Your experiences and opinions are needed!

Hi lovely people! It seems I’m inviting you to take part in research once again! This time, your experiences and opinions are needed by Queen’s University Belfast. The researchers want to know people’s views on excess weight in today’s society.

They’re particularly interested in hearing from people who’ve been pregnant.

If you’re experiencing research survey fatigue, I apologise! It’s a really positive sign how far we’ve come that researchers aren’t just looking into issues around high BMI, but we’re regularly asked questions about our views on the subject too.

I advocate getting involved in as much research as possible that looks at our experiences, and gives us a platform. This is why I regularly publicise research on here.

As I see it, the only way to effect change is to make our voices heard. Your experiences and opinions are needed so the people making decisions know what’s really happening, and what we think about it! Change is slow in coming, but it is coming, and you can help make it happen!

Queen's University Belfast logo - Your experiences and opinions are needed!

Here’s the blurb:

Your experiences of having excess weight in today’s society

Have you ever had excess weight? Would you like to share your experiences and opinions?

Researchers at Queen’s University Belfast invite you to complete a questionnaire about your experiences of excess weight and your opinions on different terms used to describe weight/size.

We are looking for men and women who are over 18 years old to complete the questionnaire. We are also particularly interested to hear about the experiences of women who are or have been pregnant.

Please click on the link below to find out more about it and to complete the questionnaire: https://qubpublichealth.fra1.qualtrics.com/jfe/form/SV_2nUDx0DJGg8kFKZ.

They say the survey should take about 15 minutes.

Image courtesy of the World Obesity Federation
Image courtesy of the World Obesity Forum

Are You A Researcher?

Are you looking to publicise your study, or trying to find participants?

BigBirthas.co.uk is always happy to publicise relevant research on the topics of BMI and pregnancy.

Are you struggling with working out what terminology to use? Do you want to check you’re not missing something with the people your research actually concerns? Want to just check your thoughts and assumptions with some people with lived experience of the thing you’re studying?

If you’d like to run a focus group, we can help with that via the BigBirthas Facebook group.

It’s a friendly, welcoming space for people to discuss the issues surrounding higher BMI pregnancy. There’s healthcare professionals and doulas on board, as well as people who are, have been, or would like to be pregnant. We’re also happy to facilitate Q&A sessions. It’s generally better if these happen in the evening once children are (theoretically at least) in bed!

If you’re looking for members of an oversight committee or similar, we can probably help with that too. Lots of our members have experience with conducting research!

You can get in touch via the Contact BigBirtha page.

Research Continues!

The world may have practically stopped in a lot of ways, but behind the scenes, research continues! The ever-effervescent WRISK Project is attempting to map all the COVID-19 pregnancy research that’s happening right now. Anyone doing research in this field is invited to add their project details to their google doc: http://tiny.cc/pregnancyandcovid19.

BigBirthas has also had contact from quite a few academics and researchers. They are continuing with pre-COVID-19 research and need our help. There are a few in the pipeline I’ll be publicising soon. I can’t share all the details of the other projects yet, but I can remind you about the LARC Project, which I brought to your attention in January, and which would now like you to complete a short survey, if you’re able:

LARC Project Research Continues

Image showing forms of LARC (long-acting reversible contraception) and Lancaster University and BPAS logos along with the words "Have you been encouraged to use LARC?" - their research continues

LARC stands for Long Acting Reversible Contraceptives, things like the implant, coil or IUD, injections etc. This is being run by the British Pregnancy Advisory Service (BPAS) in conjunction with Lancaster University.

They’re interested in hearing about people’s experiences with LARC or LARC services. If you take part in their short survey you can win a £20 High St voucher. (it says it takes 10 minutes to complete, but I think that’s an exaggeration, it took me much less!)

You do not need to have used a LARC type of contraception to complete this survey. They’re interested in your experiences with the services that provide LARC. It doesn’t matter whether you have tried the methods or not.

I’ll let you know more about the other research projects and how you can help and get involved as I know more myself.

