My birth story started much earlier than January 6, 2011. It started in an examination room of the High-Risk Unit. I was twenty weeks pregnant with my first child.
I haven’t shared this story with many people, and over two years later, it is still an open wound on my soul. So I’m asking any readers, if you hate fat people, if you think fat people shouldn’t have children, or if you just like to hide behind your computer to spew cruel judgement on people, please stop reading.
My pregnancy was going great. I had gained very little weight, which as an overweight mom is a good thing. I had been taking prenatal vitamins before conception. I had no pre-existing medical conditions that posed any risks to the fetus. I had cut diet Coke, rare beef, blue cheese, dippy eggs and alcohol entirely out of my diet. I was eating lots of fruit and vegetables and drinking lots of water and riding the stationary bike four times a week. (It was August, ragweed season, and way too hot to exercise outside.) I was finally feeling less exhausted, and the first trimester nausea had gone away. My big indulgences were cheese popcorn and Kraft Dinner.
I had just turned 30, and my Integrated Prenatal Screening results came back negative for developmental defects. I had no bleeding or cramping. My ultrasounds looked good. My regular family doctor/OB was on maternity leave herself, so I her locum was providing my prenatal care. Upon reviewing my file, she found that my BMI was on the border for high-risk, so she referred me to the High-Risk Unit in the city for a consultation. “Just in case.”
I was both worried and ashamed. What depths of selfishness possessed me when I started trying to conceive? A person is not automatically entitled to procreate simply because they have a uterus. (My tendency to self-critique had a field day.)
I had done lots of research, and I knew that there were more risks for overweight women during pregnancy, but I had many friends and acquaintances who’d gotten through pregnancy and delivery with success. I certainly didn’t know anyone who had been referred to High Risk for the sole reason of being fat. At the same time, it was my doctor’s responsibility to do what she believed was best for her patient.
I won’t identify the doctor by name, because he never did anything un-Hippocratic, or at least not in the legal sense. He didn’t touch me inappropriately or behead my child with a forceps during the birth. In fact, after the first hand shake, he didn’t touch me ever again, even to examine me, and he wasn’t there during my labour or birth. I don’t think that the dignity of fat patients is something that many medical practitioners are concerned with preserving, so ethically he comes out pretty clean too.
I also know that he has helped many women (maybe just not the fat ones) through difficult and risky pregnancies with excellent results. He had posted thank you cards from many patients who were obviously pleased with the treatment they received.
My first appointment was torture. The first question he asked was, “Do you know why you’re here?” How could someone possibly end up at the High-Risk Unit with no idea why they were there? Some people have suggested that maybe they have lots of patients who are uneducated and need to asked questions like that, but if he had taken thirty seconds to talk to me he might have figured out that I was well aware of how I got there and that I didn’t need to be spoken to like an idiot. He might have learned that I was doing my best to make my pregnancy as safe and uncomplicated as possible.
I was asked about my diet and exercise routine. He asked me if I ate fast food. Less than once a month. I didn’t eat a lot of fast food before I got pregnant either. (A waste of calories if you ask me.) Did I consume a lot of greasy food, a lot of candy, a lot of sugary juice, chips, processed meat? No. I didn’t buy any of those things, because I didn’t want them in my house. I had been extremely careful about what I was eating, and I told him in great detail about a typical day’s food consumption. Then he handed me a copy of the Canada Food Guide and told me I should study it carefully. It was just like the one I already had on my fridge at home.
He told me about all of the increased risks for fat pregnant women. I had a greatly increased risk of stillbirth. I would likely end up having a caesarian section. An epidural probably wouldn’t work on me, and I might have to be put out completely for surgery. I asked if I could have my baby at the hospital in my hometown, because I knew the staff and my mum lived close by. He shook his head and said, “They’ll need special equipment to operate on you. They won’t want you there.”
