Delphmoon, I said it in a tongue in cheek way but I was making the point that obesity has implications for reproduction generally.
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Delphmoon, I said it in a tongue in cheek way but I was making the point that obesity has implications for reproduction generally.
That's true N2L, it really does. I has an impact in birth too but I'd rather be informed. I'm a really freaking annoying patient to have because I have printed off one of those papers to bring in my birth folder ;). If I can remind DH to show the MW/Obs that obese women can dilate slower and yet still perfectly safely, I have more ammo to tell them where to go. Not all information needs to be viewed as a tool for unwanted intervention... it can be useful ;).
thanks M
As an obese woman who has struggled with dilation in my last 2 births, I needed to know if larger women in general do have issues dilating and if so why- so I can do something about it....
Its rude and unfair to turn this into a thread about anything else.
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well sorry but I didn't find it helpful.:
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soo spot on to what I am trying to say.:
If i had the info I could stand up for myself more and therefore avoid further interventions :o
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I thought it was just following the natural progression of the discussion. You can't talk about something like that and not talk about the impact that it will have in reality. If anyone can take those studies to a Doctor and actually have them take on board the findings of the study and let you labour for longer then that is fantastic. I am genuinely hoping that is the case. However the reality is much harsher. Many, many women who even try to do their research and get informed are virtually patted on the head, eye-rolled and told not to google if they present their information to their doctors. If I had a dollar for every woman who was scoffed at when they presented their care provider with a nicely typed and well thought out birth plan I'd be rich.
Its not easy to ask for help when your admitted your obese and had trouble labouring.
I think that yes, I should be able to do a thread and not expect it to go down the whole ' too much interventions, doctors don't know everything' track.
I was thinking I would get more supportive posts, personal stories, suggestions etc rather than rants about validity of studies etc.
Sigh....
Anyway....
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I misunderstood your intentions with starting this thread, delphmoon - and I apologise for that. I think it does follow that comments like 'fat women dilate slower' are unhelpful and the greater impact may be restricted birth choices and unnecessary intervention.:
Regardless of whether there's any statistical truth in the statement, I think you should still reasonably expect to be treated with care and respect. If it's helpful for you to take studies like M listed into an appointment as back up to ask that your care provider take a wait and watch approach then I think you should absolutely do that and I hope they respond well to your efforts to be informed. My experience: my labour was 42 hours (only 35mins of that was pushing) and I'm a size 12-14 (have a normal BMI). I was pretty tired but had a midwife who supported my wishes and didn't intervene because it wasn't necessary to.
thankyou :-)
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You didn't say that in your OP - how was anyone to know you actually wanted help and advice? I took your OP to mean that you'd heard some comment you thought sounded a bit ridiculous and you wanted to know if there was anything to it. had i known that you wanted to hear from women who had BTDT, then I would have responded to the thread differently, so I apologise for that.
From my perspective (and purely anecdotal) I have had 4 births. For 3 of them I would have been in a higher range BMI. It didn't affect my ability to dilate or labour at all. My labours were all under 12 hours. Although the 3rd one was induced with syncto and it was also incidentally the fastest of my 3 births at 4.5hrs. the 2nd and 4th were 8hrs and 6hrs long. never was it suggested to me that my size would/could have an impact on the way I would progress with my labour. I think that if you really wanted to make a point of it when you have your next baby then emphasise how your first two births were - you have that history of previous labour that is going to count for far more than your size will. Analyse your births - were they active, were you supported by people who encouraged you to stay active or try new positions that may help you, did you labour on your back, was there any emotional issues that could have made things slower, did you have an epidural etc. All of these things can impact on the way your body works during labour and it would be a good idea to look closely at your first two births and see if there is anything there that could have been the trigger.
Good luck :)
TBH- For both labors Im glad I was induced. Both labors I starting contracting on my own. the first birth I had contractions every 4-5 minutes for 2 days. My second I got stuck for a day at contractions at 2.5 minutes...I Didn't dilate with either and with both labours I was 41.6 weeks and 42 +1 weeks. With both I asked for induction in the end and with both I gave birth within the hour after induction so I think I have an issue dilating....lol...
I was super active with both labours and had my hubby and mum present. I knew my midwife very well so emotionally I was good.
Im not pregnant at the moment but we are planning on afew more. I believe my birth issues are related to me not dilating...maybe a cervical dilation exercise exists out there...lol...anyway...no one has been able to tell me why i wasn't dilating...any ideas?
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I read something recently about scar tissue on the cervix potentially being a factor that might affect dilation (from biopsies, infection s etc)...could that be a possibility? From memory the examples I've read, women stalled at a particular point in their labour each time (each had birthed a few times) - one woman had a MW that suspected scar tissue was the problem and massaged the cervix which broke up the scarring and the woman then fully dilated. Now I wish I'd saved it!!
It might not be your weight at all. While obesity does seem to factor into it, the variance components basically says no more than 30% of the blame (it's a crap word to use, but you hopefully know what I mean) about dilation arrest is attributed to obesity and obesity related issues. So even if you were obese at the next birth, there is still a LOT (70%) of variation in outcome still unexplained. :hug:
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? I got told by my public ob who hadn't even opened my file and had never set eyes on me in his life, that because of my size I would have a Csect. I had a 95% chance if I was really desperate to attempt labour, but he wouldn't suggest it. I bawled.:
Thankfully all but 3 hours of my 38.5hour labour were spent at home allowing me to do what I wanted. I was too stubborn and I had more faith in myself than most, to allow someone to bully me into full blown intervention. I was able to avoid everything but the gas although I barely used it anyway. I birthed vaginally with no complications.
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. :(
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 : )
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".
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.:
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 :)
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))
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. ;)
:-( 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??!!
Delph,
The article about cervical scar tissue that was mentioned earlier in the thread.
http://www.birthresourcenetwork.org/...-talking-about
Thankyou Onyx. I will read it tonight xx
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