Seeking advise re midwife issue

588 Views 18 Replies 15 Participants Last post by tsk_mum, Mar 31, 2006

Roots

Discussion Starter · Mar 29, 2006

Hi everyone,

I haven't posted on this board much because of an internet hiatus, but I could really use some advise. This is my 2nd pregnancy and I am under midwifery care after being under obstetric care for the first. I liked my OB, and the main reason I switched was my experience in L&D with some very unsupportive nurses. I thought that it would be better to form a relationship with people who I know would be there on delivery day rather than take the chance of having an unknown nurse care for us. Also I am trying for a VBAC and would like to go as intervention free as possible.

My problem now is that I'm not sure if I am meshing well with my midwives on one issue. I am obese. I am not usually overly sensitive about this. It is what it is. I understand that this puts me under more risk for health problems in all areas of my life but right now I just don't have the energy to put towards losing the weight. I enjoy exercise and do aerobics 2x per week and yoga poses almost daily. My eating habits are good as far as I do get the proper nutrition, but on top of that I overindulge on sweets, which so far has prevented me from losing weight.

My weight seems to be an issue that is brought up at least half a dozen times in each midwife appointment. They seem to make a big show of having to dig out the extra large size cuff for taking my blood pressure. Yesterday they were measuring fundal height and were having a hard time finding the top of my uterus, and were asking me if this has always been a problem for me, and getting other people to come in and try. Its not like I have massive folds of fat on my stomach. I am about 40 lbs overweight, (most of it in my rear end). My OB never mentioned my obesity or weight gain. I feel like I am being treated like I am stupid and uninformed which I am not, but at 6 months pregnant there is really not much I can do now to loose the weight.

I refuse to hate myself for my appearance. My fitness level is actually not bad all things considered. I am sick of leaving the appointments in tears over this issue. I am really torn over whether I should leave their practice and go back to my OB or not. Is this important enough, or is it something I can just live with for the next few months? I am very disappointed by this. I had read so many wonderful things about midwives, and their philosophies on birth seem to match mine so much better. I get the impression that I am the first fat woman they have ever had in their care. Do you think I have a real issue or is this the hormones talking?

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1 - 19 of 19 Posts

Miss Juice

· #2 · Mar 29, 2006

I am really surprised and

: that you would be treated that way. IMO 40 lbs overweight is not wonderful, but it's not that bad!! I started my first pregnancy at 215, so probably more like 60-65 lbs over, and while the midwives had to use the overweight charts and whatnot, nobody ever gave me grief about it, much less asked me to lose anything while pregnant!

Is there another midwifery practice you could consult? If you feel the OB and nursing staff contributed to a stressful delivery, I wouldn't be in a hurry to go back, but I wouldn't stay where I was if I was unhappy with my treatment, either. I do agree that if you're going to VBAC you need a supportive environment, but I would have a hard time trusting in those folks if they're this insensitive already. I would see if there was anyone else I could meet with - it's never too late to change practices.

Good luck! And keep us updated.

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Roots

Discussion Starter · #3 · Mar 29, 2006

Thanks!

These are pretty much my concerns. I am worried about being body consious during labour (although in the thick of it I probably won't care), and just feeling vulnerable being in the care of someone who I feel does not respect me, and is making other assumptions about me because of my weight.

We were discussing GTT yesterday and they listed the risk factors to help me decide if I wanted to do it. The only risk factor that applies to me is my 'inflated BMI'. I did the test last time and passed no problem so I was thinking of declining it, but by the end of the appt. my midwife said she wanted me to do it regardless of my feelings on it because of my obesity. Its strange because I am a cautious person and probably if left to my own devices have choosen to do the test anyway. I put a bad taste in my mouth that the choice was taken from me because of this one risk factor.

They have not asked me to loose weight, but despite starting out in pregnancy overweight I still manage to gain a ton during. I was looking at a spreadsheet I kept last pregnancy, and I am at the exact same weight gain now, as I was at the same time then. I gained 46 lbs total, but to defend myself, I lost 40 lbs of it less than a month after I delivered.

Part of me wishes I had the guts to discuss my concerns with them. I really do understand that if you have not had weight problems yourself it is hard to understand why someone cant just get some willpower and eat less. I certainly do not enjoy being overweight but I have some wicked emotional issues with food. In order to loose any weight I have to put all my energy into it and pretty much obsess about food and exercise iron control over my impulses for all my waking hours. I hate that it is so damn hard, but I know to avoid health problems as I age, I will eventually have to do it.

