more c-sections.
2) Fat women tend to have higher BP, and some doctors have a tendency to look at the numbers rather than the overall picture. See point 1.
3) Fat women are told that they are more likely to experience shoulder dystocia in childbirth due to birthing a larger baby. The evidence isn't there to support this, btw- 1000 c-sections would need to be performed to prevent one shoulder dystocia. See point 1.
4.) Fat women are more likely to suffer a PPH:according to the studies I've seen, this may actually be true but fat women are LESS likely to need a transfusion after PPH. Again, looking at the numbers rather than the individual.
Plus pre-eclampsia- no studies exist to prove a link between weight and pre-eclampsia- and gestational diabetes, which our senior consultant doesn't believe exists.

Helen mum to five and mistress of mess and mayhem, making merry and mischief til the sun goes down.
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#24 of 33 Old 03-16-2006, 09:34 AM
 
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Another fatty mama goddess here.

My regular non-pregnant weight is 235-245. I'm not sure where I got to during pg, but I didn't have much "extra", since I went back down rather quickly. I had a 9 hr labor, vaginal birth, and the only problem was a totally iatrogenic slight pph.
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#25 of 33 Old 03-16-2006, 10:46 AM
 
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well, I am a midwife and a large and lovely woman and my opinion echoes all these others....

fat phobia has gripped the nation, but in other times and in other lands, lovely mamas just like me were the ones that LASTED through the hard and dark. Why do you think it is that when I travel to the islands or am around african men, they follow me and lust....they are the last men on earth not programmed away from big women. that is a whole 'nother subject.....i digress...

when I was pg for my first i was probably only 190....the first midwife i interviewed was not supportive, so I moved on....had a great homebirth with the mw that trained me. two years later, and maybe a little bigger myself....another great homebirth. by then i was taking my own clients and loved having the oppotunity to support other BBWs in having the births they wanted. not one time did i see a problem, in fact...the opposite was true. jennifer, my partner in midwifery crime(now being prosecuted/persecuted in the state of IN), and I used to joke about how we would rather have a large and lovely than a buns of steel mom anyday. i did tons of births during the jane fonda induced excercize craze and had to tell my moms to STOP making all your yoni's so tight!

i consider it my quest in life to symbolize all that is rich and beautiful about being a big woman, and it makes me want to smack that doc for making this lady feel less than, and for perpetrating yet another myth against normal birth. send her to me and she can have a happy healthy normal birth and get to feel her power.

bodies are bodies. they work at every size shape color. we are awesomely and wondrously made. all of us.

Krystn Madrine
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#26 of 33 Old 03-16-2006, 01:32 PM
 
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I think the congenital defect thing has much much MUCH more to do with overall health ( and thin does not always =healthy) than what the scale says. If you are overweight and have other health issues with BP, blood sugar, liver function, whatever, yes that is a risk BUT if you are overweight and have good health overall, you are fine.
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#27 of 33 Old 03-18-2006, 02:39 AM
 
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Quote:
Originally Posted by hippiemom
I think the congenital defect thing has much much MUCH more to do with overall health ( and thin does not always =healthy) than what the scale says. If you are overweight and have other health issues with BP, blood sugar, liver function, whatever, yes that is a risk BUT if you are overweight and have good health overall, you are fine.
And of course the flip side to that is that sometimes the weight is the result of the health problem that contributes to the increased likelihood of congenital problems. It's all corellational, not causal.

Another facotr may be age. It's well known that the risk of certain defects increase with maternal age; it's also known that women tend to gain a bit of weight as we age. There are just too many factors contributing to too slight of a difference to say that excess weight causes defects.

And who decides what is overweight/obese anyway? People from some cultures are just heavier.
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#28 of 33 Old 03-18-2006, 04:39 AM
 
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Well I only had gest diabetes with my FIRST baby in which I was thinner than I was with my second baby (and no diabetes.) I was 230 at the time of my natural vaginal homebirth with Daph. I say it's a bunch of crap. I did wonder if I was "too fat" for a homebirth at first. Nope, I wasnt. LOL I pushed her out in 5 minutes too. I've heard people say that fat people cant push a baby out as well cause they arent in shape. That's a load of garbage IMO.

Desiree

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#29 of 33 Old 03-18-2006, 04:50 AM
 
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Fat people aren't in shape?! Ok, so I'm not huge, but I'm 5'8" and non-pg around 200--according to the CDC I'm "obese." Let me tell you that weight came in very handy at judo practice! I had to quit a couple of years back due to an injury but I was in fabulous shape--as was the other "obese" woman in the club.

Yeah, so it's all about balance, I still think it's easier to flip a 300 lb, 6-1/2 ft tall marine over my head and slam him into the mat if I weigh two-thirds what he does rather than one-third.

But that's just me...

And I'm going seriously off-topic...
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#30 of 33 Old 03-18-2006, 04:57 AM
 
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Originally Posted by Kannon99
I thought it was supposed to the be other way around. More dangerous for a C-section if overweight. My 5'2" friend is 300lb and was told they would try everything they could for her to birth vaginally.
As a morbidly obese (or whatever they are calling it these days) woman, I really felt it was more important for me to avoid a surgical birth than thinner women, because I felt like my recovery time would be worse, given my excess abdominal adiposity. It does seem, at least anecdotally, that larger women are more likely to have c-sections. I was involved with a plus sized mothering site, and very few women had vaginal births.

I also felt like my OBs were pushing me towards surgery because of my size. I ended up having a 14 hour hospital birth with my first, epidural, pitocin augmentation and a 7 hour homebirth with my second.

I have heard that the excess fat tissue in the vaginal area is supposed to cause more problems, the shoulder dystocia Flapjack mentioned. I've also read of midwives who do not have obese patients because they are considered high risk. Thank goodness my midwife was not one of those.
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