Until then, stay safe.

x
Big Birtha

Our PSG Research at the Medical Sociology Conference 2019

The best thing about ParentingScienceGang was discovering all the other articulate people passionate about the issues of high BMI pregnancy. One such woman is Dr Mari Greenfield, who presented our research at the Medical Sociology Conference in York in September. Mari has written a guest post about the experience:

Dr Mari Greenfield, who presented our PSG research at the Medical Sociology Conference 2019
Dr Mari Greenfield

Big Birthas: unpacking ‘choice’ for pregnant women with a high-BMI

I took part in the Big Birthas Parenting Science Gang as a Parent Scientist. I helped to decide the research question, design the methods we would use, and undertake some of the analysis.

When the project ended, we Parent Scientists had the data and the findings, but needed to decide what to do with them. My day job is a doula and researcher, and I’m passionate about choices in birth for all, regardless of BMI. Some of the stories women had shared with us were heartbreaking; stories of choice and power taken away, and of upset and trauma as a result.

Some of the stories were also uplifting, when women took power back; asserting their rights to make choices and decisions about themselves, their bodies, and their babies. Women had shared so much, giving time and investing themselves by telling their stories. I want to make sure we do justice to that. 

One way I can do that is to present our findings to a diverse range of audiences. In my day job, I frequently present research to conferences of academics, so I applied to the Medical Sociology Conference. Hosted by the British Sociological Association, it is a brilliant event which focuses not on what we do within health care, but how we do things, why we do things, and how we could do health care better.

our research at the Medical Sociology Conference 2019

Pecha Kucha!

My talk was accepted, in a format called Pecha Kucha. These presentations allow you to present 20 slides, and talk about each one for 20 seconds. It’s a challenging format because it makes you really focus on the key points you want to make. There is no room for waffle!

I wrote the both the initial application and the presentation collaboratively with Big Birthas and several of the other Parent Scientists, using the Facebook group to refine ideas and try things out, in the same way we had used it during the Parenting Science Gang project. It was lovely to have that very supportive and equal way of working. This is quite different from the creation of most other academic and medical presentations.

The high BMI ‘box’

I chose to focus on one of our findings, the idea of the ‘high BMI box’. Many women explained how, once in this category, BMI was the only thing anyone seemed interested in. They described having serious medical conditions ignored. One woman explained how the difference between her starting weight in her two pregnancies was objectively only 7 pounds, but in one this was ‘normal BMI’, while the other saw her put into the ‘high BMI box’. She eloquently described the differences this made to her care.

Programme excerpt about our research at the Medical Sociology Conference:

Big Birthas: unpacking ‘choice’ for pregnant women with a high-BMI

What does it mean to be labelled as having a high-BMI whilst pregnant? How does this label affect women’s experiences of navigating maternity services?

This presentation is based on a novel user-led Citizen Science collaboration between Big Birthas (peer information and support service) and Parenting Science Gang (Wellcome Trust funded user-led citizen science project).

The results described complex journeys, where interactions with healthcare professionals revolved around conversations of BMI-related risks to the exclusion of other factors, and ignored other events of the pregnancies.

Women also reported disrespectful and shaming language from healthcare professionals, and conflict if they asserted a decision that was not in line with the healthcare professional’s views.

This led some women to decline care that they actually wanted, or avoid attending appointments, to avoid conflict or denial of choice; a consequence which was particularly apparent when we examined how those women chose to approach their second pregnancies.

The presentation and our research at the Medical Sociology Conference was well received. Questions after the talk asked about both the Parenting Science Gang methodology, our methodology, and our findings. People spoke about how our research overlaps with work they are doing.

The Parenting Science Gang’s project is over, but the journey of the stories we collected is not. Next, I am hoping to work with some of the other Parent Scientists to turn our findings into a piece that can be published in a midwifery journal. Watch this space…

Dr Mari Greenfield

Academic researcher in maternity care, doula, birth activist. Special interests in traumatic birth and LGBTQ experiences.

Huge thanks to Mari for bringing our research to a wider audience, and for writing up the experience too!

Would you like to write a guest post for Big Birthas? Have you got experiences or a perspective that the Big Birthas audience might be interested in? Do you have a birth story you want to share? Please get in touch via the Contact Big Birtha page.

