Monday, March 30, 2009

Sharing Your Fears and Questions

I'd like to start a new series on addressing people's fears and questions about pregnancy and parenting at larger sizes.

However, first let me get some feedback from you. And please, I'd like to hear from as many of you as possible, regardless of your kid status. I want to hear from you whether you've already had kids or not, and whether or not you even plan to have kids.

When you think about the possibility of having a baby (or parenting) at your size, what are your biggest worries, your deepest concerns? What would you most like to see me address here on this blog? What information do you most need?

Let Me Hear From You, Regardless of Child Status

Obviously, readers on my site tend to fall into several categories.

Some haven't had kids yet and are reading here to get more information about "obesity" and pregnancy and parenting. These folks are the primary ones this series would be aimed at, but I don't want to limit it to just them.

I also want to hear from those of you who have had kids, to share what you were most afraid of beforehand, what you think is most important to pass on to those who haven't had kids yet, and to share your continuing struggles with parenting and childbearing and all that entails.

And I want to hear from those who are undecided about having kids, and even those who are sure they are not going to have kids. Your perceptions about pregnancy and parenting are valuable too. Even if you never put this information into practice for yourself, it's still important to hear your own assumptions and concerns so I know what to write about, and to make sure you get accurate information too, even if you personally don't use it.

I also have readers of average size who are involved in the birth world in some way, as birth workers (midwives, doctors, doulas, lactation consultants, childbirth educators, birth advocates) or as parents. Part of the mission of this site is to address the concerns of these folks too.

So here's what I'd ask each one of these groups.

If you haven't had a baby yet:

What worries you most about the thought of pregnancy, birth, parenting? Medical complications, social complications, raising a child in a fat-phobic world, what?

Where does the concern come from....media hyperbole about the risks of "obesity," scare tactics from your doctors, internalized fat hatred, worry and guilt-mongering from your family, knowledge of someone who did have complications.....what are the sources for your concerns? What has you the most concerned and why do you think that is?

What could we do here to most alleviate your fears? What do you most want me to address on this blog?

If you already have children:

What were your biggest concerns, looking back? Were your concerns about pregnancy, about birth, about parenting? Why did you have those concerns?

How realistic were those concerns in the end? What concerns turned out to be no big deal? What blindsided you that you really didn't have on your radar? What are your continuing concerns as you parent your children now?

What would you most like to tell the women thinking about having kids but who haven't yet? What's your top parenting tip having to do with size/weight issues? What do you most want to see me cover on this blog?

If you aren't sure you're going to have children (or even if you're totally sure you're not):

What do you know (and what don't you know) about pregnancy and birth? What would be your fears if you were to go through this as a person of size? What would you most want to know to tell a beloved fat friend or relative about pregnancy, birth, adoption, or parenting?

Remember, you never know for sure whether you're going to have to deal with these issues. About half of all pregnancies are not planned. Surprises happen. Or there's a death in the family and you suddenly need to take in your sister's kids. Or you fall in love with someone who has kids and suddenly you are a step-parent. Or you have the opportunity to do some size-positive mentoring of someone else's kids....nieces, cousins, god-children, friends of the family, whatever.

Life happens, and plans change sometimes. It's important to have this information even if you don't really know if you personally are going to need it.

And even if you are positive you won't/can't/aren't going to have children, discussing the fears and concerns that you would have had is helpful to me to know what sort of things people worry about the most, the kinds of things that most need to be addressed on this blog.

Also, discrimination against women of size in pregnancy, birth, and parenting is an important issue for everyone, regardless of their own plans. Even if this discrimination doesn't personally affect you, you should still care about it, be informed about it, and work against it.

If you are a person of average size and involved in the birth world:

What concerns would you have for a woman of size in pregnancy, birth, or breastfeeding? What worries or concerns do you have for them in parenting? What would you most like your co-workers in the birth field to understand about women of size?

What would you most like to see addressed about "obesity" issues in this blog to benefit other birth workers and advocates?

What I Am Looking For

I particularly want to hear about fears and worries that are particular to people of size.

Everyone out there worries about the usual concerns.....will the baby be healthy, will I be a good parent, how do I combine a career and children, how will this impact my marriage, how will I afford children, etc. etc. Those are definitely important worries too, but certainly not unique to people of size.

What I particularly want to hear about are the specific concerns you might have about pregnancy and parenting as a person of size.

These might include fertility concerns, worries about birth defects, worries about complications in pregnancy, worries about birthing in a larger body, worries about size bias from healthcare workers, worries about parenting children in a fat-phobic world, worries about keeping up with your kids, worries about your kids being embarrassed by your size, worries about your kids being fat too, worries about finding the right balance between promoting health for your kids but not pushing eating-disordered behavior, worries about dealing with "obesity" bias from other parents, teachers or doctors......things like that.

