Episode 21: Fat and Fertile with HeavyWeight Midwife
Episode Summary
In this episode of Fat and Fertile, I’m joined by the brilliant Dr. Alice Keeley – also known as The HeavyWeight Midwife. Alice has over 20 years’ experience as a midwife, completed a PhD on plus-size pregnancy care, and is fiercely committed to challenging the weight stigma baked into our maternity systems.
We get stuck into the reality of being pregnant in a bigger body – from being weighed without consent at booking appointments, to automatic referrals that leave people feeling confused, judged, and “high risk” before anything’s even gone wrong. Alice breaks down how these moments impact care, and shares her passion for creating a more personalised, compassionate, and evidence-based approach to pregnancy support.
We also explore Alice’s own journey – how her background in social justice shaped her care values, how she came to launch The HeavyWeight Midwife in 2022, and why she believes confidence and communication are essential for navigating pregnancy with autonomy and self-trust.
In this episode, I talk about:
Why BMI-based guidelines don’t tell the full story
How weight stigma shows up in maternity care (and what to do about it)
What’s actually useful to know about risks in plus-size pregnancy
How to advocate for yourself at appointments – even when it feels scary
Why scans, referrals, and medication should always involve informed consent
The surprising role that things like wind and tissue density play in ultrasound scans (!)
And why water birth access is a fat-positive issue we should all be talking about
Alice also shares how her online community and trimester-by-trimester courses are helping thousands of people feel seen, supported, and prepared for pregnancy and birth on their own terms.
Links and Resources
Email me: nicola@nicolasalmon.co.uk
Find me on Instagram: @fatpositivefertility
My book: Fat and Fertile – available via Amazon
Alice’s website: theheavyweightmidwife.com
Connect with Alice on Instagram: @theheavyweightmidwife
Find Alice’s support programmes and membership via her website
Listen to Alice’s podcast: The HeavyWeight Midwife Podcast
Get Involved
Nicola would love to hear from you! If this episode resonates, share your story, ask a question, or leave a review.
Support the Podcast
If you’re enjoying Fat and Fertile, you can buy me a coffee here to or share this episode on your favourite social media platform. Every share helps make this info more accessible to everyone who needs it.
Follow Me on Instagram: Join me here for fat-positive fertility tips, updates, and encouragement.
👉 Explore all these resources here and take your first step toward parenthood without stigma or shame. I’m cheering you on every step of the way!
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Ep21 - Fat and Fertile with HeavyWeight Midwife
Speaker 2
[00.00.03]
Hey my lovely. Welcome to Fat and Fertile, the podcast. I'm Nicola salmon. Pronouns. She and her. I'm an award winning fertility advocate and fat positive fertility specialist, and I am so passionate about supporting fat folks who feel excluded or dismissed by traditional fertility spaces. On this podcast, we'll tackle weight bias within the fertility industry. We're going to explore how to navigate your fertility journey without diets, shame, or stigma, and empower you to trust your body and take control of your reproductive health. If you're looking for more support, be sure to download my free Fat Person's Guide to Getting Pregnant. Or join my Coffee community. It's a space for fat folks to connect, share, and find compassionate support. You'll find all the links in the show notes. I'm so glad that you're here. I'm in your corner, and we've got this together.
Speaker 1
[00.01.07]
Welcome to another episode of Fat and Fertile. Today I am so chuffed to be introducing our brilliant guest, Doctor Alice Keeley. Although you might know her better as the heavy weight midwife, Alice has spent over 20 years supporting pregnant folks and her role as a midwife with a special passion for helping plus size folks. She completed her PhD looking specifically at plus size pregnancy care, and set up the heavy heavy weight midwife in 2022. What makes Alice so special is her belief that pregnancy care should be personal, and not just a bunch of rigid rules. We are so lucky to have her with us today. So without further ado, let's chat with Alice. So today I'm so excited to welcome Alice to the podcast. Me and Alice have been
Speaker 2
[00.02.00]
talking ever since she started her business. Um, called The Heavyweight Midwife in 2022 and I am so thrilled that she is doing this work because it is so, so needed. Thank you so much for joining us today, Alice.
Speaker 1
[00.02.15]
Hello. Thanks for inviting me, Nicola. It's it's nice to be here. Thank you so much. I'm really excited.
