obesity and dilation

[LittleB+1]

Niadalla, I am really saddened to hear that you were treated like that and I wish I could tell you that there was only a few of us like that around. Eutra_phalia, I am one of the founding OB's of a birth centre in Queensland. I am a huge activist for home birth and women's rights when birthing their babies, Trillian. So yes, while I am medically trained I am not so one-eyed in that regard. Is it true that we have higher intervention rates, TRUE. WHY? Because, we are bound by the law to preserve life and to do no harm. It seems harsh and very black and white, which I agree it is, but that is how hospitals and our health system is governed. Ofcourse, we are not just going to knock you out and say you must do it this way or else, but it is our duty of care to give you all the information. It is not meant as a way of bullying or even as a scare tactic, it is just the bare facts. Ofcourse, it is not 100% what will happen if you dont agree but that isnt up to the medical team to decide. Ultimately, before any interventions are made, you and your partner, have to agree based upon the information you have been given. This is why, I fully support sites like BB and women asking questions like Delphmoon did to gain as much information as they can for not only next births but as reassurance or even understanding of what happened in previous births. Birth dissapointment is very real and can be crippling to families, I have seen it. I have seen the fear in women's eyes as they labour but what doesnt help is the whole 'us' versus 'them' mentality that has created such a distrust. I pride my doctors, nurses, midwives on the trust and rapport they build with the families that utilise the birth center. Each party understands that the best outcome is for an intervention free, healthy, happy birth. How they get there is about them working together and communicating. Not every birth has had its happy ending but the families have returned for their post-birth check ups knowing that every option was given to them.

Niadalla, I have found OB's are less inclined to do C-Sec on obese women due to complications with healing of the wound including breakdown...? As part of our medical registration we must be up to date with research practices and studies, so I agree take as much information as you can to your births, just you having that information alone can change a birth outcome. But, physically if there is a stall in labour, dilation etc. and we dont know why, waiting can have dire outcomes which is why we act, to bring your child into the world alive. As doctors, we dont believe we are God (I know some do) but we want what you want. We want your child here, alive so you can take them home. Interventions are high, yes, but death during childbirth is almost unheard of now.

All I can ask as a mother and as an OB is go in with as much information as you can about birth and labour, have a birth plan but also have an open mind and utilise/communicate with the people around you. In relation to Delph Moon's situation, it does sound as tho there is an anatomical (physical) reason as to why you may not be able to dilate and it might not have anything to do with your weight. Prior to falling pregnant again, I would suggest you contact a GP to organise an ultrasound to see if infact there is scar tissue on the cervix. Keep in mind, if this is the case, we can do things to 'help' your cervix along : )

[~mamaspice~]

Hmm, I think I'd like to see a BIG systemic review on this one! Perhaps I will need to base my research proposal on this topic lol. There are so many unaccounted for variables to the above studies as already mentioned. Maybe there is some merit to the theory, or maybe not. But either way, whatever size you are, have faith in your body that it can birth your baby when the time is right. What is "normal" length of time of dilation anyway? Perhaps we need to rethink our concept of "normal".

[e_p]

Niadalla, I am really saddened to hear that you were treated like that and I wish I could tell you that there was only a few of us like that around. E_p, I am one of the founding OB's of a birth centre in Queensland. I am a huge activist for home birth and women's rights when birthing their babies, Trillian. So yes, while I am medically trained I am not so one-eyed in that regard. Is it true that we have higher intervention rates, TRUE. WHY? Because, we are bound by the law to preserve life and to do no harm. It seems harsh and very black and white, which I agree it is, but that is how hospitals and our health system is governed. Ofcourse, we are not just going to knock you out and say you must do it this way or else, but it is our duty of care to give you all the information.