Of all those things (and any others that occur to you), what is most on your mind as you consider the possibility of having kids, whether or not you actually end up having them? What kind of information on addressing fears and questions about pregnancy, adoption, and parenting would you most like to see on this blog?

Hearing from you will help guide me in knowing what is most on people's minds, on what I most need to address, and perhaps in what order I should consider writing this stuff.

Caveats

Before I start this series, I do have to add a few caveats.

Remember, I'm a busy mom of four who wears a number of other hats besides parenting. I have a lot of demands on my time and can't always devote the hours I'd like to my writing. Also, I prefer to cite research whenever possible to back up what I'm saying, and that kind of writing takes quite a bit of prep time.

Therefore, this will be a periodic series, not a sequential one. I'll do a couple of posts on some common concerns, then take a break and talk about other things. Then in a while, I'll do another one on common worries, then take another break, etc. I'll get to all your needs, sooner or later, as best I can.....but sometimes it may be later than sooner. Don't expect all the answers tomorrow, okay?

Also, obviously I can't promise to have all the answers either. I'm not a medical professional or a parenting guru, and I'm still learning and formulating my own answers. Frankly, I still struggle with some of these worries and questions too, especially the parenting ones.

But I think it's important to open up a dialogue and talk about these issues more, and not just with people who already have parenting down to a science. Maybe we can figure out some of this stuff together.

One thing I've learned in my own journeys is that the first step to working through fears and worries is to name them, talk about them, and share them with others.

Doing so takes away some of the power of the fear or worry, some of the stigma around it, makes it more approachable. Name it and why it worries you and you can develop a proactive plan to deal with it.

Examine your pre-conceptions and assumptions and see what they have to teach you and where you can still do some learning.

Then reach out for new information, review where you were right and wrong, and develop a proactive plan to deal with your concerns. Continue to question everything as you move along your journey. Stay flexible so you can meet each new challenge with grace and creativity.

Share your learning and your process with others, to help them on their journeys too.

Remember, sometimes there may not be easy answers to every question. Sometimes we just have to figure things out as we go.

But let's start a dialogue as a first step in that process.

I look forward to hearing from you.

*Please feel free to comment anonymously if you prefer, or even privately by email. Sometimes it's easier to name your darkest or "silliest" fears if you do it anonymously. All your fears deserve hearing; feel free to do it anonymously if that helps.

23 comments:

Sarah said...

I have SO MANY fears and questions that are size specific - after trying to get pregnant for about a year (male factor), I am now 6 weeks pregnant and I have already started to worry about the birth. Here are a few of my concerns.

* My biggest concern is managing institutional anti-fat policies surrounding pregnancy and birth. I am an HMO member and the care I've received there has varied widely in fat-phobia from provider to provider. While the HMO has the lowest cesarean rate in town, and provides both in-hospital midwife care and a home birth option, I found out that the home-birth option is only available to mothers with a BMI under 30. I don't know if I will be allowed to choose hospital midwifery care as my BMI is over 45. One provider (who was terribly fat-phobic and tried to talk me out of getting pregnant in the first place because of my size) told me that if my BMI at delivery was over 50 then I wouldn't be allowed to labor at their birthing center, but transferred to the local university hospital. I don't know what to do if I am bullied into choosing a high-risk specialist; we can't afford to not have our care covered. I'd love advice on how to circumvent (or have a healthy delivery in spite of) such size restrictions.
* I'm worried that I won't know what interventions are genuinely necessary and what interventions are a result of sizeism or failure to understand how women of size vary from smaller women in their births. I'm also worried that I won't be able to advocate for myself effectively while I am in labor.
* If I am allowed to try for a natural vaginal birth, I'm worried that I won't be strong enough to hold myself in some of the more helpful birthing positions, such as squatting, and that this will lead to a "failure to progress" c-section.

Ms. Heathen said...

One of the things that bothered me is that one of the pregnancies my mother had, and all 4 my sister had were breach births. My mother started having her kids in the 70's, and my sister in the 90's. My maternal grandmother had 6 kids and a few of those were breach as well. Is it a trend away from manual re-positioning that's causing this, or could breach birthing be hereditary? It does seem to be increasing with every generation/the passage of time.

(For the record, I know for certain I'm not having any. MS runs in my family, it gallops! I'm still waiting for that particular shoe to drop on me.)

penguinlady said...

