About The Plus-Size Pregnancy Website

by Kmom

Copyright 2005-2006 Kmom@Vireday.Com. All rights reserved.  Last updated: November 2006


CONTENTS

 

Introduction

Since creating this website many years ago, Kmom has often been asked who she is, and how/why this website was developed.  This FAQ is an attempt to summarize the history of the website, why it was created, who the website is for, who "Kmom" is, and common questions about the site.  

If there is a question that you have that you do not find answered here, you may contact Kmom by emailing her at kmom@plus-size-pregnancy.org. However, please note that Kmom does not answer personal questions about herself or her family.  Please respect her privacy.  

Kmom greatly enjoys hearing from readers. In the past, she tried to personally answer every email. Now, however, due to the increasing volume of email inquiries to the website, Kmom is not always able to respond.  Even when she is able to respond, it may not always be in a timely manner.  

Please don't hesitate to email Kmom, but keep in mind when contacting her that she may or may not respond, or that her reply may be delayed significantly.  Apologies to all for not being able to keep up with everything.   

 

Purpose Of This Website

The main purpose of this website is to bring accurate and empowering information about pregnancy to women of size, their loved ones, and their care providers.  

To do this, the website focuses on 4 main components:

  1. Present accurate information and analyze the research on pregnancy and obesity
  2. Discuss proactive strategies for women of size to  have healthier pregnancies and births
  3. Present positive stories from women of size from a wide range of experiences
  4. Encourage women of size to become empowered health-care consumers

Present Accurate Information and Analyze the Research on Pregnancy and Obesity

This website exists to help answer questions about obesity and pregnancy, minus the scare tactics often seen in other resources.  It acknowledges that there are some risks to pregnancy at larger sizes, but rather than take an alarmist tone, seeks to review neutrally the research on these risks, translate the research for the layperson, discuss the results, and place the risks in proper perspective. 

While there are potential risks and some plus-sized women do have complications, many women of size have healthy babies and pregnancies.  This is not the image of plus-sized pregnancy usually found in the media, and it is important to acknowledge the positive stories and outcomes too, something few other resources really do.  

Discuss Proactive Strategies for Women of Size to Have Healthier Pregnancies and Births

This website also analyzes the research and anecdotal experiences of women of size for possible preventive measures for improving outcome and having a more empowering birth. Contrary to the beliefs of many providers, there are strategies for lessening risk that involve more than just dieting, and many of the interventions commonly used to "lessen" risk actually increase risks instead.  This website looks at common interventions and strategies to see whether they really decrease risk, discusses ways for women to be proactive about their health, and examines the experiences of women of size to find what helps women have a positive birth experience.  

Present Positive Stories of Women of Size From a Wide Range of Experiences

The birth stories of women of size are an important part of teaching and inspiring other big moms.  Thus, a large part of this website is devoted to telling the stories of plus-sized women and their journeys to motherhood.  This includes a wide variety of births, from highly interventive to completely natural, from births with complications to completely normal births.  While Kmom has strong opinions about birth issues, her purpose in these birth stories is not to endorse or promote any particular type or place for birth, but merely to portray the many different types of birth experiences of women of size.  Reading a wide variety of experiences can help newly pregnant big moms see what is possible for them and make decisions about the birth choices available to them.  

Encourage Women of Size to Become Empowered Health-Care Consumers

This website actively seeks to empower women of size.  For too long, women of size have been subjected to a poor standard of care, often enduring mistreatment by hostile or ignorant care-givers, and misguided bias from families and friends. This website encourages women to empower themselves, to seek size-friendly care, to learn how to stand up for and advocate for themselves, and to become informed and empowered healthcare consumers.  Detailed summaries and research references are given whenever possible so that women can become partners in their own healthcare decisions.  

 

Is This Website Only For Plus-Sized Women

In becoming a childbirth educator and through her work researching pregnancy and obesity, Kmom has learned a great deal about pregnancy and birth issues in general.  In her research she has noted a great need to "translate" the scientific research for the layperson, especially on certain controversial topics. Thus the website is for both larger women and women of average size.   You will note that the website cover page explicitly states:  

Empowering Information for Women of Size----- and Women of All Sizes.

Although the website will primarily contain information pertaining to larger women, it also contains a great deal of helpful information for childbearing women in general.  Issues such as prenatal testing, cesareans, VBACs, and gestational diabetes affect all sizes of women.  The point of the website is to empower yourself through detailed information, so that you can be an informed consumer and participate in your own healthcare decisions.   There is no reason to limit such information only to plus-sized women.  Kmom welcomes women of all sizes to this site and hopes it will be helpful to them as well.  

