The stuff my OB says...

jessib10

I am a plus size and pregnant girl. My doctor has some concerns about me gaining too much weight, which, I agree with to a point. But! He keeps threatening me with a cesarean and I'm totally not ok with this. I had my 1hr glucose last week, and since I haven't heard back from them yet it is safe to assume I have passed. So beyond me gaining too much weight ans getting gestational diabetes I believe I'm fine. I haven't gained much weight at all, approximately 10lbs from my starting weight. My doctor claims that even if a woman doesn't get gestational diabetes, gaining too much weight while pregnant causes her to have more fat in the birth canal, and will increase her risk of having a bigger baby, both of which may make it difficult to have a vaginal birth.

This is the first time I've heard of this personally. Wanted to know if anyone else has read or heard of it? Also-I would switch doctors but the practice I go to has nearly 20 OB's in their on-call rotation so the likelihood of me seeing this doctor at my birth is slim to none.

ncbelle

Do you see this same doctor for every appointment?  Is it possible to switch?  Yes, there are risks associated with being overweight but fat shaming is simply unacceptable.  Threatening you with c-section is uncalled for and unprofessional - you deserve better!  Personally, I'd file a compliant and move on.  If he has concerns about your weight gain, then he should be proactive about offering solutions - and it doesn't sound like that's the case.

jessib10

He's offered solutions, but unnecessary in my opinion since I haven't gained a significant amount of weight. His advice: don't eat fast food or ice cream and exercise.

dogsombrero

Fat vagina the lovely @$$hat doctor shaming tool. I'm pretty sure that your baby can come out the same way it was made. Here is a link to a pretty good article on a website I love about plus-sized mommas: https://plussizebirth.com/2011/05/plus-size-stigma-2.htm

FemShep

First, your doctor sounds like a jerk.  Instead of shaming you, he should be focusing on making sure your diet is healthy and giving you support and constructive feedback.

Second, there are actually significant health risks during pregnancy associated with obesity (the book Expecting Better had a great section on this).  Women who are obese have a much higher rate of complications across the board, including c-sections, so while he's being an ass, there are legitimate reasons for him to be concerned about your weight.

Since none of us are your doctors, we have no idea what an appropriate weight gain is for you, and can't give you the support you need.  Can you switch OBs?  Can you get a referral to a dietician to help you figure out the best diet for you and your LO?

Good luck!  

jessib10

ljbreck said:

Fat vagina the lovely @$$hat doctor shaming tool. I'm pretty sure that your baby can come out the same way it was made. Here is a link to a pretty good article on a website I love about plus-sized mommas: https://plussizebirth.com/2011/05/plus-size-stigma-2.htm

Ya-fat vagina.. That's exactly what popped into my head when he told me about a fatter birth canal.

bridetobeJessF

I too am plus size and have been told not to gain ANY weight during my pregnancy. That said, my doctor has me going to a nutritionist and is supportive of me trying for a vaginal birth. Since conception, I have lost 15lbs.. I am hoping to continue on that journey but it is still early to tell. 

I have heard many doctors will try to steer girls towards having a C-Section. You may consider going to a midwife as I've heard they can be a little more helpful and understanding with plus size births. 

Rrrrrachel

That's idiotic. The risks of gaining too much weight during pregnancy are all for the mother, it's not going to hurt your baby or make them grow too big, outside of gestational diabetes.

FemShep

bridetobeJessF said:

I too am plus size and have been told not to gain ANY weight during my pregnancy. That said, my doctor has me going to a nutritionist and is supportive of me trying for a vaginal birth. Since conception, I have lost 15lbs.. I am hoping to continue on that journey but it is still early to tell. 

I have heard many doctors will try to steer girls towards having a C-Section. You may consider going to a midwife as I've heard they can be a little more helpful and understanding with plus size births. 

Congrats, @bridetobeJessF!  That's an accomplishment, well done!

dogsombrero

Here's an additional resource about plus-size birth and the "fat-vagina" myth. I use a mid-wife practice and while I have been advised to gain a max of 15 pounds (currently down 3) I have never been told a vaginal birth would not be possible. I'm sorry that Dr. stunk I hope you never need to see him again. If you are metabolically healthy (I'm fat but low BP and cholesterol) then maybe a more midwife centered care would be better for you.

https://wellroundedmama.blogspot.com/2010/12/fat-vagina-theory-soft-tissue-dystocia.html

FemShep

Rrrrrachel said:

That's idiotic. The risks of gaining too much weight during pregnancy are all for the mother, it's not going to hurt your baby or make them grow too big, outside of gestational diabetes.