Speaker 2
[00.02.21]
So I was just saying before we hit record that I don't know tons about, like, what got you into this work, how you started. I would love to hear more about your whole life story that got you to helping support plus size folks, um, in pregnancy
Speaker 1
[00.02.36]
as well. Then I'm 51 now, so, you know, I'm gonna have to give you a quiet version because there's quite a lot of life behind me already. Um, so, uh. Yeah. So I've been a midwife for 20 years. And I guess a couple of things sort of underpin, uh, what kind of, um, maybe made me sort of approach a paradigm that I've got to, to care. One is that, um, my family background is very much around kind of social justice, and they are quite a political bunch. So there's sort of fairness and, and, and, and, and and speaking up for people, I suppose was sort of instilled in me. And I guess I didn't really realize I took it for granted a little bit and didn't reflect until sort of later, until I was a proper grown up, really. And then the other thing was that when I was so qualified as a midwife is sort of like mid 20s, and I was I worked in London and I trained in London and worked in London, and one of the very early jobs I had was at one of the big London teaching hospitals, and I worked in a complex care team. I think that that that's all that all that sort of branding there stayed with me because the midwives and all of the specialist consultants that we worked with were just all so brilliant in terms of, um, the way they communicated with women and the way that they didn't lose sight of the uniqueness of each pregnancy And the way that things weren't divided into a binary kind of high risk, low risk, um, categories. And so those two things really sort of combined. Um, and that was a really good grounding. And it's also always made me because I've worked with such brilliant doctors. You know, when I, when I work I'll come across doctors or hear things about what doctors say, which happens to me daily in my work as a head midwife. It sort of makes me feel even more passionately that that just is not good enough, because I've worked with the really good ones. You know,
Speaker 2
[00.04.37]
that's like,
Speaker 1
[00.04.38]
right. Yeah. But, you know, I'm absolutely in awe of the brilliant doctors that I've worked with over the years. And, and, and unfortunately, there are some that need to do, need to do better. And so then I, uh, I relocate to Scotland. Um, so yeah, that was that was it was a man. It was all the midwives and all the work. If it were from that area not long ago. How did you end up here? It was. It was because of the man
Speaker 2
[00.05.11]
it was on.
Speaker 1
[00.05.13]
I'm still with that man. So it was worth the move. Um, and then I, um, got the opportunity to work in clinical research, and that was specifically looking at the size of pregnancy. Um, so I worked with, um, the doctor who wrote a team that wrote the current guidelines for the Royal College of Obstetricians and Gynecologists that, um, care of plus size of plus size of women in pregnancy. They use the L word in those guidelines. So my boss rewrote those guidelines. Um, and there was a clinic that I set up and ran alongside the rest of the team there, which was which invited women that had they been elected at 40. And I'll just come on and have their, their pregnancy care. And also they're invited to take part in kind of nested research studies. Okay. And I've just got really interested at that point in what, what women's experiences were going to clinic of having the additional care. Well, you know, whether going to a specialist clinic is a good idea at all. Um, oh, just lots of questions popped up into my mind. Um, and so and eventually I got, I got this funding to do a PhD, and, um, I did that about what is it? It's been it's it's really, um. A lot of it is around, as you would imagine, some sort of stigma risk. Um, and the more I found out about the actual stats around risk and the evidence around risk. Oh, yeah, it's just endlessly fascinating, isn't it? So it's wild. What a different let's do what a difficult experience it is. And, and then sort of navigating the evidence and then, you know, navigating a huge system which is the NHS in this country and a huge and complex system and overstretched system and are the individual practitioners within it, you know, some of which are great, as I said, and some are not. Yeah.
Speaker 2
[00.07.19]
I love humans, right. Like some are really good at their jobs. Some
Speaker 1
[00.07.22]
people aren't. Um, so what was
Speaker 2
[00.07.24]
the biggest kind of takeaway that you took from your PhD project? What was was there anything really surprising about it? It was the only thing that really stuck with you.
