While I deplore the fact that any woman would be refused care due to her size, I do understand the issues for clinicians and other staff.
I recently had a follow through woman with a booking in weight of 147 kg. She had gest. diabetes + quite bad cellulitis in her right leg. She was cared for by a known midwife in our Midwifery Group Practice and had collaborative obstetric care due to the 'risks' involved. She was booked for IOL with gels at term due to suspected LGA babe, but had uterine hypertony as a result. The consultant Ob. ordered a follow up U/S when he came to review and her little one had a very high head, sitting right over the brim of the symphysis pubis. He recommended elective section for that evening which she agreed to. The experience in theatre was a huge learning experience for me, and very challenging. It took the anaesthetist almost 20 minutes to site an IV (MWs and RMOs had tried without success), then 45 minutes to insert the spinal (her spines were just obscured with fat, and almost impossible to get a nice curve of her back due to abdo size). The theatre table was simply not designed for a woman of her size, it took six of us to manouvere her safely then strap her down. Her abdomen was too pendulous to be held back with retractors so in the end the theatre staff set up an improvised sling and winch system to lift it out of the way. It really opened my eyes to the risks for the woman and OH&S issues for staff. I in NO WAY feel any woman should be faced with refusal of care for these issues, rather that on a budget and staffing level they need to be dealt with by the hospital system. As more and more women with high BMIs find it easier to conceive on fertility treatments etc, we will have a real issue in the way we provide safe maternity care services for these women. The outcome for my follow through woman was great, lovely 4.3 kg baby girl and home now day 7 with clean wound and well established BF (Phew!). However, I still believe the situation she faced was potentially dangerous for her, her daughter and the staff involved in her care. Regards, Miriam (2nd Yr Bmid) Send instant messages to your online friends http://au.messenger.yahoo.com -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