Obese women who are pregnant are at greater risk for pre-eclampsia, gestational diabetes, pre-term delivery, labor induction, c-section, postpartum hemorrhage, shoulder dystocia, and a low 5min APGAR score.  So there are significant risks to the mom and baby, even though many doctors are probably too quick to recommend c-sections and induction for obese women.  There was a pretty thorough analysis, with links to 6 different studies, of the impact of BMI on mom and fetus in the first chapter of Expecting Better if you're curious about the studies and methodology behind the findings.

This is a great opportunity for OP to find a supportive health care provider, see a qualified nutritionist, and look at what she can do to improve her health and the health of her baby.  

dogsombrero

At this point the OP's weight/BMI is what it is which because we are not her medical providers we are not privy to as well as her metabolic health. OP your focus should be on doing what you can for your health and receiving compassionate care from your providers.

PP scaring her without knowledge about her exact situation is silly. The risks may be higher but at this point the information isn't exactly helpful more or less "you're fat be scared". The #1 issue a plus-size mom should be concerned about is labor progresses slower and malposition is more likely (which is a contributor to many of the items you listed) however seeing a skilled chiropractor is a know way to help keep yourself aligned which in turn affects baby's position according to the APA.

jessib10

A couple of things first my overall health has been good, with the exception that I was diagnosed and treated for PCOS before getting pregnant. I was on metformin but had to quit a few weeks ago as my system started to self regulate. Overall I eat healthy. I haven't always been this large, and none of my physicians were concerned with my weight prior to getting pregnant (oddly enough). I also was not discouraged from gaining weight in any of my prenatal appts, just told to make sure I'm not gaining too much (an exact number was not discussed).

And I know there are risks involved with being bigger and pregnant. What I was more so interested in was that my doctor said my baby could be at a higher risk for being a bigger baby simply because I was bigger. I had never heard that before.

FemShep

jessib10 said:

 What I was more so interested in was that my doctor said my baby could be at a higher risk for being a bigger baby simply because I was bigger. I had never heard that before.

Yes, that's true.  Overweight women are at higher risk for large birth weight babies (even without contributing factors like GD).

Good luck-I hope you find a new OB or your current doc develops a better bedside manner!

buganne

Switch doctors.  I'm a pediatrician (not an OB, I know), but all that "fat birth canal" stuff is bogus fat shaming.  Sounds like they are using scare tactics to keep you from gaining excess weight, which might ultimately backfire since they will likely lose their patient.

Of course you are at higher risk for complications, AGA babies, etc, when you are larger, but acknowledging those risks instead of making you feel embarrassed or ashamed would be so much more helpful.

Keep you head held high, and continue to take care of yourself and your baby. 

jessib10

Leftie22 said:

There's a big difference between "threatening" you with a caesarean, and informing you that your risks of a caesarean are higher due to your weight. I understand that weight is a sensitive issue, but you should also be as informed as possible about the risks. If it's the OB's tone or wording that are offensive, I can understand your concern. But if you just don't like what he's telling you, that's different. As an "older" mom, I don't get offended when people tell me the risks I'm facing due to my age, if those risks are real. It's my responsibility to know that information. I think weight is the same thing. Your risks of caesarean are higher. That's not a threat, it's a fact. It doesn't mean you can't have a natural birth, but may be some unique challenges. It's all about being informed so you can make the best decisions for yourself and your baby.

The first time he informed me, the 2-5 times he told me if I gained too much weight I'd need a c-section was definitely more.

jess9802

Lurker here.

I was obese when I got pregnant. I was referred to an OB in my gynecologist's practice. He was wonderful and amazing. I asked about weight gain at the first appointment. He said, "20 lbs, no more than 25, but a lot of women at your weight won't gain anything or will actually lose." I had chronic hypertension and had a lot of monitoring as a result - but never needed medication and my son was measuring large during the pregnancy (though he was less than 8lbs at delivery). I never developed GD. I ended up gaining a mere 12 lbs when pregnant, almost entirely in the third trimester. I was induced due to the hypertension, had a vaginal delivery, and pushed for less than 50 minutes.

I know two other morbidly obese women who had vaginal deliveries - natural, unmedicated ones at that!

