"Pregnant, obese...and in danger"

[laundry_queen]

25. I will try this point by point

I don't know if it will make it any clearer for you, because it IS difficult to understand the 'catch words' if you haven't been in that position. Not all my issues are with fat shaming, but the whole article does have an undercurrent of blame and I don't agree the doctor is giving strictly 'clinical data'.

First - the title of the article - "Pregnant, obese and in danger". It's a generalization. Not all obese women are unhealthy enough to be in danger while pregnant. Most aren't in danger while pregnant. Can you imagine if the title was "Pregnant, type 1 diabetic and in danger"? Or "Pregnant, Old and in danger"? How about "Pregnant, little person and in danger"? It sounds like hyperbole to me. Yes, some of those conditions are choices and some aren't. However, women can choose to be pregnant or not. Can you imagine the outrage if there was the same headline with "Old" in the title?

Also, the term "more likely to" is used numerous times in the article. "more likely" is meaningless in a scientific sense. Same with "twice as likely". So, if 1 in 100 thin women get it and 2 in 100 fat women get it, are fat women now 'in danger'. KWIM? Numbers are more useful in this case. Something like (these are made up btw) "5% of thin women get high blood pressure needing treatment during pregnancy, but that jumps to 45% in obese women" is far more accurate and helpful. The only reason this probably wasn't used is because the differences, when put into numbers, are less scary and thus don't make as convincing of an argument. "3% of thin women get pre-eclampsia and 9% of obese women" does not sound as scary as "three times more likely". Interestingly, smoking reduces the incidence of pre-eclampsia (one of the reasons the rates are going up - less pregnant women smoking) but I don't see anyone urging pregnant women to smoke.

Then there is talk of shoulder dystocia, again talking about how it is 'more common' in obese women. But there is no resolution to that paragraph. Again, we are not told how big of a difference 'more common' is. I learned in some midwifery courses that doctors yanking on heads can cause some cases of SD. Doctors often panic and tug (ever watch "A Birth Story" on TLC? You'll see it there). Most doctors won't, mind you, but there are those who graduated at the bottom of their class. And they are more likely to panic if they are fat phobic and have it in their head that fat women are going to inevitably have SD.

The whole pre-eclampsia part made me angry - the patient wasn't monitored carefully enough while she was being induced, obviously. At any rate, blaming being unable to intubate etc on her obesity instead of the preeclampsia (have you ever seen swelling with that? it's unreal. Likely it was the swelling NOT the obesity) - or that the ultrasound couldn't see the baby is ridiculous. With my 3rd pregnancy I gained an amazing amount of weight (and yes, that child was heavier, and the reason I gained weight was I had 24 hour a day morning sickness that only felt better if I ate something every 30 min or so) and I would've been only 20 or 30 lbs lighter than the woman in the article when I went and had several ultrasounds. There was zero issue with seeing the fetus. I still have the pictures, including the picture of the 4 chambers of the heart. Seriously, I question the veracity of this story if the doctor cannot see a fetus on ultrasound and blames it on the patient's weight.


"Notably, those who were told were more likely to have tried losing weight." Were they successful at losing weight? This paragraph is quite meaningless because it assumes that if only fat people know they are fat, they will then diet which then will result in weight loss. That's not how it works in reality. Also, the author talks about 'managing' obesity the same way as high BP And diabetes. I agree with that but probably not in the same way the author means it. Managing obesity is NOT the same as the other 2 issues. There is no medication for obesity as there is for the other 2 conditions. Obesity is far more multi-faceted and involves emotional issues that require therapy in many cases. As well, obesity treatments, short of getting a gastric by-pass, are not covered by insurance. That makes it costly. And treatments for obesity require lots of free time - something most people in the modern world do not have.

You know, just like it's hard for me to explain how my seemingly lovely mother manipulates and insults me when to outsides it looks like she is just a loving, caring person who wants to help, it's hard for me to explain the fat shaming in this article. It's partially in the tone, but it's how random non-facts are interjected in order to make the births in the article seem even more scary and that it's all because of obesity. The underlying premise is that these women can choose to not be fat, and by not choosing to lose weight they are a danger to their children.

While it CAN be a health issue, I think that the risks are highly exaggerated. Many years ago, when I was having my first child at age 22, there was a HUGE big deal about 'geriatric pregnancy' aka pregnancy over 35 and how there were HUGE risks, and how it would tax the health system to the breaking point...and so on. Women went forward having babies later in life and it was realized that most older women have healthy pregnancies and babies and that the dangers had been overblown. I see that happening here as well. While super obesity (which the article was mostly talking about, not 'regular' obesity) can cause some issues, the overlying panic and fear will no doubt cause more problems than it is solving. I'll never forget the story of the 42 year old woman going in for an amniocentesis because her doctor urged her to because of her advanced age. She lost her baby due to an infection caused by the amnio needle and her baby's genetics deemed the lost baby 'healthy' genetically. My aunt and 2 cousins had heard that story, and all 3 had their first babies at age 38 and went on to have more children even later and none chose amnios and none had any issues at all. Had they been to doctors that pushed them into interventions because of their ages, outcomes may have been different. Doctors also generally don't blame older women for waiting to have children and thus putting their kids in danger, but that's what the article says about obese women. I find that offensive.

I hope I've been able to make myself clear - it's not always easy to explain something that becomes intuitive when you face it every day. Being discriminated against means I can pick up things that others can't see (and sometimes, yes, I can see things that may not be there due to past experiences) so not everyone is going to see it the same way.