How Risk Is Presented In Pregnancy

Today, Big Birtha was honoured to participate in a discussion about how risks are presented to women in pregnancy, organised by the British Pregnancy Advocacy Service (BPAS).

The room was filled with intelligent, interesting and influential women, from many different backgrounds, but who all share the passion that the way things are at the moment needs to change, and what can we do to bring about this change?

After years of running this blog, and feeling pretty isolated at times, it was so lovely to be in a room of like-minded people who agree that actually;

It’s not OK to make women feel failures that they are providing a ‘suboptimal’ host for their baby for whatever reason; be that because they dare to be overweight, or over 35 years of age, or have a medical issue controlled by medication, or want to enjoy the occasional glass of wine, or because they haven’t been taking folic acid and other dietary supplements religiously since reaching childbearing age just-in-case…

It’s not OK that statistics are often presented in the most alarming fashion possible – where relative risks are focused upon as routine because it’s a sure-fire way to make very small discrepancies look much more significant and scare the bejeezus out of us.

It’s not OK to unduly worry women and make them feel guilty about their situation, when that additional stress serves no purpose, can actually be detrimental, and is often at a point where the woman is not in a position to do anything about it.

It’s not OK that during a time when a woman is most apprehensive and in need of support and reassurance that she can be made to feel like she’s a bad/selfish/negligent mother who is undoubtedly doing harm to her unborn child, when she’s probably doing the best she can right now, probably has a perfectly healthy baby gestating inside her, and needs to be able to build rapport with and trust her care givers, not feel wretched every time she has contact with them.

It’s not OK that studies tend to focus exclusively on the behaviours/circumstances of the mother when drawing conclusions (usually negative!) about maternal actions and the consequences on their children (and sometimes their children’s children!), completely ignoring paternal and other societal influences role to play.

It’s not OK that when the media reports on scientific studies and research that the results are often presented with implied blame on the mother, usually from the most sensationalist angle, and that studies with poor methodology but the most sensationalist claims get more attention than those that are more balanced and better planned.

It’s not OK that women aren’t trusted to be able to look at the evidence (or sometimes lack of it!) for themselves in order to reach their own decisions about what’s best for them, their fetus, and their family, and instead are regularly presented with an oversimplified version of the available research, or worse still, a blanket ‘this is policy’ with no justification whatsoever.

It’s not OK that women routinely don’t feel supported in their ‘high-risk’ pregnancies, but that they’re a problem or ticking time bomb to be ‘managed’.

The fight for a more balanced, consultative, and respectful treatment of women in pregnancy is far from over, but this meeting really felt like the start of something positive.

If you want to see more of what BPAS have been doing on this topic, they’ve written some great press releases here:

www.bpas.org/about-our-charity/press-office/press-releases/

Don’t Assume, ASK!!!

“Don’t judge a book by its cover”, so the saying goes. But time after time during my ante-natal appointments I found that I was persistently judged by my ample cover…

Presumptive statements like “You need to cut back on the junk food”. Without actually asking about my diet first.

“You should be getting more exercise”. Again, without asking how much exercise I was already getting!

As soon as I found out I was pregnant I enrolled in Aqua Natal exercise classes twice a week, run by my local NHS service, and was pleased (and somewhat surprised) to discover that I actually had more energy, more stamina, and was seemingly fitter that a lot of the skinnier women in the pool with me.

Even I had made assumptions about myself. So perhaps I shouldn’t be so surprised when Health Care Professionals do the same…

What got me thinking about this today was this article I read on Lauren Laverne’s ‘The Pool’ Website: Why the BMI is just one more unhelpful figure for women

Why BMI is yat another unhelpful figure for womenThis isn’t new news. Especially since scientists and doctors have been pondering the “Obesity Paradox” for a while now – that people in the BMI ‘overweight’ range, 25 to 30, may enjoy significantly lower mortality rates than their ‘normal weight’ counterparts.

Forgive me for linking to a health article in the Daily Fail, but for once, this one written by cardiologist Dr Carl Lavie is actually quite balanced, well put together, and helpful (if you can ignore the sensationalist headline).

What the science seems to show is that obesity in and of itself, while not necessarily ideal, is secondary to your level of fitness in determining how ‘healthy’ you are.

Feel free to remind your presumptive healthcare providers of this!

If I was being told the same unhelpful advice in ante-natal sessions now, I’d be fully prepared to challenge the speaker on their assumptions first. Trouble is, at the time, all I could do was mumble somewhat defensively that actually I was eating healthily and getting a reasonable amount of exercise…

Now I’d be a bit more confident at pointing out the blatant rudeness and frankly unscientific approach to advising more of something, or a change to something, without establishing a baseline first.

Also, as anyone who’s ever been to anything espousing the values of SMART goals – you’re much more likely to achieve something if it’s Specific, Measurable etc. I think a more targeted suggestion recommending increasing exercise to three sessions a week from the two I was already doing (having asked about that in the first place) would be far more person centred and motivating.

For the record, I’d really recommend Aqua Natal. I totally credit those sessions for the two incredibly easy, pop-a-pea-out-of-a-pod births I experienced, and no-one can see your wobbly bits in action!

x

Big Birtha

Sharing the love

The BigBirthas website has been active for a little over two years now. While I haven’t ever got as much time as I’d like to work on the site, it isn’t hard to stay motivated, as every so often I get a lovely email from someone in the BigBirthas community about how the site has helped them.