Hi Mama - I love your site and all the great information you provide. I'm a woman of size who is currently on an IVF waiting list, so your posts about bp cuff size and VBAC have really helped me to understand the challenges I may face (hopefully).

Fertility is such a complicated issue, and it almost feels like doctors use obesity as a scapegoat so they don't actually have to find a real treatment. It's so important for women of size to hear that you don't have to accept "lose weight" as a panacea.

That said, my biggest worry is that once I do become pregnant (touch wood) that I will automatically become a "high risk pregnancy" simply because I'm overweight. My fertility issues are only that my tubes are blocked - everything else is great - but from what I've heard, any IVF pregnancy can be classified "high risk", and I fear that my doctors will cave to the obesity panic. What really are "high risk pregnancies", what makes them that way, and how can a woman of size avoid that classification?

Thank you again for putting this information out to the world. It's so important!

Shotgun Mary said...

Right now I am 35w3d into my first pregnancy. Going into pregnancy I weighed 212 lbs and I am 5'7. So far I've gained 13 lbs.

Prior to becoing pregnant I was told that I had PCOS (probably because I was fat) which turned out not to be true. I took metformin for years to combat a disease I didn't have. I was also given the impression that I would have a difficult time getting pregnant. I talked with doctors for months prior to making my decision to see what I would need to do in order to get pregnant. It was pointless, it turns out that I conceived on my first full cycle off of birth control.

I never thought much about how my size would affect my pregnancy, until I went to the first OB appointment. My BMI is 33 or so, which means I'm obese. As such the doctor just knew that I was at risk for high blood pressure, gestational diabetes, large babies, alien abduction, and elephantitis. -_-

Instead of allow myself to fall into the fat trap at the OB's office, I found a homebirth midwife that had no problems with my size. She has encouraged me to eat a healthy diet but she has never put a limit on my weight gain. I'm discovering how lucky I am.

The biggest concern that I have is that women of size are not told that they can have normal, healthy pregnancies. I am not a walking disaster waiting to happen. I would like to see advice on how to talk to doctors who may already have an unconscious bias against fat women.

Heidi said...

"What were your biggest concerns, looking back? Were your concerns about pregnancy, about birth, about parenting? Why did you have those concerns?"

I was scared that I'd be mis-diagnosed with all sorts of complications (GD, high blood pressure, etc.) and was terrified that I *would* develop GD.

"How realistic were those concerns in the end? What concerns turned out to be no big deal? What blindsided you that you really didn't have on your radar? What are your continuing concerns as you parent your children now?"

No GD, although they monitored me throughout my pregnancy because of the concern that PCOS would put me at a higher risk. I also had monthly ultrasounds, as I have (medicated) hypothyroidism and they wanted to ensure the baby was growing well.

I was taken aback at the sheer hostility of one of the ultrasound techs late in pregnancy, who forced me to lie flat on my back for nigh on 20 minutes, predicted that "I'd better hope my baby didn't put on much weight, or he'd be HUGE" (he weighed 6lbs, 9oz at birth), and was the rudest medical "professional" I've ever encountered. I was pleasantly surprised by the u/s tech who did my 24? 26? week scan who, when I said I knew it could be hard to scan because of my size, said that was nonsense and that if I lay on my side, she'd be able to get everything she needed. She was the ONLY one who didn't mention "difficulty imaging due to maternal habitus" (or whatever) on my scan report.

I cried when I was told I was too fat to use the birthing pool because if I went into distress, the midwives felt they might not be able to get me out quickly enough. After 36? hours of labor, that was the very worst moment of my pregnancy.

I was terrified that if my son got over the 50th centile in weight, that I'd get dire warnings about his size - so far this has not happened, although he hovers around 50th.

I'd tell other mothers to FIGHT for their right to have the birth experience that they want. If there are concerns about GD, etc., start a modified diet early (Brewer's, etc.) to try to head them off. Get as much exercise as you can and ignore anyone who tells you you CAN'T have a complication-free vaginal birth *when the baby is ready to come out* because of your size.

Anonymous said...

I wouldn't have any trouble keeping up with a kid - not a concern. I'm fit and active. I'm sure I'd have as good if not a better shot at a healthy pregnancy and birth than average, because I'm quite healthy and resilient.

What I'd worry about is that the kid would come out looking like me, as children naturally look like their parents, and that it would be considered blameworthy. I would be blamed and shamed; the child would be blamed, shamed and pitied. The child would go through all the crap I did as a fat kid, and though I might be better able to help them deal with it than my parents were, the world is nastier about this issue than it was 30+ years ago.

So, even though I'm talented in many areas, have three university degrees - am even quite good looking - I'm sure that society would prefer it if I eliminated myself from the gene pool. More than sure. Positive.

