I comment as the anaesthetist to whom all women with …

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Comment on Countess of Chester Hospital NHS Foundation Trust (Countess of Chester, Chester) by Dr Simon Bricker.

I comment as the anaesthetist to whom all women with a BMI of 40 or greater are referred for an antenatal appointment. The driver for this is less clinical need than the requirements of the CNST (Clinical Negligence Scheme for Trusts)who make this one of their criteria for level 3 status. I would be very disappointed were I to be perceived as patronising because I see my role as essentially to provide reassurance. There is nothing that a mother with a high BMI can do about it mid-pregnancy and there is no justification for creating alarm by discussing theoretical risks for which there is little good evidence. I do tell them that practical procedures such as epidurals and spinals may be more difficult to perform (‘may’, not ‘will’), but that otherwise they will be treated from the anaesthetic point of view just like any other prospective mother.

Dr Simon Bricker Also Commented

Countess of Chester Hospital NHS Foundation Trust (Countess of Chester, Chester)
I do like the title ‘plus-size-positive clinician’! (Happily I am spared doing any manual handling assessments.) I think that this web site must offer very useful support for higher BMI mums who can feel very stigmatised. I made the comment to one whom I saw that it was my impression that they all tended to be very uncomplaining, and she agreed by saying rather poignantly that ‘us big girls just don’t want to be noticed’. I always realised that most women with raised BMI don’t like it that way, but she did give me a new perspective.