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Maman*Musique

· #4 · Mar 29, 2006

2

Please discuss this with your midwives. You absolutely have a right to feel respected and it doesn't sound like that is happening. If they turn out not to be a proper fit for you, are there other midwives in the area? Whether or not you stay with them, letting them know how they have made you feel is very important. Maybe they will make changes and help the next mama.

ETA - oops just noticed I posted in a DDC. SOrry didn't mean to barge in here just saw the post from the front page

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~pi

· #5 · Mar 29, 2006

That's awful!!

, mama.

I would definitely discuss it with your MWs. Even just in the context of a "bedside manner" discussion. E.g. "I do realize that being overweight is a health risk and trust me, I intend to do something about it once the baby is born. However, I can't do anything now about the weight at which I started my pregnancy, and as you know, it isn't a great idea to try to lose weight during pregnancy so for now, we just need to deal with my body as it is. The comments/attitude I get about my weight here have been bothering me. I would really appreciate it if you would be more sensitive to my feelings on the issue."

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AidansMommy1012

· #6 · Mar 29, 2006

I would say find another midwife. The third trimester will still give you enough time to bond with the new midwife before delivery. Body issues are the LAST thing you should be having to think about during labor. If you can't find another midwife and you think your old OB would be supportive of your VBAC, could you possbly go back to the OB and hire a doula or two to act as a support and as gatekeepers when it comes to dealing with the staff?

MsGrizzle

· #7 · Mar 30, 2006

My first thought was that you should try to find another practice - one with midwives and not MEDwives!

You should not in any way try to lose weight right now. You need calories. Everything I've read says the baby gets its nutrients from your current eating and not from fat stores.

I started this pregnancy 60-65 pounds overweight. (I was the same weight last pg). I am seeing a CPM for a home birth and never once has my weight been treated as a problem. I am eating well, but yes, I still have my chocolate occassionally (and other junk)!!!!! I'm not perfect. I try to get my 80g of protein in, take my fish oil and keep myself moving with exercise videos or long walks. My weight is a concern to me - I had just started losing weight to get pg in the future and we were surprised instead - but I will not stress over gaining or put a limit on it. I have gained 20 pounds already at 25 weeks and frankly, I feel like I'm eating much better and taking care of myself more than my last pg (gained a total of around 26 for that one).

I hope you are able to resolve this or find someone more supportive!!

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gumby74

· #8 · Mar 30, 2006

I truly do feel for you. Weight has been an issue all of my life and I have always felt a trmendous amount of guilt, brought on by others, about my weight. Like you said though "it is what it is." I guess if it were me in that situation, I would mention to your midwife your concerns and her response to your feelings about the issue will tell you what you need to do next.

Hang in there!

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ksjhwkr

· #9 · Mar 30, 2006

I would talk to your midwife very openly at your next appointment. Tell her what you told us here. Maybe she just doesn't understand how insensitive she is being. If it continues, I'd find a new midwife. I wouldn't go back to the OB if you want a vbac, but also, to get a vbac, get a doula. That will increase your chances more than anything! A cnm isn't guaranteed to be with you during all of labor at the hospital, but a doula is.
my two cents...clink, clink.

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Max'sMama

· #10 · Mar 30, 2006

I would give them the post you just wrote. Let them know that you feel that this is important. Remember that you are employing them. You need to go into delivery with no hesitation and it sounds like you will have hesitation with them regarding your weight. My midwives don't even have me give a weight at each appt. I wasn't gaining well until my 24 week appt, and so I tried to update them, now that I am not having trouble gaining, they won't worry, as long as I don't have a jump in weight.

I agree 40 lbs isn't what I would consider obese. Don't feel bad about 40lbs, let them know that you are a person, not just a client on a paper and that pestering you about weight now, is not appropriate.

Roots

Discussion Starter · #11 · Mar 30, 2006

Thank you for all your replies.

I think I will bring up the issue in my next appointment in 3 weeks. I do have options. There is another midwifery practice the same size as the one I am in now (8-10 midwives plus students). My old OB was quite good. Mother of 4 and overweight herself. My current midwives work with her in cases which become more high risk.

I hesitate to completely break the relationship now because at the appointment before this past one they said that based on the operative report for my c-section they determined that I was low risk for uterine rupture and would be comfortable doing a home birth. I know a lot of VBAC moms have a hard time finding good support so I was very happy to hear this.

