To My Midwife, from Your Plus-Size Patient
A friend of mine sent me this letter awhile back, asking for editing and proofreading help. Reading it was like being punched in the gut. When I wrote her back, I asked if I could publish it here. All of us need to hear her message, not just those in the healthcare industry.
I was a patient of Dr. F’s over seven years ago, and you were part of my maternity care when I was pregnant. On March 3, 2006, I delivered a beautiful, healthy boy.
I have reflected often and with gratitude on that day and the care I received from the doctors and nursing staff in Dr F’s practice and at the hospital. However, one health provider especially stands out in my mind—you.
I first came to Dr. F with apprehension because of my weight. Because of this anxiety, I interviewed several OBGYNs in the area prior to choosing one with whom to entrust my care. I chose Dr. F because he assured me that the only thing that mattered to him was whether my baby and I were healthy.
Dr. F never once made me feel uncomfortable or self-conscious. He went out of his way to treat me with kindness, understanding, and caution. He never once blamed my obesity when he couldn’t hear the heartbeat on the Doppler, though we both knew my weight was the reason. He answered all of my questions thoroughly and put me at ease during my pregnancy, especially during an early scare. He was one of the best doctors I have ever had the privilege of knowing.
My experience with you stood in stark contrast, however. I always felt extremely nervous with you, like I was doing something wrong. I questioned many of the things you said to me, but I ignored them and tried to brush them off –– until the following year. When you called me with results of some well-check tests, I realized that it wasn’t me, but you who had a problem.
As an expecting mother, I had many questions and concerns about my pregnancy. Unlike Dr. F., you dismissed many of them, often making comments like, “Well, of course you are going to experience that. You are a larger woman.”
When I came to you in my 35th week complaining of severe abdominal pain, you did not examine me. Instead you sat in front of me, ignored my pain and symptoms, and stated, “The baby is just finally crowding you.”
But the baby wasn’t crowding me. The next day, I went to the hospital because the pain was so unbearable. Blood tests and an ultrasound revealed that my liver was swelling due to the toxins filling it, and my blood count was dropping precipitously. The yellowness in my eyes and skin was jaundice. I was diagnosed with HELLP syndrome and admitted, and my baby was delivered within hours. The doctors later informed me that if I had waited a few hours longer, I would have been in a coma or dead.
When I returned for my postpartum checkup, you ran into me in the hallway. Instead of greeting me, you said curtly, “I guess you gave us a surprise.” You never apologized for blatantly ignoring my concerns or my pain.
A year later, when my triglycerides were high, you called with the results. Because I had never heard the term triglycerides before that day, I asked you what I needed to do to lower them. You snarked again: “Stop eating chicken skin.”
You were dismissive, rude, discriminatory, and unapologetic in your neglect of me. But because you were the healthcare professional, I trusted your judgment. I didn’t take my symptoms seriously because you told me I was overreacting. Your approach to me made it impossible to ask questions or share concerns. It almost cost me my life. That is the reason I’m writing.
I am not writing to condemn you. I am writing to make you aware of something very important. You need to understand who plus-size woman are. We are human. We are someone’s daughter, wife, mother, and sister. We are professionals contributing to society. We donate our time and efforts into helping those around us. We are mothers-to-be, who hope we can fulfill the role of mommy and do it well. We worry about and celebrate our baby’s life.
Like all expectant women, plus-size women experience the ups and downs of pregnancy. We get nauseous, experience new scents we have never known, feel our baby move, and yes, we get cravings. We freak out when things don’t feel right, when we don’t feel the baby moving, or when we experience symptoms that are painful or scary.
We walk into the doctor’s office knowing that we are obese. We know that it’s a health risk. We know that we should have lost weight before becoming pregnant. We have serious regrets about that. But in spite of all that, we are carrying a human life. We are in awe that our bodies did what they were created to do, in spite of our human failures.
I imagine you are a much different woman than the one you presented to me. Your online profile states, “The word midwife nicely sums up J’s philosophy of care. It means ‘with woman.’ She believes in listening to women, offering them information for making informed choices, supporting those choices, and encouraging women to be partners in their healthcare.”
In spite of this, you failed to treat me like other women in your practice. For whatever reason, you did not connect with me as a human being and as a woman. You didn’t listen to my concerns or consider how your words and body language would hurt me. In your failure to remember my humanness, yours was painfully apparent.
Please consider your bedside manner the next time a plus-size woman walks into your office. Consider, for a moment, that she has feelings and see her for who she is. See her as a woman trying to experience joy in bringing new life into this world. Walk beside her in her pregnancy. Listen to her complaints, encourage her and tell her how the baby is doing, share in her joy and in her fear. Let her know that her pregnancy is beautiful. And if you are concerned about her life choices, be kind with your words and express them as if you mean the best for her, because you want her to experience life fully and abundantly.