In the future, Kmom hopes to add detailed resources for healthcare providers (doctors, midwives, doulas, etc.) to help them understand and better serve women of size, as well as research summaries on further controversial topics to better serve all childbearing women.   

Many doctors, nurses, midwives, doulas, lactation consultants, and other medical professionals visit this site regularly and offer input or ask questions.  Kmom looks forward to continuing a dialogue with them and expanding the materials useful to them.  

 

Who Is Kmom

I (Kmom) am a certified childbirth educator and long-time activist in the size-acceptance community.  In addition to my childbirth education work, I am currently a full-time mother and part-time freelance writer.  I also speak periodically at conferences and workshops on various pregnancy-related topics.

I have 4 children, ranging from school-age to very young.  Their pregnancies and births have varied immensely in scope and experience-----from traumatic cesarean, to empowered cesarean, to induced VBAC, to natural waterbirth VBAC. I have experienced a wide variety of quality of care, from mistreatment by fat-phobic care providers to loving enthusiastic support from size-friendly care providers. This gives me a wide range of experience to speak from and a unique variety of perspectives to consider.   

As a result of my own experiences, I am quite active in the VBAC movement to help keep Vaginal Birth After Cesarean (VBAC) as an option for women everywhere, and to lower the primary cesarean rate whenever possible.  Obviously, this influences my opinions. However, I am not against all cesareans or all technology.  I don't believe there is any one "right" way to give birth.  I believe in women educating themselves and deciding (in partnership with their caregivers) exactly what birth choices are right for them.

I am NOT a medical professional and I do not give medical advice.  Although I have done a great deal of research into pregnancy-related issues, I do not pretend to be a medical expert.  As noted, this website is simply health information BY consumers, FOR consumers.  I try to make a point to offer more than one side of a healthcare controversy whenever possible, and to cite extensive research sources so that readers can go on to further their own research. I feel free to give my own opinion, but I try to label it AS opinion, while also discussing the risks and benefits of various choices.  

My hope is that women of all sizes will inform and empower themselves about pregnancy-related issues through the website, and that care providers will have access to more neutral and well-balanced information about obesity and pregnancy, as well as pregnancy controversies in general.

 

How Did This Website Develop

This website was started from material originally collected and created in 1995.   It has been continually updated and added to since that time. Please note, I have a copyright on all materials.  No reprints are allowed without specific permission, except as noted.  

In The Beginning....

I began my website after experiencing a difficult pregnancy and birth with my first child, one in which there was NO information for me about being plus-sized and pregnant, one in which I had NO idea of what to expect at my size, one in which I experienced a great deal of UNNECESSARY intervention and hassle about my size, and one in which I could find NO maternity clothes in my size.  I was completely frustrated by the lack of information about what to expect as a larger woman, with very little information available even from my doctor.  My co-workers suggested that I needed to research and write a book on the topic, a suggestion I laughed off at the time.  However, the seed was planted......!

In that first pregnancy, I was treated like a disaster waiting to happen.  Some providers were nice and some were not, but they all treated me like a walking time bomb until it became a self-fulfilling prophecy.  Before the pregnancy I was a woman who was at peace with my size, in good health, and experienced in dealing proactively with care providers.  But because I had no information about what to expect in a pregnancy at my size, I suddenly became gullible, able to be manipulated into every intervention in the book out of fear of "what-ifs."  The overuse of technology and testing made for a very difficult pregnancy, labor, and cesarean experience. The good thing was that it was such a negative experience that I was highly motivated to find a different path for subsequent pregnancies.

I began to do research about pregnancy at larger sizes. At first it was simply finding maternity and nursing clothing in larger sizes for myself, but eventually I created a Frequently Asked Questions (FAQ) resource on finding maternity and nursing clothes in plus sizes.  I emailed this FAQ in various editions for a while, but it soon became too unwieldy to email easily.  An online acquaintance suggested that I create a website for it.  After some resistance, I finally started the Plus-Size Pregnancy Website with the help of my husband.  

The Website Begins

At first, the website was mostly about maternity and clothing questions, but I also added hints I had learned about nursing when well-endowed, shared my experiences about pregnancy at larger sizes, etc.  These were in answer to questions that typically came up when emailing with other larger women, so I started collecting, consolidating and rewriting my emails to create more Frequently Asked Question articles for the website.  

