Re: [ozmidwifery] News article, woman refused care for being overweight.
Miriam, You have an excellent insight into the problems, which of course is not the way it is projected on TV last night. The interview I saw made it sound like the hospital was just discriminating against woman with a high BMI instead of highlighting exactly all the issues you have raised. Andrea Q On 13/06/2005, at 5:36 PM, Miriam Hannay wrote: 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 OHS 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. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] News article, woman refused care for being overweight.
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 OHS 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.
RE: [ozmidwifery] News article, woman refused care for being overweight.
Maybe, if this woman had 'been allowed' to go into labour she may well have had a nice labour and birth, with no scar on her uterus. I have looked after many overweight women, [and am myself a short, large person.] I remember two extremely overweight women who had beautiful labours and lovely water births. While fat can interfere with descent etc, the psyche plays such an important role that I believe it can overcome just about anything. These women had faith in themselves, they knew their bodies would do the deed, and they had sense not to present in labour until in transition. There can be no general rule. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Miriam Hannay Sent: Monday, 13 June 2005 5:37 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] News article, woman refused care for being overweight. 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 OHS 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. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] News article, woman refused care for being overweight.
I find this website very helpful for info on larger women and pregnancy. Cheers, J http://www.plus-size-pregnancy.org/ -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] News article, woman refused care for being overweight.
We too have a BMI cut off of 35. The reason is that the anaesthetists regard this as a risk factor should there be a need to anaesthetise - as Miriam has related the story of one lady quite clearly below. While I find it very hard to refuse a booking on these grounds, we do have to follow protocols laid down for medical reasons. Women who are clinically obese are referred to the tertiary hospital. I agree that women labouring naturally do not usually have problems, whatever their size, but the fact is that smaller units are not equipped to deal with the extra issues that may arise if a large woman does require an emergency anaesthetic. I am very interested to know if high BMI is seen as an issue in homebirth or midwifery led units? Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: Miriam Hannay [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, June 13, 2005 3:36 PM Subject: Re: [ozmidwifery] News article, woman refused care for being overweight. 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 OHS 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. -- No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.323 / Virus Database: 267.6.9 - Release Date: 11/06/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] News article, woman refused care for being overweight.
Janet, What a fantastic web site. Thank you as this information will help the very many large ladies that I see in clinic. Their only crime being BMI 35. These women need midwifery care, just don't hand them over please. Cheers Barb -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser Sent: Monday, 13 June 2005 6:38 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] News article, woman refused care for being overweight. I find this website very helpful for info on larger women and pregnancy. Cheers, J http://www.plus-size-pregnancy.org/ -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] News article, woman refused care for being overweight.
Midwifery led units have a BMI cutoff of 35- I think this is due to anaesthetic difficulties. Sonja - Original Message - From: Susan Cudlipp [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 14, 2005 12:47 AM Subject: Re: [ozmidwifery] News article, woman refused care for being overweight. We too have a BMI cut off of 35. The reason is that the anaesthetists regard this as a risk factor should there be a need to anaesthetise - as Miriam has related the story of one lady quite clearly below. While I find it very hard to refuse a booking on these grounds, we do have to follow protocols laid down for medical reasons. Women who are clinically obese are referred to the tertiary hospital. I agree that women labouring naturally do not usually have problems, whatever their size, but the fact is that smaller units are not equipped to deal with the extra issues that may arise if a large woman does require an emergency anaesthetic. I am very interested to know if high BMI is seen as an issue in homebirth or midwifery led units? Sue The only thing necessary for the triumph of evil is for good men to do nothing Edmund Burke - Original Message - From: Miriam Hannay [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, June 13, 2005 3:36 PM Subject: Re: [ozmidwifery] News article, woman refused care for being overweight. 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 OHS 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. -- No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.323 / Virus Database: 267.6.9 - Release Date: 11/06/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] News article, woman refused care for being overweight.