Speaker 1
[00.07.33]
Um. Oh, gosh. Well, I mean, I, um, yeah, I suppose I think it's just that there's a. And it's the gap that I've been trying to break, I suppose, ever since. Is that, um, I think that what practitioners do, because I feel like there's a very small minority of practitioners that are just horrible, worried about, you know, just, you know, and you hear about is the outrageously awful consultations or the sort of really inaccurate, um, figures of people that, you know, people are told they're going to die or the baby's going to die or just dreadful. You hear those those people in the minority, you get some people that are, um, as I say, just wonderful or great at communicating. But I think there's a, there's a there are a lot of healthcare practitioners in the middle who are well-intentioned, and they actually don't wish to, um, cause any harm, um, or humiliation or stigma for anyone. Um, but nevertheless, I do do that. Yeah. I think that there's, there's a gap between, um. I think that I think I think there's there's just this there's a lack of open communication. I think that health practitioners, but also the women that I work with in that women's rights, that that's what I, I try, I try to get them to be on the front foot with that. So you, you can take control of you and you can ensure the communication, um, happens in a better way or, and, or you can ask for what you want. Because sometimes health care practitioners are misguided, and they think that you don't want to talk about your health or that you don't. You know what? And what they also like. What they also fail to do often is just, um, by not acknowledging that there is weight stigma, you can't sort of neutralize it. You can't offer your support, that you can't tell someone that you're on their side. You can't tell someone that that's not good. You're not that type of practitioner, that you are going to support them, you know, by staying silent. Um, it causes confusion and it causes humiliation sometimes. But, um, it also is a missed opportunity for healthcare practitioners who, um, who, you know, who want to, to to give the best care. Yeah. And
Speaker 2
[00.10.01]
I think for some practitioners, if they've not had any training or they've not been taught how to have those conversations, well, then they can be, you know, I'm sure about how to navigate that without just focusing on dieting or weight loss. And they can. You know, I think there is a lot of training or a lot of support that sometimes these practitioners need because, you know, they live in the same world we do. Right? Like it's filled with now weight loss injections, dieting, you know, like all of these
Speaker 1
[00.10.28]
expectations and tick boxes that
Speaker 2
[00.10.30]
they've got to fill in about, you know, have you asked somebody their weight like, have you checked this box. They'd be on my box. So I think yeah, there's definitely a lot of systemic stuff that needs to change. Isn't there to order to support the practitioners being able to do that better for their patients?
Speaker 1
[00.10.45]
Yeah, yeah. I'll give you an example of of what really happens, um, when when someone goes to they're booking an appointment. So they think, okay, when that's going to happen somewhere between 8 and 12 weeks, usually like 10 to 12 weeks. Um, and what what will happen there is that the midwife will want to calculate your BMI, so they'll she'll probably want you to be weighed in the clinic. Um, and then but, but she may just take a self-reported weight from you. So there's a whole, there's a whole lot of stuff that I do around being weighed and, and the kind of that that's really not a routine thing for lots of people. It's really it's a really difficult thing, but it's really it's very routine. And, you know, might be proposed to take place in a waiting room or a corridor or in front of people and all that awful kind of stuff. And that the midwife will calculate the BMI. Um. Oh, she certainly wants to calculate the BMI, because what she wants to do is, um, categorize you. And then possibly what she should do then is offer you a referral. And what tends to often happen is, um, so if your BMI is calculated above 35, the guidelines say that you should be offered a referral, um, to have an appointment with an obstetrician at some point during your pregnancy. So in practice, what often happens is that that is not an offer. It's just done. Yeah. And it's and it's often not done with it's often done with no discussion. So what I often see in my community. So I have this community of thousands of women. And it comes up so often that, um, somebody will be trepidatious. I'll be, you know, dreading even their midwife appointments, um, wondering how that's going to be. Um, and then everything sounds really, um, straightforward. And, you know, the midwives didn't didn't even mention my BMI. Um, just calculated it, wrote it down. And then a week or so later, an appointment comes through, um, and it and it's full. It's. It's to say it's going to be an obstetrician. Yeah. And, um, it probably won't be clear from that letter. That's what it is. That is what it is. But it'll probably say in outpatients that, you know, like or trust. Um, and to see doctors see this doctor. So it's not explained because the communication there is set up for it to be clear, for the trust, for the hospital, not strictly for the wants to know what's going on. Yeah. So, um, then the then they go. Yeah. So then they go along to the appointment thinking, I think this is what so is it. Suspicion is this way. Not sure. Um, and and actually sometimes for the doctor as well on the other side that they're looking at their