I don’t usually share them, but thought maybe it’s time I did (with permission!) so here is my most recent lovely email from ‘Jo’:

I just wanted to say an enormous THANK YOU for your website! I have just discovered I am pregnant after trying to conceive for some time so am over the moon! But am already being body-shamed and fed so many scare stories from the medics that I fear they will make me high risk purely through scaremongering! I’m certain sure my body is not high risk and needed some evidence and research to back it up!

Your wealth of information and reassuring guidance on your amazing website has calmed me down and empowered me to advocate for myself during appointments and in particular, push strongly for a water birth which I have always wanted. This must have taken an awful lot of time and effort (there is so much info there!), but it is a lifesaver for women like me. I will be visiting your page often throughout the next few months!

Thank you

Jo

So for Jo (huge congratulations!) and everyone else reading this, you are most welcome. It has been and remains truly a pleasure.

I’m only sorry I still haven’t got round to finishing researching and writing the many articles that are still languishing in my ‘draft’ box – many of which are little more than titles. I still think I will get round to it! But it seems the right time to reflect. I’ve been involved in a few campaigns over the time that BigBirthas has been active – trying to positively influence birth treatment and outcomes, for everyone, not just the larger ladies in our community, and now the Maternity Review was just published yesterday. I’ve not read all of it yet (there’s over 100 pages!) but it does seem to be suggesting more woman-centred care, which can only be a good thing, in my opinion!

So if you’ve just found out you’re pregnant and are apprehensive of what the future brings, welcome. There’s a community here. Be strong. Have faith in your body’s innate abilities. Don’t be afraid to speak up for yourself. Request to see the evidence base on which treatment is being recommended, and object/refuse/work to find an alternative where you experience prejudicial treatment that has no good evidence for its imposition.

And if you’re ever feeling low, or as though you’re not ‘supposed’ to be pregnant, do a Google image search for ‘fertility goddess’ or ‘mother goddess’. See those carvings and sculptures of women with big breasts, big hips and big tummies?

The ancient people who made those figures knew what they were talking about.

You are a goddess.

Don’t you forget it.

Why We Should Be Positive About Our Bodies – To Our Sons As Well As Our Daughters…

Article Originally posted here:

http://www.huffingtonpost.com/rita-templeton/why-i-want-my-sons-to-see-me-naked_b_5797920.html

“I live with a houseful of boys: four, to be exact. But they’re still relatively young — so there are no nudie mags stashed between mattresses, no stealthily-accessed porn sites that someone forgot to erase out of the Internet history, nothing like that. As much as I’d love to think my kids won’t be curious, I’m well aware that won’t be the case: those things are looming and will probably start happening much sooner than I’d like. (I mean, if I had my druthers, they wouldn’t even think about sex until they were like 25.)

But before all that happens — before they’re exposed to boobs that are as round and firm as cantaloupes and pictures of taut, airbrushed, dimple-less butts — I’m exposing them to a different kind of female body.

Mine.

Ours is not a modest household. I don’t lounge around in the buff like my boys do (and I spend more time saying, “Put on some pants!” than anything else) — but I’ve never refrained from changing clothes in front of them, or leaving the door open when I shower, or nursing babies without a cover. Because I want them to see what a real female body looks like. Because if I don’t — and their first images of a naked woman are the impossibly perfect physiques in those magazines or those movies — what kind of expectations will they have? And what woman could ever live up to them?

Between you and me, I’m dismayed, big time, by my post-baby body. But for the sake of my boys — and my future daughters-in-law — I lie through my teeth. When they ask about my stretch marks, I tell them proudly how growing a baby is hard work, and that they’re like badges I’ve earned (gaming references always hit home with dudes, no matter what you’re explaining). As much as I’d like to cringe and shrink away when they touch my squishy belly, I let them squeeze my flab between their curious fingers. Do I hate it? Yes. I want to wail, “Leave my fat alone!” and run for the nearest oversized T-shirt (or, like, the nearest liposuction clinic).

But I don’t. Because for right now, for these few formative years, my flab is their one and only perception of the female body. And I want them to know that it’s beautiful, even in its imperfection.

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I tell them how strong my body is. They see me work out. They see me make healthy food choices, but still indulge my love of baked goods. And though — like most women — I might inwardly beat myself up over my jeans getting too tight, or groan in frustration at the numbers on the scale, I’m never anything but proud of my body in front of my boys. Even when I feel the complete opposite inside. Instilling a positive body image is not an issue reserved for people with daughters — and for boys, it involves not only making them confident about their own bodies, but also letting them know that real is beautiful when it comes to the opposite sex.

I don’t want to do them, or any women they might happen to see naked in the future, the disservice of telling them that saggy boobs are bad or that a little bit of flab is something to be ashamed of. I want them to know that this is the norm, not the nipped-tucked-and-digitally-enhanced images they’re going to be bombarded with. Sure, they’ll gawk at those bouncy boobies and flat stomachs and perky butts… but I have hope that, deep down inside, they’ll know that isn’t the standard to which they should hold women’s bodies. Like, ever.

There will come a time when I cover up when they’re around. I’m sure at some point I’ll hear, “Ugh, Mom, put some clothes on!” or that they’ll learn to knock before barging into the bathroom (which sounds heavenly — I’m not gonna lie). But until then, I’ll let them run their fingers along my stretch marks, and grin and bear it when they squeal with delighted laughter at the way my butt jiggles when I walk across the room to grab a towel. Because while they’re young, I want to plant the seed — so that when they’re older, and their wives say, “I wish my thighs were smaller,” my sons can say, “They’re perfect just the way they are.”

And mean it.”