Another "gem" from My OB Said WHAT?!?"
“You are short of breath because you are overweight.” – Doctor to a mother a few days after birth. One week later she was treated for pulmonary embolisms.
This is a particularly frustrating example of weight bias in medicine. This was a woman who had recently had a cesarean, and had a documented family history of blood clots, and the doctor still dismissed her shortness of breath ─ a classic symptom of a blood clot that has traveled to the lungs (pulmonary embolism) ─ as being due to her weight alone.
Because, you know, nothing else could possibly be wrong with a fat person except fatness.
So obviously, the main lesson here is that doctors need to stop blaming fatness for everything and be alert to the possibility of other complications when a symptom presents.
But another cautionary side note to this tale is how important it is to lower the cesarean rate in women of size.
One reason that the high cesarean rate in women of size is so dangerous is the risk of blood clots like these. Blood clots are a rare but extremely serious complication of any kind of surgery; do enough surgery, and the rate of life-threatening blood clots like these will rise significantly.
Remember, pregnancy increases the risks of blood clots in women of all sizes already, and "obesity" increases your risks for blood clots a bit more on top of that. Then add into that major surgery ─ and cesarean rates of nearly 50% (or more) in some hospitals for "obese" women ─ and blood clots afterwards will be seen more and more often.
Mind, it's still a fairly rare occurrence, but it can ─ and does ─ kill. Yet it's one risk doctors can proactively prevent much of the time by making sure that only truly needed cesareans are done in women of size, and when a cesarean is truly indicated, by considering the pros and cons of a blood thinner in that situation.
[Side note: If you are a person of size and have surgery planned, you should discuss the pros and cons of blood thinners with your surgeon ahead of time, especially if you have a clotting disorder or any family history of blood clots, strokes, or heart attacks. It's not always a clear-cut decision; there are benefits and risks to the use of blood thinners. However, you might want to discuss ahead of time the pros and cons of them for your particular situation.]
Furthermore, doctors should have a high index of suspicion for possible pulmonary embolism in an "obese" woman who has just had a cesarean, let alone one with a family history of blood clots.
This mother told her doctor about her symptoms a few days after the birth, and despite her recent cesarean, her size, and her family history of blood clots, the doctor dismissed her symptoms and told her the problem was because she was overweight. She was sent home.
She lived with that blood clot for more than a week and is lucky she didn't die. She was fortunate that she was seen by 2 visiting nurses postpartum, who recognized a strong possibility of a blood clot to the lungs and sent her to a hospital. The emergency room took it seriously, did the testing needed to diagnose a pulmonary embolism, and got her to intensive care right away.
From her acccount, things were a bit touch-and-go for a while, but she did survive. However, she was separated from her newborn baby for two weeks (any mother who has been separated from her newborn for any amount of time knows just how heartbreaking that is!) and had to stop breastfeeding. This doctor's dismissal of her symptoms cost her a lot, emotionally and physically.
(Fortunately, she was able to re-establish breastfeeding eventually, but many times breastfeeding doesn't survive a separation like that.)
This is yet another example of the common problem of doctors missing serious health problems in fat people because they are so busy blaming every health complaint on fatness. As if nothing else could ever be wrong!