screen, they start to walk into the room and they're sort of doing here because they've got a higher BMI, but and lots of decisions. Well they lost, you know, that's that doesn't you know I'm not going to do anything here. I'm going to have a little chat about, you know, how the how's the appropriate office of. Screening be made, etc. but I don't need to do anything. So it's all a little bit of a jumble and it's a really sort of an unsatisfactory start. Yeah, it's about what I feel passionately should be, you know. Not everybody does get to see the same midwife all the way through. They said when you go along that booking a long booking appointment. It's just it's it's a big day. It's important. And if you then get later you get that. But you feel like, oh, so we didn't discuss my BMI, but she was thinking, I've got I've got a referral because I'm high risk. But well, you know, why wasn't it raised while it wasn't because it's such a missed opportunity, it just wasn't that open communication and, um, offer support. You know, that partnership and just offer reassurance. You know, I teach and lecture these days, and I teach. Teach? Um, she was a teacher, midwives. And I always emphasize. And then you're told by the guidelines that you're supposed to talk to them about all the risks associated. With being plus size of pregnancy. Right. So that's that's what the instruction is when when they come on the book, it's just it's just it's just so unhelpful. It's dangerous and damaging. I'm not going to sit down and do that. And and oh, it's obvious to me that women. Well what do you do when you find out you're pregnant? What do you do? You just, you know, it's a few weeks later. You can do anything about that. You know, like if you wait for your, you know, midwife book and you start googling social media, googling. So, yeah, so when you get to the appointment, you just there's questions and there's what? People are really worried. Usually they're really worried or confused are just overloaded with information that they found unfiltered sources, conflicting sources. Do you worry about health? You are a qualified health professional about practices, evidence based medicine. Yeah, that is what your job is to reassure that there's because the overall the risks are low of all complications for all women. Of all weights if you're looking at it, if you're looking at it based on someone's weight. Absolutely. The evidence tells us. And actually, what we know is that once you start, you know, introducing these like, um, you know, things could be a bit more dangerous for you and that, you know, increasing those little microaggressions of wasting that then that actually then does increase the risk of these things happening. So what we want to do is reassure people that, um, or a solo, that they're okay. And even if something does happen, it's not their fault. And B, there's things that you can do to support them, right? Like you want them to feel like you're on their side, that you're a part of their team. And I think you're right, like, like having this random letter come through your door. It almost feels like it breaks a little bit of that. Trust that you've built that
Speaker 2
[00.16.43]
rapport because it's like, I don't know, you know, that they're gone and that you're in trouble somehow. And it feels like they've gone against you, that they haven't got your consent. And it really breaks that trust and that rapport with them, your
Speaker 1
[00.16.55]
life. I definitely like that. So people come into my community all the time since it's up to them all the time, and it's never and it's a sort of a little, little cascade of what. Well, so what happens then is if they really what just happened is that offer is honestly, Nicola, this is we've gone off on this track and it's just I could talk about this one issue. There are so many issues around the way, the way it has given. But anyway, more on this one. It's very cool. Um, so what typically happens is that women go to that appointment of an obstetrician. Because lots of them say, oh, they thought it was so nice. And, um, you know, I felt, you know, I felt reassuring afterwards. I think, oh, it's good, but that's, you know, it's good for your worries. You know, I think it's, you know, it's maybe you got to make me feel better not, you know, so it's, you know, that's why you that's why you're reassured now. Because you're expecting expectation. And there's sort of a stigmatizing experience, isn't it? You know, why wouldn't you? So I just I get very frustrated that there isn't as an offer of a referral, and it isn't clear what's going to happen in that appointment. And in fact, lots of women are having second and subsequent babies if sussed out themselves like, oh, that up. I mean, yeah, nothing really happened there. You know, if you've got a significant history, if you've got complications, it's a completely different matter. Individual issues. But but actually it should be explained to them what's going to happen there. And because for lots of women, apart from the practicalities of maybe you got to arrange childcare, that sort of work, you know, you, you, you worry what they post about should be explained what it's for, you know, for other people, not much. It's not it's not for much. Yeah. It's it's me. It's made behind people's backs. And then there just it's confusion and humiliation around
Speaker 2
[00.18.44]
it. And if you don't have that information you can't consent to it. And you said overstretched NHS, why are we giving these appointments which actually don't have any, you know, great outcome out of them, apart from the reassurance that they shouldn't need in the first place.