I also began to research pregnancy issues, especially gestational diabetes, since this was the source of a great deal of the intervention and problems in my first pregnancy.  Through a friend, I was introduced to the writings of Henci Goer, a childbirth educator, doula, and impeccable researcher who used the medical literature to question the prevailing thinking on Gestational Diabetes.  Through her writings I began questioning the treatment protocols from my first pregnancy, and began believing that things could be different next time.  

I began to learn how to read the research and examine it critically.  I made my way to my local medical library and the wonderful librarian there began to show me how to access the medical literature on- and off-line.  As I began reading it, I was shocked to learn that there was actually very little medical "consensus" about the proper treatment of certain care issues and in fact, a woman might receive TOTALLY different obstetric advice from different medical practitioners.  At the same time, I heard women online with similar situations being given completely conflicting advice, all presented as the "right" way or the "only safe way" to proceed. How could the doctors always be right when they couldn't even agree amongst themselves? This was a real revelation and confirmed to me the importance of questioning care protocols instead of blindly accepting whatever the doctor said.

I saw this disagreement between caregivers in action when I switched care providers. When interviewing,  I received many different recommendations on how my pregnancies "should" be handled.  Eventually I realized just how different my births could be, depending on which care provider I chose and which interventions I agreed to or avoided.  It was not just about what complications did or did not occur during pregnancy, it was also largely about the beliefs, interventions, and routine protocols of the care providers, and these differed vastly from one provider to the next. 

This was an amazing eye-opener.  It meant I had choices.  And it meant that I had a responsibility to research the issues so I could help choose the wisest course for myself and my baby, not simply choosing a doctor because he was located nearby or didn't yell at me about my weight.  It gave the responsibility for my pregnancy and my choices back to me.  I found that tremendously empowering.

In the middle of my second pregnancy, I switched from the medical model to the midwifery model of care. However, despite gentle and proactive care (and no recurrence of the GD!), this pregnancy also ended in a c-section because the baby was in a poor position for birth.  Even so, it was a much more respectful and caring experience, and some of the trauma from my first pregnancy began to ease.  Still, there was a lot to process.  I realized I needed to do a lot more research into the physical aspects of pregnancy (like fetal malpositions) and also processing the emotional trauma from my first birth.  

The Website Becomes More Research-Oriented

Between my second and third children, I continued to research pregnancy issues.  I went beyond "obesity in pregnancy" and "gestational diabetes" issues and began also to research fetal malpositions, Cesareans, VBAC, and many other issues.  I began to collect huge files of medical studies that I pored over and analyzed.  I learned more about understanding and interpreting medical research, I attended workshops and conferences to learn more about pregnancy issues, and I read a wide variety of pregnancy books to sample varied approaches to birth. Eventually, I began my certification as a childbirth educator.  

This led me to expand the scope of the website. I felt it was not enough for me to make short summaries of the issues like so many other websites. I felt strongly that too many pregnancy resources were simplistic and patronizing, as if pregnant women could not understand the research studies or the issues.  Just because  a woman is pregnant doesn't mean her brain has stopped working.  Something different was needed, something that presented the research intelligently and let women make their own choices.

But most women did not have access to the data or any experience in interpreting it. So I began to "translate" and summarize the research for the layperson online so that they could further understand the care decisions that were being recommended to them. I tried to present more than one point of view so women could see multiple sides of an issue before making their decisions, and to thoroughly document my references and resources so that women could research further if they so desired. This means that my articles are more in-depth (and way longer!) than those you find on most other websites.  I view this as an advantage, but not everyone does!  Still, I feel such detail is an integral part of my purpose now.   

I also deepened my research to encompass not only the physical aspects of birth but the emotional ones too.  My certification process as a childbirth educator (in a program more demanding than most) not only helped me deepen my knowledge of the physical aspects of birth, but also helped me recognize the importance of emotional preparation for birth too.  I began to see pregnancy and birth as a true mind-body experience----and not just the mind-body experience of one person, but of two people in one, the mother-baby dyad. I came to believe that both mattered deeply, a radical idea in some circles.  

I also came to believe that birth could be about both the process (giving birth) and the product (the baby); that birth was not simply something you had to endure to get the baby, but that the process could be healing, positive, and powerful.  I believe strongly in the process of birth as a sacred and empowering part of the arrival of a new life.  

