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 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)
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