That's great LittleB+1 - really refreshing and positive to hear of your woman-centred approach and the other care professionals you're surrounded by. I don't agree that we have high intervention rates because Drs are bound by laws to do no harm - a lot of harm is done without informed consent (health professionals are also bound by laws around consent, I believe) where no ones life was ever in immediate danger. I've seen it with my own eyes and dozens of women on BB will agree with me. I think it's fantastic to encourage women to be well informed (and I certainly encourage it) but I also think we shouldn't really have to - we should be able to expect to be treated with respect and evidence based care without having to battle for it. I see a lot of blaming women for either not being informed enough, or for knowing too much and expecting too much. I don't think that's right.

[~mamaspice~]

Sorry Delphmoon, I have only just read the whole thread, and whilst the purpose of my post above was to try to encourage you to have faith in your body, it may not have been much help. Had you dilated at all before recieving oxytoxin? Were you feeling fearful or anxious, or do you feel you were in a good place within yourself? Was oxytocin started because there were concerns about your or or baby? Sorry for the 100 questions, I am just trying to get more of an idea of your personal circumstance so I can endeavour to find out some more info for you, so if there is anything you can think of that you feel may be relevant let me know. There are so many variables. Perhaps it's normal for you to have a long pre/early labour. Perhaps it had something to do with baby's position. Or perhaps augmentation is completely justified for a reason which may or may not be related to your size. Big hugs, if there is any relevant info I can find I will post it. PS: please don't lose faith though

[RhiChiChi]

Yes it certainly does and I wasn't saying it didn't say that..... but can you REALLY see obstetricians and other birthing professionals ACTUALLY letting larger women labour longer? While the studies might say it's natural for larger women to labour longer, I can't see anyone allowing that to happen unfortunately. I wish that pregnant mothers weren't judged on a few notes someone might have in front of them.

I can see an OBS letting larger women labour longer, if you find the right carer. I have a very supportive OBS who NEVER suggested I'd have to have a c-sect b/c I am obese. Even being pg with this one he is more than happy to support my decision for a VBAC and told me I will NOT be limited in my time to labour. In addition to him being supportive he has assured me that my hospital of choice will be the same as him - supportive and that for a private hospital they have high success rates for VBAC.

It saddens me to hear that people are still discriminated against, like you Niadalla b/c of being a heavier build ((hugs))

[~*Niadalla*~]

I was bullied both pregnancies because of my size. Forced to have a GTT after my GCT came back perfect, made to see dieticians because I clearly wasn't eating properly. Told on numerous occasions that I was harming my baby by not losing weight( I won't go into detail but some of the comments were rather nasty). In actual fact I had a relatively normal pregnancy both times around, with no complications either time. It saddens me that some medical professionals are like this.

I would LOVE to see most OBS etc adopt the idea of giving larger people longer to birth and I know for certain that some will, but I can see now that it will be a minority more so than a majority. In my dealings with OBS and other maternity care professionals I've found that they tend to follow their books and rules rather than look at people on a case by case basis. Hopefully something will change soon.

And yes, one reason why I really was against csect FOR ME, was because of the fact I was much larger and my wound would most likely not heal as well as it should. That makes perfect sense to me.

[RhiChiChi]

:-( That is just awful and makes me so sad. I haven't been subjected to those sorts of comments or care from my healthcare providers & I am glad I haven't. I hope things do change with women becoming more informed from sites like these and standing up for their rights.
There was a lady in our local paper that was refused care at the local public hospital b/c she was obese - it is their policy and she had to go to another public hospital about 20/25 mins away 'in case' there were issues. There can be issues with any birth regardless of your size & weight!

Interesting about the wound healing - I know they were diligent on checking mine regularly and ensuring I was drying it properly b/c of my overhang (I would gently blow dry it after my shower with the hair dyer!) and I wore a sanitary pad in my knickers so the wound didn't rub.... I wonder now if the midwives suggested that to everyone that had a c-sect of just me (or others) who is overweight??!!

[Phteven]

Delph,
The article about cervical scar tissue that was mentioned earlier in the thread.
http://www.birthresourcenetwork.org/...-talking-about

[delphmoon]

Thankyou Onyx. I will read it tonight xx

Sent from my GT-S5830 using Tapatalk 2