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Fat Women Give Birth Vaginally

While at first glance the title of this post might seem more like a spam ad for some weight loss product or sex site, but it's not. A recent study says that obesity in pregnancy costs more money and causes more cesareans. This is a newer, but familiar tune, one that blames the "difficult births" on the women, though this time just the obese ones.

I do admit that when I first read this report, the first person I thought of was long time activist and pregnancy supporter of overweight women, KMom. Through her Plus Sized Pregnancy site she has done more to help women have healthy pregnancies when dealing with weight issues than anyone can imagine, and certainly more than most practitioners combined.

So you can imagine how pleased I was to see her information at another great blog on this very topic. Please take a minute to stop by and read Our Bodies, Our Blog's coverage of: "Fat Women Can Give Birth Vaginally": Obesity and the Skyrocketing Rate of Cesarean Sections

By robin@birthacti... at 04/04/2008 - 11:10am | robin@birthactivist.com's blog | add new comment | email this page

Obese women are actually

Obese women are actually more prone to soft tissue dystocia than their skinnier counterparts. This can cause dysfunctional labor and failure to progres. I have seen it many times, and while the doctors that I work with are more hesitant to do sections on obese women because of the risk of wound dehiscence and infection, they will do them after about 6-10 hours of no progression. It is very sad for the women, especially those that go without epidurals for hours and hours and end up having to be under general anesthesia for the birth of their child.

By Guest (not verified) at Mon, 04/07/2008 - 1:47pm | reply | email this page

Soft Tissue Dystocia Myths

Ah, the old "fat vagina" myth. The idea is that all that fat "pads" the pelvis and prevents the baby from moving down easily, esp if the baby is big at all itself.

However, this is one of those self-perpetuating myths that care providers routinely pass on without questioning whether it's really valid. In the only study I've ever seen that actually examined the question, the researchers found NO support for the common conclusion that soft tissue dystocia prevents babies from getting out (Wischnik 1992).

However, it is true that fat women have more cesareans for non-progressive labors (dystocia). Providers commonly attribute this to soft tissue dystocia because it's always assumed that fatness is the cause of every problem a fat person has. Instead, the issue may be malpositions. Obese women tend to have more malpositioned babies (Jensen 1999). This can make for slower, harder labors. But it's not the woman's vagina that is the problem, it's the baby's position...and the providers' inability to recognize or help the baby resolve its position.

"Soft tissue dystocia" is the medical scapegoat for the high cesarean rate in women of size, and doctors (and midwives!) often suggest to women that they'll never have a vaginal birth unless they lose weight and reduce that pelvic padding. However, many many MANY women of size have been told they had a cesarean because of soft tissue dystocia or "fat vagina" and then have gone on to have a vaginal birth after cesarean (VBAC) WITHOUT LOSING WEIGHT FIRST. We see it all the time in the VBAC community. Their pelvic padding is the SAME as before, but because the fetal position is better, they have a VBAC. The issue is not a fat vagina, but the baby's position.

Fat women CAN birth vaginally. I did and so have many others far larger than I. The myth of the "fat vagina" preventing vaginal birth is just one of those unchallenged teachings that have been passed down over the years by well-meaning but unquestioning medical professionals.

kmom
http://www.plus-size-pregnancy.org

By Guest (not verified) at Tue, 04/08/2008 - 10:57pm | reply | email this page