BMI & BIRTH: MY STORY OF SELF ADVOCACY

When I found out I was pregnant my bodyweight was somewhere around 105kg. The week before I gave birth and had to step on a scale the number was 112kg. My daughters’ weight at birth with 4.2kg. I will let you do the math on how much weight I gained over my 40+6 week pregnancy. I am 1,76m tall, which resulted in a BMI of 33. This number would go on to define what kind of birthing experience I was permitted to have under Dutch medical protocols.

The number 33 (or more specifically anything above 30) put me in a “high risk” group that 9 months postpartum I still haven’t been able to find details on ("we don’t know the numbers, we just know it´s a higher risk"). But before we go there, let´s jump back a little .

My whole life I have lived with a higher bodyweight. There have been ups and downs but in the end, I have always been bigger than what society would define as “normal”. I have fought many battles against my body, hating it and wanting it to be smaller so I could finally live the magical life that was promised to the thin version of me. Endless tears and sweat have run down my face torturing my body with yet another diet or a “shred it all down” workout. When I finally did shed 30kg, it had come at the cost of my wellbeing and I promptly submitted myself into long-term therapy.

Fast forward some years, all the weight and more was back on, but I had surrounded myself with body-positive people and attitudes. I had learned to be thankful for my strong thighs and the legs that carried me through my day. My wobbly belly that had become a beautiful canvas for my tattoos and my soft arms gave the biggest and warmest hugs.

Despite the common opinion within the medical community that I would probably have a hard time getting pregnant because I was fat, after three months of trying I held a positive test in my hands. Shortly after a big rush of joy a wave of anxiety and fear overflowed my body as I began to dread the comments from my gynecologist about my potentially high blood pressure, my weight, and risks of gestational diabetes. Luckily, none of the above happened. My blood pressure and heart rate were always perfect, my weight was not once commented on and the diabetes test came back negative.

26 weeks into my pregnancy we moved to a new city and the fears that had gone away with my previous healthcare provider became a reality at my first midwife appointment.

The first question I was asked, before looking at any of my data documented by my doctor back in Germany, was how much weight I had gained so far. When I said three kilos, the midwife laughed and said “no, no I don’t mean in the last month, I mean since you found out you are pregnant.” “Three kilos.” “Oh, I see, so you already weighed so much before? How long did it take you to get pregnant?”. Needless to say, many tears ran down my face that day.

I had just finished my BA thesis on the topic of stigmatization and discrimination against high weight individuals, and I was very familiar with the latest research regarding this topic, including the history of BMI and the consequences for the fat community. I knew I had to surround myself with a strong support network to stand up to this kind of discrimination and keep myself in a positive headspace. I hired a Doula, made sure I was seeing my therapist on a regular basis again and started a hypnobirthing course with a provider I had heard lots of positive stories about from people of all sizes. None of these people ever mentioned my weight or indicated that I would have any problems giving birth or was restricted with my choices for my birthing process. After educating myself about all the different birthing options, I opted for a home water birth. I began to work on a birth plan with my Doula and my husband and was back in a positive headspace looking forward to this experience, knowing that my body could do this and would not let me down.

Regrettably, not everyone had this same faith and belief in me and my midwife said she would not assist with this kind of birth. When asking what exactly the problem was, she bluntly said “Your weight. Your BMI is over 30”.

After looking into my baffled and confused face she said that my risk for extensive bleeding was increased and because we were not living on the first floor, it would take too long to bring me through a window into the ambulance in case of an emergency. Grabbing my bag,I stormed out the practice, and felt the hot tears yet again running down my cheeks. The fact that they totally ignored all of my data, clearly showing that I was in perfect health- no high blood pressure, no diabetes, no problems whatsoever during the entire pregnancy, shocked me to the core and was a horrible moment to have one week before my due date.

After consulting with my Doula and my hypnobirthing instructor, I found myself in a peaceful space again. They assured me that nothing except my midwife’s discriminating views was preventing me from having my chosen birth experience. My husband and I spent the next day calling midwife practices. At the end of the day and numerous calls with midwives who were also outraged hearing my story (but were already fully booked), I had found two practices that were able to take me on board at short notice. It ended up being in the best care I could have wished for.

On July 18th, 2020, I gave birth to a perfectly healthy daughter and neither she nor I encountered any problems during or after the delivery.

Postpartum, and having done previous research on this topic for my thesis, I was able to navigate my way through the evidence surrounding my original midwife’s claims. I indeed did find two studies that said there is a slightly increased risk of more extensive bleeding when the placenta comes off if your BMI is higher than average, but this increased risk was only found to exist in individuals having specific pre-existing conditions of which I had none. More than the ability to research, my previous experiences being subjected too subsequently studying body discrimination gave me the tools I needed to stand up for myself, and create the experience I wanted. This is the first in our series on body positivity and pregnancy, join us on instagram live on May 3rd as we explore this conversation more.