Monday 24 October 2016

Bring back the stern doctor terrorising his pregnant patients into following a strict diet

Fiona Ness

Published 16/06/2016 | 02:30

'The maternity hospitals are right to be so concerned about it. What they need is the power – and the manpower – to do something about it.' Stock image
'The maternity hospitals are right to be so concerned about it. What they need is the power – and the manpower – to do something about it.' Stock image

No one, least of all pregnant women, enjoys being reminded of their weight. In fact, just try bringing it up, then sit back and watch as they rage into their Häagen-Dazs. But with yesterday's report that rising numbers of overweight pregnant women are risking their own health and serious complications in the birth of their child, we have at least made a start. Pregnancy, it seems, is the one area where fat-shaming is actually allowed.

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Because unless you're Claudine Keane, up until now it's been taken as a given that when you get pregnant, you've got a licence to let things slide a little. You're going to get 'fat' anyway, so you might as well have that extra biscuit. And all during a period when physical activity is becoming more and more difficult to maintain. Didn't Milla Jovovich put on three stone during her pregnancy? You can always work off the 'baby weight', afterwards.

The National Maternity Hospital has reported that more than a third of all attending expectant mothers are now classified as overweight. One-in-eight is classified as obese. The hospital's study comes after a UCC report found that more than half of Irish mothers who lost an infant in the weeks close to birth were either overweight or obese. This is hard reading for mothers who may have lost a child in such circumstances. By implication, they are shouldering some of the responsibility for their child's death. But while we're dishing out responsibility, what about the doctors themselves who didn't do a better job of managing their patients' weight?

It flummoxes me that at a time when there is a surfeit of information via the various media on what expectant mothers should eat in order to produce a healthy baby, there is also a surfeit of women ignoring all the advice. Perhaps it's because it's not really the media's place to police what pregnant women put into their mouths. The maternity hospitals are right to be so concerned about it. What they need is the power - and the manpower - to do something about it.

Back in the 1970s when my mother was going through pregnancy, it was altogether different. "This is what happens in your body when you eat a tea biscuit; so don't eat them!" the doctor would say, sternly taking said biscuit and dunking it in a glass of water while his pregnant patients watched it swell up to fill the glass. He would then dispatch his patients with their weekly diet sheets and personal weight-gain goals. My mother would trot off obediently to the newsagents to buy her allotted sugar ration for the week: a half-pound of boiling sweets. Nine months later she emerged from maternity ward four, fitting neatly into her wedding 'going away' outfit and carrying a healthy 6lb baby. (And, sickeningly for anyone who has left hospital as a new mum, but looking just as pregnant as when they went in - she did this multiple times.)

This story has made its way into legend among the womenfolk of our family: that of the stern doctor who terrorised his pregnant patients into following a strict diet which - with our current reinstatement of fat as the good guy of the dietary spectrum - proved that he wasn't just a good doctor, but must have had some sort of prophetic capacity too.

Which is why, today, with the country in the grip of an obesity epidemic, I was surprised to be told upon requesting a dietary guide from a midwife in a maternity hospital I attended in recent years, that I could eat what I liked because "the baby would take only the good stuff from it anyway". Something we know to be categorically not true.

The National Maternity Hospital, we are told, is grappling with the challenges posed by an ageing and increasingly overweight cohort of expectant mums. And these factors are raising the risks both for the women and their unborn babies. Holles Street Master Dr Rhona Mahony has warned overweight mothers-to-be have all the attendant medical risks, including miscarriage, congenital malformation and gestational diabetes.

At the same time, Mahony has raised the issue of inadequate resources being given to cope with the volume and increasing complexity of the hospital's caseload.

Giving pregnant women the personal responsibility to monitor their own diets clearly isn't working. So the medical system must have the provisions to allow them more input into the care of the women (and by extension, their unborn babies) under its care.

We could do worse than return to a time of strict dietary monitoring at primary care level for pregnant women, and for the duration of their hospital visits. I for one would champion the weekly GP weigh in - no matter how humiliating - if it hammered home the very real dangers mothers-to-be are courting with their weight. Oh, and a return to the 1/2oz allowance of boiled sweets.

Irish Independent

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