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A professional, or a ‘professional’

I’ve got my first meeting/appointment with my midwife tomorrow and I’m nervous. (Just as a quick explanation; under the NZ medical system maternity care is free – you pick a ‘lead carer’ who can be a GP, obstetrician, or a midwife. Due to shortages we pretty much all end up with midwives; obstetricians are set aside for difficult cases and few GP’s do maternity anymore. Technically you have the right to chose and shop around for your carer or LMC but again shortages mean you usually end up being ‘assigned’ to whoever has a space. With all this in mind I’ve chosen a midwifery collective within walking distance, and I’ve been assigned to D, whom I’ll meet tomorrow).

I’m also nervous every time I move town and have to get a new GP, for the same reason; I have no idea how this medical professional will respond to me and my super-fatness. I worry that they’ll look down on me, and I worry that they won’t treat me as effectively as they would do a thin patient. I’m especially nervous this time around because my own preferred way of doing things (hospital birth, pain relief, and possibly not breastfeeding) is very much against the ethos and ‘norm’ of current maternity practice. If I add being fat to being a heretic then I may well be damned… and I don’t want that. Yes, this isn’t my first pregnancy but I still need support, y’know?

Am I the only fatty who takes a deep breath before she or he enters that office, ready to find out if their medical practitioner is a professional… or a ‘professional’?


10 Responses

  1. It’s definitely not just you! Can I make a suggestion? Bring a version of this letter with you and have the new person read it BEFORE he/she sees you:


    It has been a great took for me with new medical professionals.

    Good luck!!!

  2. You know, where TOOK = TOOL.


  3. It’s tough – I went through it too, especially when I was pregnant.

    I had a hospital birth and used gas and air (available in the UK, do not know about NZ) for pain relief, which was plenty. You should read up on the various forms of pain relief available to you and their pros and cons before making up your mind. Breastfeeding is encouraged, certainly, and I did nurse my son for 22 months but there are certainly plenty of women who do not choose to do that and the midwives should be quite accustomed to it.

    The plus-size-pregnancy site by K-Mom is very helpful, if you haven’t taken a look at that. I highly recommend it and found it a great resource when I was pregnant. I also can’t recommend a doula enough, whatever your choices in care – they will be your birthing advocates and provide additional support even if you have the least helpful medical staff!

    • This isn’t my first child (i had twins about 5 years ago) so I did some homework back then on pain relief methods. I found the gas didn’t work for me (felt like the top of my head was coming off!), and I was worried about the risks of pethedine. As it was I was encouraged to have an epidural and I found it wonderful. Of course, that labour was unusual – I was induced for medical reasons, and in labour for a couple of days – so there is every chance that this time things will be smoother/easier. That said, though, I want to have all my bases covered. I’ve heard horror stories (too many!) of women who suddenly decided they wanted pain relief halfway through and were told they couldn’t. As for the breastfeeding I did that last time too, but I had issues which make me less willing to do it this time around. I’ll probably give it a go (it’s just easier in hospital, they make life difficult for bottle feeders) but if the same issues arise I will swap to formula.

      I found that site last time and it was great!

      What’s a ‘doula’?

  4. Yes. Every time. Last time I went to the doctor I was going for a simple dry skin problem (though one no home remedy or OTC medicine could cure). The first thing the nurse did was march me down to the scale. I told her I wasn’t in for a full physical, so I wasn’t going to get weighed today (I wouldn’t have allowed her to weigh me even if I were having a complete physical, but she didn’t need to know that at the time). She said huffily, “But you’re a new patient to this practice, we need to start *somewhere*!” (I immediately thought: How about with, Hi, I’m nurse so-and-so, are you from the area? And what are you in here for today?)

    But I politely refused, and she haughtily accepted and we went to the examination room. I told her to use a larger-sized blood pressure cuff, but of course they didn’t have one, so she squeeeeeeeezed the smaller one until it broke blood vessels. Joy! I warned her she’d get inaccurate readings with a too-small cuff. She ignored me. I guess that’s standard procedure when a patient happens to know more than a practitioner, these days? When was the last time she ever cracked open a journal, I wonder?

    The doctor came in, looking a bit amused. He made no mention of my weight, checked out my skin, got me a prescription (which sort of works, not permanently, which means I might have to go back, gah).

    So yeah, even for the most routine or weight-unrelated things, I’m prepared for some kind of weight mention or ill treatment. From what I hear midwifery is a bit more fat accepting compared to OBs, but I would go in prepared with a few facts about fat and pregnancy. I wouldn’t let them tell you that fat women are supposed to gain less than non-fat women (though it can and does happen that way naturally, sometimes); I wouldn’t let them scare you about diseases of nutrition that they just assume fat people will get during pregnancy, because they assume fat people are ill-nourished.