Title: News article, woman refused care for being overweight. This smack in the face of DISCRIMINATION!!! I have provided birthing services for another Werribee mother her home some years ago, because she was fearful of the repercussions she had experienced with her pregnancy and birth of her first born in the Melbourne hospital system. I have just recently consulted with a woman from the same region, referred to me by her Chiropractor because of a constantly crying baby. She weaned her baby at 2 weeks according to her story she was told her breasts were so big she would smother her baby and the midwives called [her] my baby a TURD. How on earth do we as a profession accept this, deal with it and better still prevent this type of appalling unprofessional behaviour. The mother who was told she is to fat needs to know her rights and take these up with the appropriate authorities. Robyn -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Megan Larry Sent: Monday, 13 June 2005 1:30 PM To: ozmidwifery Subject: [ozmidwifery] News article, woman refused care for being overweight. Woman 'too fat' for birth June 13, 2005 From: AAP A PREGNANT woman says she has been told she cannot have her baby in a Victorian hospital because she is too fat. The woman, only identified as Lisa, was told she would not be admitted to Werribee Mercy Hospital, in Melbourne's outer south-west, because her Body Mass Index (BMI) was 41. A healthy BMI - a measure of body fat based on height and weight - is between 20 and 25 in men and women, and under 40 in pregnant women. A figure above that indicates a person may be overweight. Lisa, who is 31 weeks into her third pregnancy, weighs 110 kilograms. She told Southern Cross radio today that she had already filled out the paperwork and participated in a hospital survey before she was taken by a hospital staff member to a room to be weighed and have her height checked. She weighed and measured me, then sat down with her calculator and worked it out and just told me sorry you're 41, Lisa said. She said she was told by the staff member she would have to lose 8kg if she wanted to have her baby delivered at Werribee Mercy hospital. I've only got nine or 10 weeks left in my pregnancy, basically that's drop a kilo a week. Lisa told the staff member she could not do it and that she did not believe she had put on too much weight during the pregnancy. She asked what would happen as she had already filled out the paperwork and alleged the staff member then told her they would tear it up. Director of medical services at Werribee Mercy Hospital, Dr Peter Longmore, today confirmed the hospital did have a policy of not accepting pregnant women who had a BMI over 40. Dr Longmore said the risks during delivery were significantly higher for women who were overweight. Women who have a high BMI usually have larger babies and that causes difficulty during delivery, Dr Longmore said. He said the hospital did not have intensive care or neo-natal facilities if the baby or mother needed emergency treatment. The only hospitals which provide neo-natal facilities are the Royal Women's hospital, Monash Medical Centre and the Mercy Women's hospital, which are all in Melbourne. Dr Longmore said pregnant women with a BMI over 40 also had an increased risk of developing high blood pressure, diabetes and heart problems. Lisa said no-one from the hospital explained the risks to her. Had I been sat down and said look Lisa you've got high blood pressure or you've had an emergency cesarean before or you're overweight, we don't want to risk you being here, lets send you to the women's (Royal Women's hospital) that's fair enough ... instead of turning me away. Dr Longmore said he was not personally involved in Lisa's case so he could not comment on whether or not the hospital had explained the reasons for her being turned away. If the communication was lacking when she turned up then we need to look at that, Dr Longmore said. Obesity is a problem, it is important that patients need to know about the risks, he said.
Re: [ozmidwifery] News article, woman refused care for being overweight.
This is not that uncommon. BUT it is not exclusive to pregnancy. Here all patients undergoing surgery must have a BMI below a certain level or are considered not suitable for our Operating theatre and for anaesthesia by GP anaesthetists. Andrea Q Woman 'too fat' for birth June 13, 2005 From: AAP A PREGNANT woman says she has been told she cannot have her baby in a Victorian hospital because she is too fat. The woman, only identified as Lisa, was told she would not be admitted to Werribee Mercy Hospital, in Melbourne's outer south-west, because her Body Mass Index (BMI) was 41. A healthy BMI - a measure of body fat based on height and weight - is between 20 and 25 in men and women, and under 40 in pregnant women. A figure above that indicates a person may be overweight. Lisa, who is 31 weeks into her third pregnancy, weighs 110 kilograms. She told Southern Cross radio today that she had already filled out the paperwork and participated in a hospital survey before she was taken by a hospital staff member to a room to be weighed and have her height checked. She weighed and measured me, then sat down with her calculator and worked it out and just told me sorry you're 41, Lisa said. She said she was told by the staff member she would have to lose 8kg if she wanted to have her baby delivered at Werribee Mercy hospital. I've only got nine or 10 weeks left in my pregnancy, basically that's drop a kilo a week. Lisa told the staff member she could not do it and that she did not believe she had put on too much weight during the pregnancy. She asked what would happen as she had already filled out the paperwork and alleged the staff member then told her they would tear it up. Director of medical services at Werribee Mercy Hospital, Dr Peter Longmore, today confirmed the hospital did have a policy of not accepting pregnant women who had a BMI over 40. Dr Longmore said the risks during delivery were significantly higher for women who were overweight. Women who have a high BMI usually have larger babies and that causes difficulty during delivery, Dr Longmore said. He said the hospital did not have intensive care or neo-natal facilities if the baby or mother needed emergency treatment. The only hospitals which provide neo-natal facilities are the Royal Women's hospital, Monash Medical Centre and the Mercy Women's hospital, which are all in Melbourne. Dr Longmore said pregnant women with a BMI over 40 also had an increased risk of developing high blood pressure, diabetes and heart problems. Lisa said no-one from the hospital explained the risks to her. Had I been sat down and said look Lisa you've got high blood pressure or you've had an emergency cesarean before or you're overweight, we don't want to risk you being here, lets send you to the women's (Royal Women's hospital) that's fair enough ... instead of turning me away. Dr Longmore said he was not personally involved in Lisa's case so he could not comment on whether or not the hospital had explained the reasons for her being turned away. If the communication was lacking when she turned up then we need to look at that, Dr Longmore said. Obesity is a problem, it is important that patients need to know about the risks, he said.
RE: [ozmidwifery] News article, woman refused care for being overweight.
We have had a similar thing here in WA but not BMI driven. If you are over 100kg then some hospitals will not allow women to birth in their facility. Sally
