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Heavy women and compromised childbearing


A young woman whom I have known since her babyhood is now preparing to become a mother. And she and her husband are taking this very seriously indeed. They are not yet ‘trying’ for a baby, but are reorganising their lives and lifestyles in anticipation of conceiving a baby later this year. Both have given up drinking. Both are now eating a healthy breakfast (yoghurt and fresh fruit with granola, fruit juice and wholemeal toast) and ensuring that their main meal of the day is appropriately balanced with vegetables, carbs and proteins. Both are exercising twice a week at the gym and taking long walks at the weekend. They’ve sold their house (on a dangerous road) and their beloved VW and have bought a sensible second-hand Volvo.

Too good to be true? Well, you’ve got to take your hat off to them; they want to be the best parents they can. They’ve read the advice on the internet, and talked to friends who are in the health professions, and this is the plan they’ve made. I don’t think I myself went to anywhere near these lengths before I started trying for a baby.

And just in case you’re thinking that this couple are probably doctors or researchers, they’re not! They have ‘ordinary’ jobs and a modest lifestyle.

I am quite sure that the majority of women and men who have planned pregnancies are equally determined to be good parents. And yet, the figures say that almost half of new mothers are seriously heavy at the start of their pregnancies. (‘Heavy’ is the word the Americans tend to favour. I dislike the word ‘obese’; it makes women feel humiliated – not a good starting point for a discussion about healthy lifestyles.)

Do women not see being overweight as a problem? Have we, as birth and parent educators, explained the potential problems sufficiently clearly, as well as kindly? How can we get this conversation right?

Possible problems with being heavy are that women are more likely to develop diabetes in pregnancy and to suffer a miscarriage, and more likely to have a difficult labour or a stillbirth with the appalling emotional trauma that these events bring with them. The RCM recommends that women should try to be an ideal weight before they become pregnant and then follow the dietary advice given to them by their midwives.

Naturally, I agree with the RCM. But that rather misses the point, doesn’t it? Whatever ‘advice’ is being given, it’s either not being heard, or not being believed, or not being actioned because it’s too difficult. In the last years when I was active as an Antenatal Teacher, I spent a lot of time modifying my sessions to ensure that when we were discussing active birth positions, all the women in the room could comfortably participate. It seemed unkind and pointless to demonstrate positions that only some women attending the session could manage (kneeling was often very difficult for heavy women).

A series of British Birth Cohort studies (now often called Life Projects) started in 1946. This was followed by cohorts starting in 1958 and 1970, then by the Children of the ‘90s’ cohort, and most recently, by the millennium cohort. Comparing the data, it is noticeable that females in the first two cohorts were not overweight by the time they came to childbearing; those in the last three cohorts were/are.

Ways of solving the overweight epidemic? Ways of preventing the host of problems that our childbearing families are facing and going to face, and all the unhappiness that those problems will bring in their wake? Answers on a postcard please asap. How can we stop Britain being the most overweight nation in Europe by 2050? This is an issue for every one of us involved in birth and parenting education.

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