Sara A. said...

What worries you most about the thought of pregnancy, birth, parenting? Medical complications, social complications, raising a child in a fat-phobic world, what?

I was diagnosed with PCOS when I was 18 based on hormone levels and external symptoms. I was told then that by going on the pill I'd be effectively putting my ovaries on ice, so that when I finally do want kids it wouldn't necessarily be a problem. I've since gained about fifty pounds and now at around 235-250 I'm beginning to hear differently. My endocrinologist has been telling me all sorts of lurid tales of what happens to those that don't lose weight which include difficulty in getting pregnant. She's also been telling me that all of my problems will magically disappear if I were to get below 200, which I think is bollocks because I was diagnosed at 190. But the pregnancy thing hit home because I just got engaged and we want kids in the next 5-10 years. Will my weight and PCOS affect that?

I'm also worried about complications because when my mother was pregnant with me she was put on bed-rest for the last two months of her pregnancy, had gestational diabetes as well as a long, painful, labor that ended in a c-section. From what Mom has let drop over the years the c-section had more to do with a narrow pelvis than anything else. She was told by her doctor that because of how terrible this pregnancy was she shouldn't have more children because it might kill her. She didn't, but I'm wondering how this bodes for me. Will I have a hard pregnancy(ies) because my mom did?

How do you raise a kid that loves itself in this social climate?


What could we do here to most alleviate your fears? What do you most want me to address on this blog?

Just keep on doing what you're doing.

Whiner said...

I'm not very likely to ever have kids - my partners aren't interested and my PCOS status means my fertility is practically zip anyway. If I did really want to get pregnant, getting that way would probably be a huge hassle.

I'd be pressured to lose weight, and I'd probably agree to it since I know that if I can get my weight low enough, my cycles start again. I suspect that would make the conception business a lot easier.

When I was younger and still thinking about having babies, I eyed up prospective mates and worried about how our genes might combine. If I married anyone of even average size, our kids would be doomed to teh fatz! I desperately wanted to find someone skinny and nearsighted to balance out my own plump farsightedness so that maybe the kids could be Normal. I didn't want to raise fat kids and have them feel like I felt.

Anonymous said...

I'm planning to have a kid in the future. I'm fat, my partner is fat, and we both have many fat family members, so any kid we make between the two of us is going to be a chunky kid.

My big concern in the area of pregnancy and childbirth is pressure from doctors and medical people. In addition to being fat I'm also almost 30 (and will probably be at least 31 before I have a kid), and while I'm a short-ass my partner is 6'10" so who knows how big a baby we might make. I'm sure that most doctors would take one look at my file and see only risk upon risk.

I want to learn how to advocate for myself and I want my partner to learn how to advocate for me. I want good sources of information that won't include scare tactics.

In the area of raising the kid I'm concerned with fostering self esteem and self respect, and also teaching the her/him to accept all types of bodies other people might have.

I feel like I suck at advocating for myself and I'm scared I'll also suck at advocating for my kid.

--low-budget cyborg

Anonymous said...

I don't usually like to leave anonymous comments, but my fear is so stupid and shallow that I don't want to put mt name to it. My husband and I are just at the point where we're entertaining the idea of having kids, and I feel like I have to lose weight first because otherwise I won't be a cute pregnant mom. In all the movies and magazines I see skinny women with tight, pregnant basketball bellies, and I know that won't be me. As a bigger woman, I'm wondering if I'll even look like I'm pregnant. Will the fat on my body hide the pregnant looking belly? I know this is stupid. I know that the health of me and my baby is the most important thing, but I can't help but feel this way. I also know that gaining weight is inevitable (and important for the health of the baby) during the pregnancy, and for someone who hasn't fully accepted themselves as a woman of size yet this is a hard pill to swallow. I know this will seem like a completely immature and pointless concern, but I want to be the cute pregnant lady with the tight basketball belly. I went over to the Shape of a Mother blog because I thought it would be encouraging to see pregnant women that looked more like me, but almost all the women that post on there are skinny. I just have body acceptance issues, which maybe means I'm not ready to have a baby yet anyway. =(

Cece said...

What were your biggest concerns, looking back? Were your concerns about pregnancy, about birth, about parenting? Why did you have those concerns? I am a woman of size, and I really wasn't worried about pregnancy because of that. With the birth - I was totally terrified that I was going to have a c-section. My mother is a wound care nurse, and had me pariniod that if I had a c-section, I wouldn't heal well because of all my fat tissue (I obviously have a few issues with MY mother, but let's not go there yet). Then, I have to admit - I was very nervous that my child would be a girl - and I would manage to f-up her relationship with food the way my mother did for me.