Thankfully, the doctor told me that I could see my own doctor for the next few months and return to High Risk near the end of my pregnancy. I left feeling deeply ashamed and guilty. I also felt lost, because aside from having an extremely late (and wholly unwanted) abortion, there was nothing I could do to make things better. My husband was furious and wanted to ask for a transfer to another doctor, but all I could think of was having a dead baby. Changing doctors wouldn’t change the fact that I was fat. It wouldn’t change the statistics.
Perhaps that doctor didn’t understand how much power he wielded, but from that moment on, all I wanted was to get through the next four months without my fat killing my baby. I frequently sat pedalling my stationary bike, weeping and loathing myself. I thought I had been doing things right, but I learned, far too late, that nothing would have been enough to make up for my fatness.
When I returned to High Risk, I spent most of my appointments with one of the nurses. I often got the same nurse, who was a kind, friendly woman around my mother’s age. She was a soft place for me to land. She never made me feel ashamed and she listened to me. Each appointment was mostly the same – ultrasound, pee in a cup, nurse, then the doctor. Every time the doctor met with me, he seemed surprised when I said that I had no problems to report. He seemed especially surprised to report that my gestational diabetes test results were “very, very good.”
The worst part of each appointment was being weighed. I could have vomited on cue when the nurse led me to the scale. Every visit, my weight gain was minimal. One day near the end, I put on two pounds in two weeks. I sat in the exam room, trying to swallow the hysteria bubbling in my throat. The nice nurse came in to take my blood pressure and I completely lost my shit. I told her I was going to be in trouble with the doctor because my weight had gone up so much. She kindly patted my hand and told me that every doctor has a pet peeve, and his just happens to be fat people.
One could argue that someone who hates fat people might not give them the best care, and that perhaps he is being assigned to the wrong kind of patients. I did feel a little better, but I wondered how long people had been making excuses for his lack of compassion. I’ve been fat my entire life. I wasn’t looking for anyone to lie to me about the potential health risks of being overweight. I wasn’t looking for a doctor to lie to me about the risks of being overweight and pregnant. But he never treated me as a whole person, which I am. I didn’t need that doctor, a person who is supposed to inspire confidence and trust, to point out my flaws. I was, and am still, acutely aware of them.
But for all of the grief he gave me, I was an easy patient. I showed up for my appointments on time. I didn’t smoke. I didn’t have any pre-existing medical conditions. I read all of the information sheets he provided me, even if the information was obvious or redundant. I diligently filled out the baby kick chart. He rarely spent more than five minutes in the room with me, and he didn’t conduct a single physical examination of me while I was a patient.
My last appointment was scheduled the day before my due date. Nothing had happened to indicate that I might go into labour on my own, and he was adamant that I could not be allowed to go past my due date because of the tremendous risk of stillbirth. Again with the dead baby. Telling a woman that her baby will probably die is an ironclad way to ensure her total compliance. He booked me for an induction the next morning.
I didn’t sleep much that night. I was nervous about the induction because they often result in a c-section, which I was hoping to avoid. The hospital called in the morning to tell me they were ready for me, and my husband, my mum and I packed up and headed to the hospital.
When I arrived around ten thirty, I was given a room. I gowned up and we waited for someone to come in and talk to us. My nurse was a very kind and friendly woman named Karen. She introduced herself and we reviewed my birth plan. She asked me why I was being induced on my due date. I told her what my high-risk doctor had told me about stillbirth and the other dangers of fat pregnancy. She frowned. She asked again why I was being induced. High blood pressure? No. Gestational diabetes? No. Did I have a history of stillbirth? No. I’m fat, I told her again. It’s dangerous. My doctor filled out the paperwork. He told me to come here. I’m not sure what else to say. She looked at me sadly. I shrugged. What fun.
Then came the first doctor. He was pleasant and polite. He reviewed the induction process with me. He looked at my chart and said “I see that your amniotic fluid is a little low.” I looked at him blankly. He told me that the reason given by my doctor for being induced was that my fluid was slightly low. At my ultrasound the day before, I was told that everything looked great.
Either the paperwork was fudged because there was no actual, medical reason to induce me, or I was not being fully informed about what was happening with my pregnancy. Both possibilities sucked.
