Birth Brouhaha :)

Women of Size

2/3/2015

Women of Size (yes, the ladies who started their pregnancy heavy)
Women of Size often are told right off the bat that they will get diabetes, and end up with a cesarean--even before given the first exam! What a load of poppy-cock.

When you are looking at studies, it's hard to figure out how caregiver bias has effected the outcomes. Don't assume that labor won't work for you.

Women of Size, let's be up front about a few things.

Yes, women of size have sex and get pregnant. Sigh, I really wish I didn't have to put that in this list. You're not the only one. Honest. It happens all the time. (well rounded mama has some great WOS pregnancy photos if you want to explore.)
Your OB/Midwife might not have experience with women of size and s/he might jump to conclusions. Hold their feet to the fire. You are entitled to the same quality of EVIDENCE BASED CARE as their tiny little mamas.
Yes, there is some extra skin and fat, so your OB/midwife might have to move some around to get a good heart beat. Help them, it's not a big deal.
There is no evidence that your uterus will explode should you want a vaginal delivery. (I'm just saying...)
The vaginal canal is not clogged up and your baby will get in position, just like all the other babies in all the other mommies.
Make sure your provider uses an extra large blood pressure cuff. A cuff that doesn't fit will give out the wrong reading. Same goes for tiny women, they need a child's cuff.
If your care provider shows a strong tendancy for bias against your weight, go ahead and find another provider who might be a better match.
It seems that it takes women of size longer to get to 6cm than smaller ladies. That means that you should be ready to give yourself extra time before agreeing to a "failure to progress" diagnosis.
Weight gain/loss may be different, depending on why you're sized the way you are. Sometimes women of size lose weight during a healthy pregnancy, and others gain. It's not the time to diet, but eating healthy (including enough calories to create a new human) is smart for all pregnant women.
Breast feeding is still the best for your baby. A good lactation consultant will help you find the right hold for you--just like she would for other moms.

I guess what I'm trying to say, is to please do not let the medical community assume you are anything other than the individual you are. Don't let them sign you up for more ultrasounds, non-stress tests, poking, proding, blood draws, prep you for an early cesarean, just because you carry more weight.

You have the same responsibilities as other moms-to-be:

Eat healthy--this is not the time to diet.
Drink water.
Move your body--yoga, walking, and swimming are great for pregnant women.
Expand your mind--a good childbirth education class is a great way to prepare for birth and to know your options.
Hire a doula--Really, did you think I would leave this out?
Pick out cute baby clothes.
Try to stay calm while family members drag up all the scary birth stories that they heard about cousin Bob's ex girlfriend's Aunt Joan's co-worker's daugher's best friend.
Be assertive in telling anyone who wants to tell you a scary birth story to wait until next year to tell you. Take-a-way lessons are good (e.g. don't forget to wear a pad to the hospital in case your water breaks on the way over), but tell them to skip the scary stories.
Wear your own clothes. Buy something that may very well be a one use item, but BYO cute nightie and cover.

For any test or procedure, the same goes for you as goes for everyone else. Ask:

What is this test for?
How often is there a false positive or false negative? How accurate is it?
What happens if I don't do it?
What would I change depending on the results? If nothing, then why do it?
What are the risks to my baby?

Of course, you can always further your research on the internet. Look for medical sites (not just "I was fat and had a baby and I was fine" chit-chat). Look for research. Look for best practices.

And don't forget (fat or thin): YOU CAN'T MEASURE WEIGHT BY BONE LEGNTH (this is about the ultrasound to guess weight at the end of the pregnancy).

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Birth Plan / Birth Intention / Birth Preference

1/31/2015

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Especially in busy hospitals, it is unlikely that your particular preferences are all that unique. That said, there are as many different thoughts about birth as there are hair styles, so make sure that the nursing staff is familiar with the type of birth that you want.

Of course you've discussed your feelings with your doctor before you went into labor. Now it is time to make sure that your nursing staff is also on the same page. Unfortunately, during the intensity of labor, you might not be in the best position to describe (rationally) what you do and don't want during your stay at the hospital.

Do's

Keep it brief: Try to keep your letter to the nurses easy to read and digest;
Introduce yourself and who will be with you at the hospital (a picture is nice);
Include relevant medical information to make sure it is top of mind;
Use bullet points to list preferences;
Be polite;
Bold and highlight relevant allergies to medicines;
Print out multiple copies so that one can be kept at the nurses station, and there is an extra one if the nursing shift changes;
Remember that labor is a process, knowing the facts and your personal preferences will empower you;
Bring food, healthy if possible;
Do your homework. Find out about hospital procedures so you can be realistic in your expectations. (e.g.: I would only like women with children to attend my birth is not realistic, but "Please do not offer me a pain scalle, I will let you know if I decide to consider an epidural" is totally appropiate)
Discuss your birth plan with your partner, doctor, and doula.

Don't

Threaten (If you do X I will sue);
Be insulting about different birth philosophies (I'm not one of those women who...);
Fill out some form on the internet and print out the results, you should think through your wishes and describe them accordingly;
Ramble on. Your birth plan is not a biography.

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A Doula Is

1/31/2015

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A Doula Is A doula is a woman who loves birth, loves laboring women, and is dedicated to bringing about a positive and meaningful birth in others. A doula digs birth. She is your own personal birth junkie.

A woman's job during labor is to focus her mind and body on birthing her child. Her partner's job is to love and support her unconditionally. A doula's job is to support that partnership and offer her experience and expertise to the laboring couple.

A doula can help minimize the fear that can be present during labor. She can offer suggestions, motivation and encouragement.

Her final job is labor support. Part of that occurs during labor, and part of that occurs before labor. The stronger the relationship you and your partner build with your doula, the better she can serve you during labor.

Her first job is a resource consultant. She should be able to help you find the services you need in your community. You should feel comfortable asking your doula about anything birth related, and she will help you find the resources you are looking for.

A doula knows that if a woman feels empowered and knowledgeable about her birth then she is more likely to look back on the experience favorably. A positive impression of birth is beneficial to both mother and child.

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Women of Size

Birth Plan / Birth Intention / Birth Preference

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