How realistic were those concerns in the end? What concerns turned out to be no big deal? What blindsided you that you really didn't have on your radar? What are your continuing concerns as you parent your children now? I did end up with a c-section. It was the right decision (cord was wrapped around the baby's neck, and too short to even make it to the birth canal, he was sunny side up, and his head was 13 inches! The sunny side up I could have handled on it's own. The 13 inch head also (I think!) but he just couldn't move anywhere. The healing? I was ahead of the average curve in terms of my wound healing. I felt awesome. Sure - there was some pain to manage - but it was honeslty not the horror I thought it was going to be. Do I mourn my 'dream birth'? A little. I'll get over it.

I was blindsided by the total failure of my body to produce milk. I tried everything. I really didn't think breastfeeding was going to be such a huge deal. In the end, we moved to formula at 2 weeks. I really didn't know how invested I was in the idea of being a 'natural' mama - natrual birth, breast feeding, baby wearing... which I do think that a lot of that thinking was tied up in the fact that I was forced to do IVF to get pregnant in the end (when we are diagnosed with unexplained infertility - SO FRUSTRATING).

I'm only 4 months into the whole parenting thing. I'm just taking everything as it comes. I'm super interested in seeing what works in respect to food and food choices... I'm a loss for what to do. My mother limited my food intake so serverally that I'm able to live on about 600 calories a day. (I did an ironman triathlon at 230 pounds. I went to a nutrionist wondering why the heck I wasn't losing wiehg when I was working out 4 hours a day - she figured out that my mom was weighing and measuing my food growing up so that I was eating 1200 calories a day. But I was also a long distance swimmer - so I was probably burning about that much working out - so my body adapted to be able to surive by training itself to live on a very small amount of food. It's turned me into a VERY good long dinstance athelete - I can train for hours and have no issues - but I also would basically have to eat like 600 calories a day AND work out to lose any weight). So. I never ever want my son to have to sit after dinner still hungry like I always was - no seconds in my family - but I'm sure I'll really struggle with it if he ends up 'chunky' because I know that kids tease chunky kids... augh. What do you do with that? I never had ice cream or cookies or potato chips growing up - or even peanut butter! Too much fat!!! It sucked. Where is the balance? How much 'fun' food is ok? I know it's going to be a very active struggle to not label foods as good/bad... blah blah blah.

Ok. I think you know what I'm stuggling with.

What would you most like to tell the women thinking about having kids but who haven't yet? What's your top parenting tip having to do with size/weight issues? What do you most want to see me cover on this blog? Forget all the BS that people tell you that your are too fat for 'x'. I was an All American swimmer in college at 190 pounds and a size 16. I did the AIDS ride (a 360 mile bike ride in 3 days) at a size 18 and 210 pounds. The day I did my Ironman, I weighed in at 230. Heathly at any size is a total truth. I did the Breast Cancer 3 day walk when I wieghed 260. I had a VERY healthy and painfree pregnancy where I topped out at 300 pounds. Screw them. Talk walks. Go swimming. Enjoy life. Size only matters if you let it.

orodemniades said...

My son, my first (but hopefully not only) child just turned 1 year old last month. I'm infertile and the journey to get treatment was hell, as I've got a bad case of the DeathFat - 270lbs - but once I found my clinic, the treatment and care I received was exemplary. Seriously, it was a dream, one which resulted in my son.

The OB-GYNs I had were also fab, and though I was weighed every time I went for a checkup, they assured me this had nothing to do with being fat, but as I have PCOS, was 39, and did IVF which resulted in late-onset Ovarian Hyper Stimulation Syndrome, they were concerned about preeclampsia. I was 'borderline' for gestational diabetes, but I am convinced that was only because of their testing method (ie, drink glucose on an empty stomach then sit still for 3-4 hours without eating or drinking anything else). I ended up having an emergency c-section - no, it really was an emergency - but again, was treated incredibly well by everyone involved.

My greatest fears were the constant DBTs - dead baby thoughts - that only the pregnant infertile can truly grasp. Infertility puts a special spin on pregnancy, let's just leave it at that. Otherwise, I s'pose it was the usual fears that most pregnant women have, GD, Spina Bifida, Downs, Trisomy 18.

The c-section, though necessary, was a great disappointment. I wish I could have actually labored, but do to the fetal stress test results, I was induced w/Cervidil Friday morning and later on Pitocin, neither of which did much apart from give me erratic cramping. The breaking of my waters Saturday afternoon started more cramping, but again, not much.