Fat Vaginas

I’m sorry. There’s no point beating around the bush. This happened yesterday, and now fat vaginas are on the agenda:

Milli Hill, author of Give Birth Like A Feminist, spoke on BBC Radio Scotland for a discussion about induction rates. With her was Dr Marco Gaudoin, brought in for the ‘expert’ perspective. However, it turns out that Dr Gaudoin’s expertise is in fertility, not obstetrics or gynaecology… which may explain why he said this:

‘With obesity you’ve got increased fat tissue in the birth canal, which makes the birth canal that much narrower, which makes it harder for the baby to squeeze through the birth canal. So you are more likely to end up with what is called an “obstructed labour”‘

Dr Marco Gaudoin, speaking on BBC Radio Scotland 12th November 2019

What’s worse was that this happened at the end of the interview! Milli had no opportunity to challenge the doctor on his statement, or ask for evidence.

Fat Vaginas – Fact or Myth?

It’s no surprise that Milli had never heard this before, because there is NO EVIDENCE for Dr Gaudolin’s words whatsoever. They echo a theory suggested in a research paper back in 1997, and no-one has provided any evidence for it since.

It’s just more fat shaming.

Fat Vaginas: a display of inside-out purses looking remarkably like a selection of vaginas.
Vaginas come in a plethora of different shapes and sizes… image courtesy of The Vagina Museum

Ugh. Makes me want to beat some people over the head repeatedly with a copy of Give Birth Like A Feminist. Shame it didn’t come out in hardback.

You’d really hope that a qualified doctor would stick to established, evidence-based information. Sadly (too often, in my experience) when some doctors feel under pressure, they dredge some half-truth they heard somewhere from the back of their mind and present it as fact, rather than admit they don’t know.

It’s why I recommend anyone embarking on a high BMI pregnancy journey do their research and ensure they’re informed.

I have spoken to countless midwives (who have extensive experience of actual vaginas giving birth) and most agree that with the right support, there is no reason why a high BMI pregnancy shouldn’t proceed as with any other. Indeed, most of them do.

What Happened Next?

On Twitter, plenty came forward to challenge the “expert’s” ill-informed and misogynistic statements.

Then to my surprise, for once, the print media responded positively to the story! This may be thanks to Milli Hill knowing the right people to approach, but it was a refreshing change! The resulting article was comprehensive and well written.

Screenshot of Grazia online article on fat vagina comments.

Then other media outlets picked up on the story, including the Sun, who got an actual expert in obstetrics and gynaecology to comment!

Dr Virginia Beckett, consultant obstetrician and spokesperson for the Royal College of Obstetricians and Gynaecologists clarified that having an “obstructed labour” has nothing to do with “fat vaginas”. Which we knew, but it is nice that someone well qualified to address the issue has done so.

Screenshot of the Sun online article about fat vaginas

Next Up to fight our corner was the Daily Mail!?

Yes, really! Asking lots of people with much more experience and expertise… and me. So, yeah. That happened. I was tempted to be indecent and suggest that if our vaginas are so ‘restricted’, how lucky must our husbands and partners be? But I behaved myself. And contrary to my expectations, the journalist didn’t twist or change what I wrote at all, bar removing a paragraph that had already been covered by a previous interviewee. You can read what I wrote here:

https://www.dailymail.co.uk/femail/article-7680527/Doctor-claims-obese-women-fatter-vaginas-likely-experience-obstructed-births.html

Jaw on floor.

The article came with the usual stock headless belly image, naturally! But as soon as I realised and offered an actual picture to replace it, it was quickly swapped.

Of course, the article goes on to report the bloody relative risk stats rather than the true percentages, as always. So there’s still a way to go, but feeling strangely positive at how this story has turned out, for once!

As I have said before and seem to need to keep saying; having a higher BMI while pregnant is associated with a slightly increased risk of some less desirable outcomes. But there is also evidence that the precautionary way high BMI labours are managed may contribute to this.

There is no evidence that fatter people have fatter vaginas. There is no evidence that having a fat vagina (if such a thing exists) is a cause of birth obstruction.

If you want to read more about how micromanaging our births can cause a spiral of negativity and interventions – see article I wrote on The Impact of Negativity on Labour and Birth.