Yes, being obese increases a number of risks related to pregnancy, but it doesn't make any of those risks foregone conclusions.

jenb_99

Well...obese women do have a higher risk of needing c-sections, due to a number of factors, many of them weight related. I wasn't there and couldn't hear your doctor's tone, but could it be that he was just being blunt and honest in telling you the risks and realities up front and was not, in fact, "fat shaming"?

I'm obese. My baby's giant head wouldn't drop into the birth canal and I never went into labor despite a weeklong induction process. Related? I don't know for sure, but I did end up having a c-section. And I loved it so much I'm doing it again.

Y I Oughta

Switch doctors.  Maybe ask for another one in the practice.  Has this doctor talked to you about the risks of a serious surgery while being a plus sized woman? A CS is a serious surgery and should not be taken lightly. Maybe you should talk about these risks and don't let the doctor bully you into what he wants. 

jodyen

Switch docs ASAP! I am a big girl also my pre-pregnacy weight was about 245ish and atm I am at 263 and my doc says after 250 it will most likely be baby weigh and that when it comes time deliver we will see which plans...I don't want a c section at all and he said we will try all we can to do a vaginal birth but there is a chance that I will have to. Hopefully all goes well keep us updated...good luck love!!!

jodyen

LOL@Mrssparklebottom....2 babies oh my....yes hon u need a new doc!

tbmadeamistake

I'm of the firm belief that you'll do better if you're comfortable with your doctor.  You are obviously not comfortable with this doctor, so you need to switch.  That simple.  Find one you can talk to openly about your weight and will work well with.  GL!

dragossoul84

I'm a big girl I'm a size 24/26. Never once was it mentioned to me I could not have a vaginal birth. I tried for one for 3 days with DS before having my c-section. I had to be induced due to medical reasons having nothing to do with my weight. I will be having a c-section again but again nothing to do with my weight no one has even mentioned it to me 

kimprudhomme

Much like everyone else, I totally think you should switch doctors.  I am plus size too and at my last appt I left there thinking I was the worst person in the world.  My regular midwife was out so I saw another one who basically made me feel like an idiot.  She sat me down and questioned me about what I was eating like I was in Kindergarten. It was totally humiliating. I have had emotional issues related to my weight for most of my life and she certainly did NOT help.  I will never see her again!  

JillD08

My doctor warned me about gaining weight too. I had gastric bypass and just reciently lost a lot of weight. She explained it to me this way: smaller baby is less likely to need a c- section. Less weight on my abdomen will make it easier for me to push. And the baby can gain too much fat therefor possibly increasing chances of hip and shoulder dislocation during birth. The risk, as explained to me, seemed more structural to the baby and increased recovery time for me.

Twiggymommy

If it makes you feel any better, not that I'm expecting it will, I'm on the opposite end of the spectrum. I have a long history with eating disorders and although I'm gaining as expected my ob is constantly reminding me how I have to be eating and how pregnancy is no time to diet. I lost a lb over 2 weeks and my Dr almost lost his shit at me!

That being said, as long as you're being healthy and not downing a carton of ice cream in one sitting your Dr is out of line and I would look in to switching to a new one

lovemyzeppelinWed117837

I would switch doctors.  I wanted a natural birth for my first pregnancy.  I too was overweight when I got pregnant, but that wasnt their reasoning.  The doctor kept saying that my baby was measuring so big I wouldnt be able to deliver.  Really? My body is going to make something that I cant deliver? Riiiight.  They kept pushing me to C-section which I was very against, so I switched doctors at 30 weeks.  I had my son vaginal and natural and everything was fine.  He was premature and yes he was big, but there were no complications with the birth.  If you are not comfortable, pay attention to the warning signs, and switch!!! And great job being in control of your weight gain.  Too many women use pregnancy as an excuse to gain a ton of unnecessary weight and eat unhealthy (which is not good for baby!) 

bingbongsmama

I'm very surprised that some PP's have been told to lose weight or not put any on. Pregnancy isn't the time to try and lose weight (it sometimes happens, but you should not be dieting to lose). I'm not obese, but am overweight and was told to keep it to 15 lbs. and I am having a RCS yet the ob told me I have the option of a VBAC.

OP, you don't deserve to be treated badly, shamed, stressed out. Switch doctors or even practices so you don't end up with that jerk in the delivery room. He will ruin this awesome experience for you.