I'm grateful that I was 39w gone, though, and that my son was born alive. My only beef with my primary OB (it's an office of two, plus midwife and nurses) is that she doesn't like 'late babies', and doesn't 'allow' anyone to go over 40 weeks. Yeah. I hope I can get pregnant again (bring on FET 2009!) but now am concerned about VBAC, which the local hospital 'doesn't do', and the next nearest place is 1 1/2 hours away. But I'm counting those chickens before they hatch, so...

Now that I'm a parent, what really gets my goat is all the concern about babies and weight. My son is 24lbs and the way people talk about him, you'd think he weighed 240. Grrr...I manage to smile and talk about how pleased I am that he's healthy, with nice plump cheekies and normal baby fat. I do know of one fellow blogger whose 1 yo has been put on a diet for 'eating too much'/'weighing too much' as he drinks 40oz of formula in addition to solids. I haven't spoken up about it, but I'd relaly, really like to.

orodemniades said...

A couple of other things:

1) I was 'high-risk' because of weight, age, and IVF. In retrospect I had very few problems despite the DBTs.

2) I'm happy to pass info about my clinic to anyone who wants it

3) I gained 17lbs, 13 the first trimester, 4 the last trimester

4) no one spoke about how big my son 'might be', and as it turned out, he was 7lbs 2.5oz

5) my OBs did not bring up weight or eating habits apart from stressing that I get lots of good food, and that weigh gain up to 40lbs was perfectly normal, although larger women tended to gain less

6) my primary OB was concerned that I might be more narrow hipped than my size suggested, but she was fantastic and did as much as she felt comfortable in me trying for a vaginal birth - for which I am grateful!

Paranoid said...

I'm a fat mom of two, suffered pregnancy loss and secondary infertility, and ended up having c-sections with both of my kids (first one totally unnecessary b/c I was poorly educated, second one my choice after a BS excuse from the OB and 11 hours of hard labor).

When my first birth was difficult, my immediate reaction was "it is because I'm fat?", a reaction that recurred over the next two years as we ultimately did IVF. Luckily, I had doctors who were quick to assure me that my weight had nothing to do with my miscarriage, ectopic and subsequent infertility. That's why it was all the more shocking when, starting around 36 weeks, I started hearing about how concerned they were that my baby was huge. I was told at 37 weeks that my daughter already weighed 8.75 pounds and that I needed a c-section because she was going to be so big. No apology, of course, when she came out at 40.5 weeks weighing 8 pounds even.

My biggest worry now is that I'll pass my own food issues on to my girls. I am, sadly not one of those "fit and fat" people -- I'm heavy because I eat too much and exercise too little, and I worry that my kids will pick up my laziness. I work really hard at providing my daughter with a variety of healthy foods and avoiding junk, but I worry about going too far in the other direction. ANd the truth is, while I know what I should be eating, I don't really know how to make that kind of healthy eating into a daily habit, rather than something I need to think about every single day. I sure didn't learn it from my own parents (their eating habits were awful).

Anonymous said...

I have a 22 mo old daughter, and I have PCOS. I am 5'10" and currently weigh 202. When I got pregnant with my daughter, I weighed 260. I didn't think much of my weight when pregnant, and no one ever said to me that I was too fat for this or that. When I was about 7 mos pregnant, I had to have a physical for work. I went to my GP, who told me straight up that I should NOT gain any more weight while pregnant. I just said okay and laughed about it with my midwife. She told me that my weight was perfectly fine and that was a very old recommendation. I went on to have a perfectly normal vaginal delivery and healthy baby girl. I weighed about 287 lbs at delivery, so gained about 27 lbs. Which I lost in the first 6 weeks due to Post-Partum Thyroiditis. Anyway, I am extremely thankful that my midwife was so wonderful and supportive and never once made me feel badly about my weight. However, it wasn't until after my daughter was born that I read that just being fat makes you "high-risk". I was totally shocked! I did not know that at all! Thank you for posting more information on this topic. I guess for me, my worries surround my weight and its effect on my daughter. I constantly worry about what she is eating, if its healthy, and how much junk food she eats. And I cringe everytime someone mentions how "big" she is. She is in the 95th percentile for her height, and only the 75th for her weight, so she is a little slim for her height. I have SUCH a hard time finding pants that fit in both the length and waist. All her pants fall off her butt. Even her ribs show a little. But every time someone mentions that she is "big" I IMMEDIATELY assume that they think she is fat, and I get defensive. It happened this evening. I responded that she is very tall for her age, like her momma, and has chubby cheeks, like every baby should have. I am sooooo very afraid that I will pass on my body image issues and junk food passion to my daughter. I want her to be a healthy eater, no matter what her size. Every morning she asks for cookies and cake for breakfast, and when I tell her no, I think of every time I have eaten cookies or cake for breakfast (or lunch or dinner...). I worry that she will feel weird or different because of her height, not just her weight. I towered over the boys in my class until high school. I felt so very awkward, and to top it all off, I was heavy as well. I have recently lost a lot of weight (nearly 60 lbs in the last year)because my husband and I want another baby, and I know from past experience that I cycle more regularly when I weigh less. At 260 lbs, I hadn't had a period in months when I went on metformin, got a period and got knocked up on my first cycle. Also, I didn't know the effect of PCOS on breastfeeding, and had a terrible time. I was only able to produce abotu 10oz a day, and needed to supplement with formula until I weaned at 6 mos. I know that PCOS isn't necessarily a fat issue (my neighbor's sister-in-law is skinny and has it), but since so many WOS have PCOS, it might be interesting to us to learn more about it. bfar.org is a good resource for women with PCOS who struggle with nursing. Also, "Breastfeeding mother's guide to making more milk" by LCs West and Marasco is awesome. LOTS of PCOS info. Anyway, thank you for this blog! It is TRULY eye opening!

