I'm feeling sensitive and need to let it out - pregnancy

thatgirlsam

I found a good article if anyone wants to read. I know this is a sensitive issue for some... so don't read it if you think it will upset you. The last thing I want to do is upset anyone!

But there are some good facts about why having a high BMI is a risk factor during pregnancy and surgery

www.csen.com/obese.pdf

I'm not sure I like the quote at the beginning though!!

thatgirlsam

Sorry, OT but conversely the opposite is true for the elderly (obviously not pregnant!!) Those with a low BMI are more at risk after surgery than those with a raised BMI

Sorry for being such a geek everyone.. I find this stuff so interesting!

Nicki

But you are making an important point thatgirlsam, which is that BMI has actually nothing to do with aesthetics, or dress size, but is a statistical tool used to good effect to calculate risk of adverse outcomes in medical settings.

The fact that a size 14 is the average dress size in this country (if that is true) or that an individual feels attractive at a BMI of 30, doesn't alter in any way the fact that those with very high or very low BMIs have some increased health risks, particularly if their other ratios such as waist/hip and waist/height are also higher than they should be.

thatgirlsam

Nicki wrote: »

But you are making an important point thatgirlsam, which is that BMI has actually nothing to do with aesthetics, or dress size, but is a statistical tool used to good effect to calculate risk of adverse outcomes in medical settings.

The fact that a size 14 is the average dress size in this country (if that is true) or that an individual feels attractive at a BMI of 30, doesn't alter in any way the fact that those with very high or very low BMIs have some increased health risks, particularly if their other ratios such as waist/hip and waist/height are also higher than they should be.

It's all about patient safety at the end of the day. And Healthcare Professionals do need to be making women aware of the facts.

However, women who are pregnant are at one of the, if not the, most vulnerable times of their lives, and there are ways of presenting this information without making the woman feel humiliated, guilty or judged. Some tact and diplomacy wouldn't go amiss.

Also, I have to say it does indeed have a lot to do with anasthetic review and outcome, as shown in the link I posted

Oh! You said aesthetics!! Sorry LOL

Nicki

I agree that pregnancy is a vulnerable time, but the whole tact and diplomacy line is quite a fine one sometimes.

Too tactful and diplomatic, and the advice doesn't always register. So you have women who are able to say after the event: "BMI wasn't a big deal when I was pregnant. I was told I was x, but that was it" and go on their way as normal (which from the pregnancy threads on here, often seems to involve lots of takeaways because too knackered to cook, and sending husbands out for industrial quantities of chocolate at regular intervals) which increases their risk factors for things like pre eclampsia or gestational diabetes. Too blunt, and you scare the living daylights out of the pregnant woman, to the extent they are terrified of the birth and labour because the potential complications have been rammed down their throats from the outset.

The ideal is obviously to state the risks and in a non judgmental way to advise the woman on how best to manage them, given she is starting from the BMI she is starting from, but from what some have posted of their experiences on this thread, it seems this doesn't happen anywhere nearly as often as it should.

thatgirlsam

Nicki wrote: »

I agree that pregnancy is a vulnerable time, but the whole tact and diplomacy line is quite a fine one sometimes.

Too tactful and diplomatic, and the advice doesn't always register. So you have women who are able to say after the event: "BMI wasn't a big deal when I was pregnant. I was told I was x, but that was it" and go on their way as normal (which from the pregnancy threads on here, often seems to involve lots of takeaways because too knackered to cook, and sending husbands out for industrial quantities of chocolate at regular intervals) which increases their risk factors for things like pre eclampsia or gestational diabetes. Too blunt, and you scare the living daylights out of the pregnant woman, to the extent they are terrified of the birth and labour because the potential complications have been rammed down their throats from the outset.

The ideal is obviously to state the risks and in a non judgmental way to advise the woman on how best to manage them, given she is starting from the BMI she is starting from, but from what some have posted of their experiences on this thread, it seems this doesn't happen anywhere nearly as often as it should.

Defintley a fine line! And there will always be those who get it wrong. I hope there are not many midwives who actually relish the idea of telling women they are overweight!

nikki2804

I was tutted at throughout my pregnancy for my weight but I was at the opposite end of the spectrum. I weighed 7.5 stone until I was around 8 months pregnant - always been of a slim build with a low BMI. The doctors thought I was starving myself and was vain - I just could not keep any food down! They told me that my baby would be premature, would be underweight etc. I felt terrible.

Well he wasn't premature, he was 8 days late and my 'underweight' baby came in at 7lb7oz. He's perfectly healthy.

I think that sometimes the hospitals/midwives/doctors feel that they need to cover themselves and don't always realise how it makes the patient feel.

thatgirlsam

nikki2804 wrote: »

I was tutted at throughout my pregnancy for my weight but I was at the opposite end of the spectrum. I weighed 7.5 stone until I was around 8 months pregnant - always been of a slim build with a low BMI. The doctors thought I was starving myself and was vain - I just could not keep any food down! They told me that my baby would be premature, would be underweight etc. I felt terrible.

Well he wasn't premature, he was 8 days late and my 'underweight' baby came in at 7lb7oz. He's perfectly healthy.

I think that sometimes the hospitals/midwives/doctors feel that they need to cover themselves and don't always realise how it makes the patient feel.

They don't feel they need to, they KNOW they need to! Fear of litigation. Most cases which go to court are for actions that weren't taken, not actions that were

shellsuit

Size 14 is obese........3 stone boobs? I don't believe I'm reading these things!

Saying that though, my BMI is 32, I'm the same height as the OP, weigh a stone more, but my dress size is an 18, which is 2 sizes more than the OP.

I had to have a GTT when I was pregnant, but anything that is in aid of the baby, I'm all for!

mumps

Re tact and diplomacy. Dr spent ages prodding and poking, turns to midwife and says, "come and feel this, what do you think it is?" Me, horrified, "I hope it feels like a baby." Dr laughing, "I mean does it feel like a head or a bum." Sigh as I relax.

Friend having scan, friendly sonographer says, "Oh, two head, three arms, let me see how many legs." Terrified friend eventually says, "Is it twins?" Sonographer, "Yes, what did you think I meant?" Crying friend, "I thought it was a two headed monster."

Like my husband says, if I haven't got something to worry about I will think of something, my friend must be the same.