Advocacy Comes Into The Picture

I went on to have two more babies after my cesareans, both VBACs.  Through these births, I learned so much about how birth could be but so often was not. I got involved with pregnancy advocacy in size-acceptance groups and other types of advocacy in childbirth groups.  I was occasionally interviewed for magazine articles about plus-size pregnancy, and expanded the scope and depth of the articles on my website as I had time.  

At the same time, I was distressed and angered when hearing the birth stories of other women of size in online support groups.  So many were not treated with respect, and so few were "permitted" to have normal labors and births.  Extreme intervention was the rule, even when not needed in any way.  And so few women questioned their care or their treatment, meekly accepting what they were told they had to endure in order to have a baby.  I was appalled at the state of birth for obese women in this country.

I knew from my own experiences that birth didn't have to be this way for obese women. So I began speaking out on the inhumane treatment of fat pregnant women, questioning the assumptions and mindsets of typical care protocols for obese women, and making sure that women of size knew that they had choices too.

I also began writing articles and speaking at conferences.  I began by educating others about plus-size pregnancy in general, then branched out by discussing VBAC and cesarean issues too.  Eventually I was contacted for more information on these topics by doulas, midwives, and even doctors.  I began to be asked to speak at many types of conferences, including size-acceptance, VBAC, childbirth education, and midwifery conferences.  I speak not only on plus-size pregnancy but also on other birth and care issues.  In the future, as my children grow older and more independent, I hope to write and speak even more often.   

A Work In Progress 

 My goals for the website are lofty, but alas, my feet are made of clay.  

I have a vision of what I want the website to be, and I have put a great deal of work into that goal.  I have collected file cabinets full of research on many topics, written many articles for the site, and have many more "in progress."  

However, I am also a full-time mom of four children.  My youngest child is still very young and demands my full attention. And I have many other commitments to other causes, to members of my extended family, to my children's schools, etc.  That means that my time for working on the website is limited.  And it means that my work on the website falls far short of my vision at this time.   

There are many FAQs and articles on the website.  It has proven difficult to keep them all as updated as I'd like while also taking care of my family, volunteering for various causes, researching new FAQs, speaking at conferences, and writing articles for journals and magazines. Because of all my commitments, I do much of my work in the middle of the night, which of course limits my output, since you can only do so much of that and stay healthy!  

So I have come to an uneasy detente with the knowledge that I can only do so much at any one time and that for now, my family must take priority.  In time, I will be able to devote more attention to the website and continue all that I have set out to do. 

Therefore you will find this website a "Work In Progress."  FAQs and articles do get reviewed and updated periodically, but there are many waiting in the queue for revisions.  I generally update the website about 1-2x per year.   However, because life is not always cooperative and family emergencies do arise, some years are more productive than others, and sometimes there are big gaps between updates.  I ask my readers to be patient if waiting for a new FAQ or an update of an old one.  

When I do update the site, I concentrate first on updating new Birth Stories, to honor the moms who have unselfishly agreed to share their stories to help inspire and teach others.  I update the maternity clothing FAQs about once per year so that women can accurately find maternity-related items in their size.  I also try to research one or two big new articles per year and update as many older ones as I can realistically fit into my schedule.

The older material on this site includes the Breastfeeding When Well-Endowed FAQ, the Gestational Diabetes information, as well as the morning sickness, due dates and birth defects information.  Some of this has been updated, but some of it has not.  Some needs editing for style and brevity, and new references need to be added.  While some of these revisions are in progress, others will have to wait.  I have kept these older articles available despite this so that others may have access to the information, but please keep in mind that revision on this material is due.

My concentration recently has been on researching prenatal testing, reflecting my own pregnancy journey as an "older" mom.  Cesareans and VBACs also receive a lot of attention from me because of the research I did while making my own decision about VBAC after 2 cesareans.  Furthermore, because I found "alternative" medicine to be very helpful to me in my health journey and I get a lot of questions about it, I am in the process of adding new articles on it too. 

Other topics pop up via discussions on big mom or cesarean online support groups, or via questions that are emailed to me by readers.  I am always open to suggestions for further topics, and I occasionally make my website available for a "guest column" from someone who has a unique perspective to offer on a particular topic of relevance.

In time, I will write a book about plus-sized pregnancy, a frequent request from my readers. I have already begun the book, but my decision to have a fourth child and the health crises of extended family have put off its production for a while.  Stay tuned to the website for more information and updates!  Eventually, my co-workers' suggestion years ago that I should write a book about plus-size pregnancy will come true after all!