    And do NOT let them put you in a high(er) risk category simply for being fat. If you have genuine health problems which need you to be placed there, then that’s what the category was meant for. But this idea that all fat pregnant women are ticking timebombs is just NOT TRUE, and it’s incredibly insulting, and can cause undue stress and pressure when what a pregnant woman needs is support and understanding.

    Good luck! Prepare some ammunition just in case, don’t let yourself get pushed around, and I hope it ends up being a positive experience!

    • Oh yes, the old “don’t care what’s wrong with you it must have been caused by fat”. Been there, done that! And it doesn’t help that I have a few well-meaning relatives telling me I’m ‘at risk’ this time too… sigh.

  5. Yes, I go through this every time.

    I now take someone with me if I think I’m likely to freak out.

    I haven’t been pregnant, but you may find this helpful:

  6. Hi there, glad to see you already have been to my website and have access to the information there.

    I’m sure you have inferred from my writings that I tend to be more in the natural childbirth camp. This is true, but I firmly believe in women choosing for themselves. If you are fully informed of the possible pros and cons of an epidural, there is not a thing wrong with choosing that. If the midwife you see is not supportive of that, find a new one. Be honest with her in the first interview and tell her you need someone who can support that.

    I tend to have a harder time with the idea of not breastfeeding at all, just because the immunological support to the baby is SO important. However, I hear with VERY sympathetic ears (believe me!) that the experience was not great last time and why go through that again? My first breastfeeding experience was VERY bumpy and miserable at first, but after that it greatly improved. But I *totally* get not wanting to go through something like that again.

    I’d assure you that like each birth, each breastfeeding experience is different. Some go easy and some do not. Sometimes more support and technical help is all you need, sometimes it just doesn’t work out no matter what you do.

    So my suggestion is just to take a wait-and-see approach. Be honest with your midwife about your last experience being less than great. Tell her your ambivalence about trying again, and tell her that you NEED her to really HEAR that and honor that. Tell her you haven’t ruled out trying again, but that if things go badly and you decide not to continue, you need her to be supportive of that. If she is not responsive, you know it’s time to find a new midwife.

    But remember, nursing twins can be a real challenge in so many ways, and you may find that nursing a singleton is easier. So while I absolutely support you doing what YOU need to do, bfing or not, I’d gently suggest that there is hope that things could be easier this time.

    Also, there are certain therapies that can be done to help improve a baby’s latch…it’s really quite amazing how much they can help. It’s called craniosacral therapy in the US; I would guess they have CST or something like it in NZ (cranial osteopathy with an osteopath?). If you find one who is trained in helping babies, it can be really helpful with latch/bfing issues and also with colicky babies.

    But most of all, I’d urge you to find the kind of birth attendant that fits with what YOU want. I think it’s okay for a birth attendant to ask you to explore different options and to be sure that you are really well-informed about any possible pros and cons about ALL choices (natural or not), but it’s not okay for them to impose THEIR birth beliefs onto you. It’s your body, your baby, your birth.

    So if you look into everything and are sure about your path, it’s so important to find a birth attendant who is on board with that. Although the de facto position is much more naturally-oriented in NZ than here in the US, I know a couple of midwives there and I know they’d support you in your wishes, even if it wasn’t what they personally would choose. I’m SURE you can find one to support you as you need; I’d just ask lots of questions and be very upfront with them about what kind of support you are looking for. And don’t be afraid to shop around and change if you need to.

    Best wishes to you! I look forward to hearing how things go.

    p.s. A “doula” is a professional labor support person. I’ll be writing more about them in the next few weeks on my blog. You can read more then to see if it’s something you’d want or not.

    • Thanks, I’d not heard of doulas before.

      As for breastfeeding… I don’t want to get too far into ‘tmi’ territory but there were physical issues (besides supply issues) that made it very painful each and every time and there was nothing I could do to alleviate the pain (and it was *pain*, not discomfort). I’m not talking about latching issues or anything like that which could be fixed. I did manage to do 6 months but it was a struggle. I’m not trying to sound defensive here; just clarifying that I did try, and I’m not adverse to trying again, but if the same issue arrises I will go straight to formula rather than spend my time in pain.

      I have seen your site, and I’m aware you’re very natural-birth orientated, and that’s all cool. I don’t have a problem with that approach, just the way it’s presented over here as being darn near child abuse if you choose differently. I don’t mind how women prefer to birth – I just hate being told what to do!

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