The rest of the day was spent waiting for someone to come and start the induction process, and listening to other women’s babies cry. I couldn’t sleep because I was sure the minute I did someone would come in to get started. I took a bath. I read a book. I tried to get the shitty hospital Wi-Fi to work. I watched Golden Girls on my laptop.
Finally around five, a doctor came in to get the show on the road. Her fingers were too short and my uterus was tipped. More waiting. Another doctor came in and, ahem, did the stuff that they do. (If you don’t know what induction involves, you don’t need to know the gory details.) I sent Mum and Ted home to get some food and sleep. They said it could take quite a while and there was no sense in sitting and staring at each other when nothing was happening.
I decided to try and get some sleep. I don’t think I slept more than an hour before my water broke. The nurse started the Pitocin drip and I started to have mild cramping. When the nurse came in to check the drip an hour later, I was still awake so she offered me something for pain.
Disclaimer: I’m all about the “just say no” but I had never taken a narcotic before, and I can completely understand why people get hooked. That shit is insane. I felt a wave of heat wash over me. I was totally whacked out. I didn’t really sleep but I felt gooood.
Eventually, I stopped feeling so good. I had been warned that inductions are often more painful than natural labour. I have a high pain threshold, so I hadn’t really been scared of the pain. Don’t get me wrong – I’d been scared of lots of things: something happening to the baby, needing my nethers stitched back together, getting an infection. But I was pretty sure that I could figure out how to handle pain.
Things got really painful, really fast. I laboured for about eight hours but nothing worked. I tried standing, sitting on a ball, rocking, massage. I barely had a moment to catch my breath. When Karen returned in the morning, I had shut myself in the bathroom and my legs were shaking so badly I could barely sit up. She asked me if I wanted an epidural. She told me that she knew I could survive without one, but there would be no medal for suffering. I hadn’t gotten more than two consecutive hours of sleep in the last two days. I could have tongue-kissed her.
I had to sit still for the epidural, which was incredibly difficult, but I experienced relief almost immediately. And then I slept. I slept for glorious hours. I wasn’t completely comfortable because of the heart rate monitor but by that point I could have slept on a park bench.
Near four o’clock, the doctor confirmed that I had not progressed past four centimetres and said that we needed to start thinking about surgery. I was disappointed, but the months leading up to that day had stripped away most of my hope already. They said they would give me another hour and then prep for surgery. My husband was upset. I feel like I disappointed him a little bit, since his other children had been natural births.
An hour later, nothing had changed so I was wheeled to surgery. Ted put on the fancy scrubs and booties and joined me. My arms were strapped down. Since I already had an epidural, they turned it up. I felt like I was a block of ice. I couldn’t feel anything from the neck down. Everyone in the operating room was very pleasant and attentive. There were a surprising number of close-talkers.
It took less than ten minutes for Nina to emerge, smush-faced and screaming. Ted got to see her first, but he brought her over to me and I got to take a look before they finished checking her over. She was healthy and perfect.
My recovery went well. I had very little pain and no infection. My incision healed very well. I was standing and walking in good time, and I got to go home less than four days later. I only saw my High-Risk doctor one more time. He stopped in for about two minutes to give me his card so I could make an appointment for my next check-up. I thanked him and he left. I went back to my regular doctor and never saw him again.
I don’t think the doctor meant to harm me while I was in his care, but he did. Not in the medical sense, perhaps, but he made up his mind about me long before he met me, and he didn’t expend an ounce of energy to do anything but belittle me. I feel like I was robbed. Of joy and excitement. But most importantly, of my dignity. And fat or not, I didn’t deserve that.
I’m not sharing this story looking for sympathy. It still hurts me to think about it, but there is nothing to be done except for me to find some way to accept it and heal. That is something I’m still working on. Having the opportunity to read lots of different kinds of birth stories, some similar to mine and some quite the opposite, I feel less alone. Maybe someone reading this will feel less alone, too.