 

What Is Size Acceptance

Readers will notice that I have an unusual approach to obesity and pregnancy compared to most websites.  Instead of "gloom and doom" scare tactics and lectures, I prefer to emphasize a positive approach, with realistic looks at the risks but also at the success stories and happy outcomes.

Most websites on obesity and pregnancy publish distorted risk summaries, highlight only the studies with the worst outcomes, tell worst-case scenario stories as if they were everyday events, and imply that complications are inevitable for all fat women.  Some even suggest that obesity during pregnancy is akin to child abuse.  Not coincidentally, many of these websites are published by weight-loss surgeons, diet companies, or people with weight-loss agendas.  Others are published by a medical community (many of whom have ties to the weight loss industry) that has embraced the demonization of fat people.

What women of size need is more balanced information.  They do need to understand possible risks of pregnancy at larger sizes, but they also need to place those risks in perspective and know that many women of size HAVE had successful, healthy pregnancies and births.  They need to know that being at risk for a complication does not mean it will automatically happen, and that many women of size never experience complications at all. Conversely, they need to know what their choices are if complications do occur; that complications don't always have to mean high-intervention or traumatic births.

On my website, I focus on presenting normalcy, promoting proactive health behaviors, and promoting empowerment about healthcare choices.  I try not to downplay possible risks, but instead give women realistic assessments of those risks, what the research says about them, and how to lower/mitigate these risks.  This is an area I plan to expand on in the future.  

I also present honestly the wide variety of experiences of big moms, from completely normal pregnancies to those with complications; from emergent cesarean births to completely natural vaginal births----and every variation in between.  

THIS is what big moms want-----honest, accurate information without scare tactics and judgment, with plenty of real-life stories from REAL big moms.  THIS is what this website is all about.

My approach is different because I am a long-time member of the "size acceptance" community.  I have been a member of NAAFA (National Association for the Advance of Fat Acceptance) for many years and have been an activist for size acceptance in many ways.   Naturally, this background influenced my approach to pregnancy as well.

The idea of size acceptance and the "Health At Every Size" movement is to accept yourself and your body the way that you are NOW, to emphasize good healthy habits in nutrition and exercise without being rigid or restrictive, and to work for a stable weight and better fitness instead of for weight loss as your primary goal.   It recognizes that dieting and weight cycling often has more risks than maintaining a higher but stable weight.  It de-emphasizes the number on the scale in favor of how you FEEL and how you ACT---your overall health and fitness.

Size acceptance recognizes that some risks may be associated with being fat, but knows that it is more difficult to discern the exact relationship between weight and health than authorities want to admit. Size acceptance recognizes that fatness is not just about intake and output, but also about genetics, metabolism and setpoints.  It recognizes that some people are never going to be "normal-sized," no matter what they do----and that forcing them to try to be "normal-sized" often causes more harm than good.  Size acceptance recognizes the significant harm that comes to many people from long-term dieting behaviors and yo-yo weight patterns. It dares to question the standard medical belief that weight loss is always the answer, and that dieting/weight loss is always beneficial and desirable.  

Size acceptance also emphasizes empowerment and intelligent healthcare consumerism at any size.  Activists know from personal experience that many people of size are discriminated against and mistreated by healthcare professionals, and that this can have many harmful outcomes.  We believe that ALL people----including people of size-----have the right to respectful, dignified, and fair care, and the right to determine their own healthcare treatment choices.

Size acceptance is not "giving up" or "letting yourself go" as some people believe; it's emphasizing good health NOW in the body you have NOW, without necessarily tying that to weight loss. It's accepting and loving yourself the way you are NOW, while still working on improving health and habits as needed.  It's giving yourself permission to live fully regardless of your size, to embrace life and happiness and feeling good about yourself with gusto and joy.

Size acceptance is about loving the body you were given; it's about being as healthy as possible in the body you were given; it's about the right to positive, loving care; it's about empowerment to make your own choices; and it's about standing up for your rights to pursue your dreams, no matter what your size.  And those dreams should include pregnancy, birth, and parenting too!!!

[For more information about Size Acceptance, click here.]

 


Copyright 2005-2006 Kmom@Vireday.com. All rights reserved. No portion of this work may be reproduced or sold, either by itself or as part of a larger work, without the express written permission of the author; this restriction covers all publication media, electrical, chemical, mechanical or other such as may arise over time.


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