That said though, I sure don't want to feel the way I felt yesterday. I am in Canada so I don't know how midwifery differs here but so far there is very little difference between the midwives and my OB. My OB was very supportive about laboring without pain meds but did not tell me that the hospital where I delivered has a 96% epidural rate. The midwives have a 50% epidural rate, and do 75% of births in the hospital.

Again many thanks for your thoughts on this.

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Boobiemama

· #12 · Mar 30, 2006

I would switch. That sounds awful to be treated like that. I am pretty overweight, and during my last 2 pregnancies my OB never once mentioned my weight as a problem. I ended up 225 at term and no one ever said anything during my labor or during routine prenatal stuff. Sure I had lots of fat around..LOL, but it never caused a problem!

Panserbjorne

· #13 · Mar 30, 2006

I will deviate from the collective opinion here and say that it is absolutely possible (and sometimes beneficial) to lose weight during pregnancy. You do this by cleaning your diet-not by dieting. You can eat plenty of calories and get all of your nutrients and eliminate sugar. It will not have an adverse effect on the baby.

That said, if you aren't interested in doing that it is ultimately your choice. They need to either respect it or ask you to find another care provider if they are uncomfortable caring for you. It is unacceptable that they are being so passive aggressive. This is your pregnancy. you need to decide if you can talk to them and get past it or if you need to seek more supportive care.

I wish you luck and hope you can resolve this.

MsGrizzle

· #14 · Mar 30, 2006

Quote:

I will deviate from the collective opinion here and say that it is absolutely possible (and sometimes beneficial) to lose weight during pregnancy. You do this by cleaning your diet-not by dieting. You can eat plenty of calories and get all of your nutrients and eliminate sugar. It will not have an adverse effect on the baby.

Yes you're right. But that is a (possibly) unintended consequence of suddenly eating right. My concern would be someone actively trying to lose weight during pg by restricting calories. I would also be concerned with those limiting calories because they believe they are gaining outside of some medically-determined range (which keeps changing every few decades)

Panserbjorne

· #15 · Mar 31, 2006

Absolutely. And that's my point. A clean diet will benefit mama and baby in more ways than I have room to type. Actively "dieting" and restricting calories will benefit noone and ultimately may do harm. And there's the problem of the low-fat, sugar free products which should never be consumed in pregnancy (or afterwards for that matter!)

One of the benefits of a great diet is weight normalization-the only way you should try to loose IMO.

I have lost a decent amount of weight this pg, and have done alot of research on this topic. Like most things, there are safe ways and dangerous ways to accomplish just about anything.

CrunchyMomto3

· #16 · Mar 31, 2006

I feel for you honey!! I'm about 100 pounds overweight and my midwife is overweight herself. Only 1 time has she made a comment that I found insensitive and that was in relation to the "big cuff" not being big enough. I just kind of glared at her and she never mentioned it again.

She told me at my 4 month appt. that finding my fundal height was irrelevant b/c I measure so much further along than I am.

Can you speak to your midwife about her insensitive comments??

Quagmire

· #17 · Mar 31, 2006

Find another practice... you don't need that kind of emotional crap when you're pregnant!

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annarosa

· #18 · Mar 31, 2006

well I don't think that pregnancy is the right time to be even thinking about losing weight
I would discuss how you feel about their comments and poor attitude at your next appointment and see what the reaction is. This seems to be the only way of really finding out if you can continue with them or need to switch to a more respectful service - at the very least you can give them examples of things they have done and said (like you gave here on the board) and then say that you never want to hear anything like this again from them .... then see what they say ..........?
you are right that you need to feel comfortable when you are in labour and absolutely supported by your MW - you are not feeling this right now so I think you need to find out if this can be corrected or not - don't just continue as it is and hope for the best ....
you deserve better

tsk_mum

· #19 · Mar 31, 2006

3

I'm sorry mama!!!

I definatly agree with what ~pi said!
Good Luck!

Quote:

Originally Posted by ~pi
That's awful!!

, mama.

I would definitely discuss it with your MWs. Even just in the context of a "bedside manner" discussion. E.g. "I do realize that being overweight is a health risk and trust me, I intend to do something about it once the baby is born. However, I can't do anything now about the weight at which I started my pregnancy, and as you know, it isn't a great idea to try to lose weight during pregnancy so for now, we just need to deal with my body as it is. The comments/attitude I get about my weight here have been bothering me. I would really appreciate it if you would be more sensitive to my feelings on the issue."

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