S said...

If you haven't had a baby yet - thats me!! (unless you count our daughter born stillborn at 21 weeks):

What worries you most about the thought of pregnancy, birth, parenting? Medical complications, social complications, raising a child in a fat-phobic world, what? - The biggest kicker for me is whether my weight is causing multiple miscarriages or whether it is my PCOS, which of course in turn is also linked to the weight. I was a size 12 and about 86 kilos when I first started IVF, fast forward 2 something years later, 5 miscarriages and our daughter's death, and I'm personally not surprised that I'm now a size 18 and 108 kilos.

Where does the concern come from....media hyperbole about the risks of "obesity," scare tactics from your doctors, internalized fat hatred, worry and guilt-mongering from your family, knowledge of someone who did have complications.....what are the sources for your concerns? What has you the most concerned and why do you think that is? I'd say all of the above. Including my husband, who has unfortunately in the past tried to blame the repeated miscarriages on me. After my doctor and I explained to him, it was more "our" abnormal embryos (we have male factor AND PCOS), the blame seems to have become better but I still feel like my weight is the scapegoat when nothing else is around to "blame". I must say the media is another inflammatory factor! I'm not terrified of having a large child because I've already planned to have a c-sec.

What could we do here to most alleviate your fears? What do you most want me to address on this blog?
I guess what I'm seeing already - does being fat/overweight mean I'll never have a child? I like how positive the blog is and the stories - it helps me to know, if so many women can do it, why can't I?

Telle said...

I've gained a lot of weight over the past year or two, and my blood pressure has started to creep up over the same time period. I'm scared that it's because I'm fat and that it'll only get worse with pregnancy and that I'll be forced to get induced due to "pregnancy induced hypertension".

Fat Angie said...

I'm not pregnant- in fact I'm actively trying to PREVENT pregnancy- but I have a bunch of fears. I'm only Class I Obese- right on the border- and I'm terrified that, should I ever decide to have children, I won't be able to use a midwife and homebirth (I hate hospitals, and I'm premed. Go figure.)because of my weight. I'm terrified that, if I marry a fat man the doctor I'll be forced to see will take one look at me, one look at him, and force me to have an abortion and sterilization because he or she didn't want more fat people clogging up the planet. I have vivid NIGHTMARES about this. I'd never tell him this, but this is part of why I couldn't let things get too serious between me and Steve.

Woe said...

I started worrying the day I tought I might be pregnant.It was an unplanned surprise.But I remembered you quickly,Mama.It's because of you I insisted to the local Birth House.I waited to take an appointment somewhere else and finnaly a midwife had a cancellation.I'm so happy!I had my first appointment monday.I could hear my baby's heart.She is verry reassuring,she really listen to what I say.When I saw my familly doctor about my pregnancy he said I was gonna be sick,with diabetes and hight blood pressure at least,would have probably a csection because the baby would be big.He said too that there would be fat in my pelvis ,that the birth would be long,that women my size have more pain...Everything possible he said to me.I told him I was not beliving him and he just continued with a pittyed look on his face.He tried to send me to his niece who is ob but I never called her.Maybe she is different but already I wanted to go to the birth house.I was joking with my husband that I was ready to lick the toes of anyone to go there.Finally it was not necessary :)

Since I will probably not have to see a doctor,a good deal of my fears are over.There is still the things on wich I have no control,like diabetes and hbp.A thing I would love to see is a post about the real ricks.They say we,lets call a cat a cat,big women,are way more at risk to have diabetes and hbp.But by what king of proportion?A good ,long and full of facts post would greatly help me.In need I could give the link to my midwife if you are ok about that.She could read and see I got my data by someone reliable,of the same craft as her.It could help other women after me too,and other readers here.Even if things are maybe different here,I believe it could do some good.
I'm french canadian so please excuse me if my wording is awkward.I understand way better than I talk english.

