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.

Birth Confidence Summit

Do you have an urge to listen to BigBirthas.co.uk founder Amber Marshall talk about high BMI birth for 50 minutes? Surely you’re keen to marvel at how much I waggle my hands around when I talk (because it’s a LOT)!? Well, I’m pleased to tell you your wait is over! I recently took part in a free online Birth Confidence Summit, organised by Birth Confidence Mentor and founder of BirthEssence.co.uk Charlotte Kanyi.

Screenshot of Amber Marshall - founder of BigBirthas talking to Charlotte Kanyi of BirthEssence at the Birth Confidence Summit
Amber Marshall – founder of BigBirthas – talking to Charlotte Kanyi of BirthEssence

Charlotte has interviewed 27 ‘experts’ (her title, not mine) over Skype about many different aspects of birth. Talk titles include Healing from a traumatic birth, Exploring Induction Choices, Dropping the Nice Girl Conditioning – Make Birth Better (which links with) Visibility, Birth and freeing yourself from the Good Girl Archetype, Hypnobirthing for Confidence and more.

It’s a great idea and you can access all the talks for the bargain price of free!

I talk about why I set up the site, research, the difference between absolute and relative risk, looking positively at pregnancy vs the self-fulfilling prophecy, the media, blaming and scapegoating, and a bit about my two pregnancies and births and how I felt about them.

TL:DR?

In my interview I discuss how our bodies are designed for making and birthing babies. That we’re no longer in the minority and therefore shouldn’t be treated as ‘exceptional’ or ‘problematic’, in fact, we should have the same options as anyone else! Yes, carers should monitor the risks and act accordingly, but until something negative arises (and odds are it won’t) we should stay positive! Do your research and don’t expect your doctor to know everything about your personal circumstances and what is best for you. You decide, and you can use the BRAIN acronym to help you ask the right questions.

The Birth Confidence Summit Speakers

It’s a formidable line-up! There are some great speakers here:

Charlotte Kanyi, Confidence Mentor at BirthEssence

Natalie Meddings, Author, doula and birth yoga teacher

Debs Neiger, Independent midwife at Yorkshire Storks

Rebecca Schiller, Writer, Doula and Co Founder of BirthRights Charity

Alexia Leachman, Therapeutic Coach and Host of the award winning Fear Free ChildBirth Podcast

Kemi Johnson, Independent midwife,  KG Hypnobirthing Teacher and Positive Birth Movement Facilitator

Liz Stanford, Owner of the Calm Birth School of hypnobirthing

Clare Ford, Birth Coach and Master Reiki Healer at Beautiful Souls

Mandy Rees,   Pregnancy and Postnatal Yoga Teacher

Mars Lord, Award winning Doula, Doula Trainer at Abuela Doulas and Birth Activist

Phoebe Pallotti, Practicing Midwife and Associate Professor of Midwifery

Dr. Amali Lokugamage, Consultant Obstetrician and Gynaecologist and Author

Samantha Nolan-Smith, Writer, Feminist and Founder and CEO of The School of Visibility

Simone Surgeoner, Mother of four and Journey Practitioner

Jo Bolden, Mother of one and Co founder and professional dancer at One Dance Epic

Emma Svanberg, Clinical Psychologist specialising in pregnancy birth and parenting

Dr. Rebecca Moore, Clinical Psychotherapist in Birth Trauma

Naraya Naserian, Mother of two and Journey Practitioner

Zoe Challenor, Professional Singer and Co Founder of B’Opera and Mother of Two

Lorna Phillip, ​Doula and Mizan Therapist at Birmingham Doula

Jennie Harrison, Energy Healer, Mindset Coach and Birth Trauma Specialist

Joy Horner, Independent Midwife, and facilitator of Positive Birth Movement Group

Kati Edwards, KG Hypnobirthing instructor and Doula at Birth You in Love

Nicola Goodall, Author, Founder of Red Tent Doulas and director of Wysewoman Workshops

Maddie McMahon, Breast Feeding Counsellor, Doula and Doula Trainer at Developing Doulas

Rachel Elizabeth, Mother of four and Doula at Creative Birth

Take a look and big thanks to Charlotte for organising and facilitating!

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.

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 https://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.