How To Submit an FOI Request for Maternity BMI Policies

If you’re pregnant or trying to conceive, you might want to know how to submit an FOI request (Freedom of Information) to your local maternity providers. It’s worth finding out as much as possible about your likely treatment beforehand, and it’s pretty simple to do.

How to Submit an FOI Request

  1. Find out which NHS Trusts cover your local area

    Quickest way to do this is to use the postcode location service on the NHS website. This will list all the local services, sorted by distance. https://www.nhs.uk/service-search/Maternity-services/LocationSearch/1802

  2. Check out the Trust websites you’re interested in.

    Mostly clicking through to the individual pages will display the website at the top under the name, if not, just Google it.

  3. Find the page on Freedom of Information requests.

    There always is one. Easiest way is to type “FOI” into the search box, usually found somewhere near the top. Somewhere on that page will list the email address you need to send queries to.

  4. Send your questions/request for relevant policies to the FOI email address.

    If you don’t want to write your own, feel free to use/adapt mine:

    “I would like to know with regard to your fertility, maternity, childbirth and post-natal services:
    1. Do you have a policy for the management of larger women? If so, what is the BMI cut off (or other criteria) where this policy comes into use?
    2. Please attach a copy of the above policy.
    3. Please could you attach any other policies/guidelines/protocols relating to fertility, maternity, childbirth and post-natal which address the management of higher BMI women. This could include (but not be limited to):

    Inclusion/exclusion criteria for use of midwife led unit, hospital birthing pool, home birth, IVF etc.
    Glucose Tolerance Testing and Gestational Diabetes,
    Clexane prophylaxis
    Pre-Birth Anaesthetist referral
    Additional growth scans

    Digital copies/pdfs preferred.

    Kind regards”

  5. Wait for a response

    The authority must reply to you within 20 working days.

    Anyone has a right to request information from a public authority. For your request to be dealt with according to the Freedom of Information Act, you must:

    Contact the relevant authority directly
    Make the request in writing, for example in a letter or an email
    Give your real name; and
    Give an address to which the authority can reply (postal or email)

    You do not have to:
    Mention the Freedom of Information Act
    Say why you want the information

    They can charge you for the costs of sending the information, such as photocopying and postage if you request a copy by mail, but not if you request copies by email. They must let you know any cost beforehand.

    By law they must provide the information unless there is good reason not to; e.g. if in the interests of public safety or security to withhold the information or they do not record that information. See the Information Commissioner’s Office page for more info.

  6. Send the documents to Big Birthas for inclusion on the website!

    If you do get copies of your local policies, please contact me via the form on http://bigbirthas.co.uk/about-big-birtha/contact-big-birtha/ to let me know, and I’ll email back (stops me being inundated with spam!). Then you can send me the documents so I can add them/update them here for the benefit of all.

Weight Management In Pregnancy – Nursing Practice

New article on weight management in pregnancy in Nursing Practice magazine:

It highlights some interesting points:

  • UK data suggests that between 40-65% of women gain too much weight in pregnancy.
  • International research suggests that women who gain too much weight in pregnancy irrespective of pre-pregnancy BMI, have an increased risk of pre-eclampsia, caesarean section, and delivering larger babies.

So while we know that being overweight before pregnancy confers slightly higher risks, it is interesting to note that for any pregnant woman, controlling weight gain is important.

  • A large UK trial recently found that limiting weight gain in pregnant women with obesity did not result in a lower risk for gestational diabetes, indicating that there is no strong evidence for what constitutes appropriate healthy or safe weight gain in pregnancy.

This is very interesting, because I have had concerns ever since the Royal College of Midwives started receiving income from Slimming World as a ‘partner’ and then the next thing I knew, larger pregnant women left, right, and centre were being packed off to Slimming World, despite the advice, from the Royal College of Obstetricians and Gynaecologists always having been to not try to lose weight while pregnant.

Now the argument for sending people to Slimming World is that by making healthy changes to your diet you may not gain any weight during pregnancy and you may even lose a small amount, which is not harmful. And I can hardly complain, I lost weight in both of my pregnancies through a variety of factors – more exercise (I LOVED aquanatal), consciously trying to eat more healthily, but predominantly because I felt sick as a dog for the first trimester and felt constantly full for the third!

My issue is – is sending pregnant women who are expressly advised not to try to lose weight to an organisation called Slimming World sending the right message? Given that the setting of Slimming World meetings and the entire focus for most of the rest of the participants in attendance is all about losing weight, is that the right environment for someone who is expressly not supposed to be trying to lose weight because it could be harmful to them and their fetus? Ho hum.

  • Midwives often report feeling anxious or worried about discussing weight with pregnant women.

This is probably true for many midwives. And may actually be the cause of some of the tactlessness we encounter. If we already anticipate resistance before we discuss something (think of a dispute you’ve had to raise with a friend or significant other) often our anxiety about raising what we perceive will be a difficult topic clouds the way we deliver the message, and so we start off on a bad foot before we’ve even got anywhere. Phrasing difficult questions or topics sensitively and non-judgementally is an incredibly important and underestimated skill.

  • NICE recommends that all women should be weighed at the start of pregnancy, but weighing should only continue throughout pregnancy if there is a clinical reason to do so; women should not be weighed repeatedly during pregnancy as a matter of routine.

So feel free to mention this if you’re seemingly getting on the scales every five minutes.

  • As there are no UK guidelines regarding pregnancy weight gain, healthcare professionals are advised to focus on supporting women to eat healthily and keep active. This advice is the same for all women regardless of their weight category.

So if you’re feeling like you’re being nagged, remember, you may not be. The same advice is supposed to be given to all pregnant ladies.

  • Moderate physical activity in 15 minute bouts three times a week is advised before increasing this activity to 30 minutes every day of the week. Women who have kept active regularly before pregnancy should be advised that they can continue this activity. If women struggle to keep active in pregnancy, they should be advised to avoid being sedentary, i.e. avoid sitting for prolonged periods of time.

This is another bugbear of mine, so glad there is an implication that questions should be asked about pre-pregnancy activity levels. It drives me bananas when women are automatically told they need to ‘get more exercise’ before the healthcare professional has actually ascertained what exercise level they are already at!

I know of fitness instructors who do a ton of exercise but are still overweight and even officially obese. Obesity does not necessarily mean inactivity. I got told to ‘slow down!?’ in a surprised manner when I galloped up the stairs ahead of my midwife once, and there were remarks at how sprightly I was at getting in and out of the birth pool too…

  • This support needs to be delivered in a sensitive manner taking the woman’s circumstances into account.

Hurrah for them making this point! So don’t forget to remind your healthcare professionals of this if you feel they’re overstepping the line at any time.

Big Birtha x

For the full text, click here:

www.nursinginpractice.com/article/weight-management-pregnancy