Holliokie said...

I'm pregnant with my third child. I had no trouble with the first two and had vaginal births despite them being "huge" (10 lbs each). I've moved states, so now I'm with a whole new practice, and while they seem great, I've got a brand-new worry. After some scary bleeding, I had an ultrasound and was told that my placenta is very low and I might have placenta previa, and that if later ultrasounds confirm this, I'll need a C-section. I've read so much about unnecessary C-sections (and complications that can be particularly rough for fat moms), and being pushed into one was my biggest fear with my first two pregnancies, but now I'm afraid that I won't be able to recognize the things that indicate a real need for a C-section. You address unnecessary C-sections a lot on your site and blog, which I think is great and which I've found very reassuring ever since my first pregnancy, but I think it might also be helpful to touch on situations in which a C-section really is needed. Like I said, I'm so scared to get one that now I'm afraid I wouldn't recognize it if I really do end up needing one.

Sluggo said...

I'm a 40yo woman with two children. I've been fat since I was a kid.

My biggest concerns going into having a family were being able to get pregnant (which was not an issue); getting good prenatal care that didn't panic about my weight (mostly the case); and encouraging a healthy relationship with food in our family as our children grow (I think we're on the right track).

Jennifer said...

Right now I'm 32 weeks pregnant and weigh just over 300 pounds. My biggest fear right now is that I will have to have a c-section just because I'm fat, and not because it is really medically necessary. And that I won't have the courage to stand up to the doctors and question whether they are making decisions based on my weight or a real medical problem.

I'm also worried about labor - that I won't be able to maintain different positions (ie: I have really bad knees and can't really squat or kneel) which will make things more difficult.

A silly fear I have is all the medical staff seeing me naked.

It also really bothers me that both my hubby and I think I look really pregnant and haven't been able to wear my regular pants in months, but apparently strangers just think I'm extra fat. Whenever I tell someone I'm pregnant they seem surprised. No one who isn't already in the know has asked me when I'm due or anything about the baby, so I must not look pregnant to others.

That has a lot to do with why when all my thin friends are posting belly pictures, I haven't even taken a single one. I don't need more pictures of me just looking fat.

As for after the baby is born, I am really paranoid that I am going to become super obsessive with my child's weight. I've always been fat, and so has my husband, and I do not want that for my kid. My niece is overweight and her weight is all I can think about whenever I see her. I'm worried that I will go overboard in trying to keep my kid from becoming fat.

Sarahthedoula said...

Hi.

I just came to your blog for the first time today, via doulangel.

As a doula who is on the smaller side at 5'3", (according to my BMI of 25.9 I am overweight) my main concern in supporting a really large woman in labour, was how to physically manage it.

I have to be very precise in my body positioning, so that when Mom's contraction hits hard, I am able to support her body weight. Things like rolling over in the bed when an epidural is in place are not the same as with a small or average-sized woman. I've worked with many large women - including some women who were very obese even before getting pregnant - and have always found a way to make it work (and it seems to get easier every time, as I learn more tricks & techniques, which is why I say it WAS a concern). But I worry that my additional efforts will somehow make them feel bad. I don't want to do that. I want them to feel like the amazing birthing women they are!
I wish that equipment was designed to accommodate a variety of birthing women's needs. That beds were bigger. That large bp cuffs were standard in every room. That caregivers knew how to help a labouring Mom change positions to optimize her labour & birth. That caregivers knew how to use their own body mechanics to support Mom so that she isn't strapped to the bed since they don't believe they're strong enough to support her upright....
I wish that they included 'plus-size' information in doula training, so that you didn't have to figure it out on the fly, with your clients as the learning tool!


On the personal side, I have gained about 10 lbs since Mar 08, and got married in Aug 08. Last week I was asked for the first time, what my due date was. I'm not pregnant. I felt hurt. And I started to worry that by the time I really AM pregnant, I'll become 'too fat' to get in with the provinicially-funded midwives, or even to give birth at our local hospital which has just instituted a BMI cap of 45 (although one of the two OB's won't take on any woman with a BMI of over 40) I know intellectually that those scenarios are unlikely - - but they are fears nonetheless.

I'll definately keep reading here!