Speaker 1
[00.18.58]
And the and I'm not saying that they, they will only get reassurance and they do. But lots of another thing that happens is lots of them don't get reassurance because lots of them. Because actually there's nothing wrong with them, but they're trying to invite them. They don't see in the console so that the confusion happens because the name of the doctor, they get called to see the doctor when they're in the waiting room and they're like, oh, that's not the name of the doctor that's on the letter, because they're at the consultant clinic. Right? The consultants name is on the letter, but they're seeing a junior doctor because they're not. There's nothing wrong with them, really.
Speaker 2
[00.19.30]
So no need to look
Speaker 1
[00.19.31]
at the consultant. So then they're sitting with a junior doctor. But the thing about a junior doctor is the junior doctor tends to be, you know, they're a qualified obstetrician, but they spend several years kind of working up and getting they're getting their specialist specialist training, but they're quite focused. And they'll be really very keen to stick to the guidelines, make sure they don't miss anything. Yeah. Um, and they, they won't be that they won't be as I mean I'm being general, but in general they won't be as person centred. And then that's where you might get a much more depersonalized approach. You know, in general, you might get a more sensible, confident, experienced, um, approach from a consultant who is a kind, compassionate practitioner. Yeah. But when you're seeing these junior doctors, it's a little bit more, mind you. Well, that's the gist of it. Yeah.
Speaker 2
[00.20.21]
So we're glad to know you mentioned earlier that often when you first go into your booking appointment, the the midwife will want to weigh you. What is your perspective on being way through pregnancy? Do you think it's important and necessary? Do you think it provides any useful information, or do you think it's just a completely complete waste of time?
Speaker 1
[00.20.40]
Um, so I don't think it's, uh. I mean, I know, I mean, I'm thinking general, um, routine type thing happens when it when it really shouldn't. So the guidelines say that it should be weighed, um, early in pregnancy, at the start of your pregnancy, so that in practice takes place, um, generally at booking. Um, and I think that, you know, what the guidelines are based on. What are the recommendations for things like, um, taking aspirin in pregnancy to reduce the risk of, um, dividing preeclampsia, um, taking blood thinning injections. So, um, anticoagulant therapy. Mhm. Um, having a glucose tolerance test, they uh, based on that uh, because, because I, there's thousands and thousands of women, um, being cared for by the NHS every year, but based on a very arbitrary cutoff. So you've got this, you've got got these cutoffs that, um, are based on the BMI. The BMI is a. It is was a useful. Tool to be used when you're looking at populations. So, you know, policy might be made around, um, population level trends where you might concentrate funds or services or, you know, sort of broad trends in things and particularly around BMI, but around just the just a general thing is that the tools that you use, of which BMI is one to kind of talk about trends, um, um, in health and, you know, it's kind of it's obvious that you don't kind of hit that golden number of BMI 30 and, and, and, and things start to go wrong. You know, why are we why we understand a tiny little bit about maybe how, um, weight might affect people's health, you know, some people's health. We've got a very, very poor understanding. You know, there's, there's, there's such a disconnection between the understanding that scientists actually have about how weight might affect people's health. Um. And the way that lots of practitioners present themselves as knowing the confidence with which they present themselves. You know you're and you'll be 30 therefore, so you know. So therefore you're up. Therefore you should take aspirin. If you're BMI 29 and it's your first baby, you're not going to get recommended to take aspirin, um, to help prevent pre-eclampsia. But if you're being -30 then you are. So I mean and that's what I see. You know, it's a it's a cross off. It's it's it's a category that's been decided upon that's used. Um, because they need to, um, make very broad decisions about thousands and thousands of people. And so what happens is, was something like, you know, um, I mean, I suppose two good examples there and would be the aspirin and then having a glucose tolerance for diabetes. So with taking aspirin. And, you know, pre-eclampsia unfortunately, is a reasonably common, relatively common. Yeah. Complication of pregnancy usually. Thankfully, it's mild for
Speaker 2
[00.24.02]
all babies. Right. Like all people can experience them. Um well yeah. So again, not not very well understood. We know it's something to do with the way that the center develops early in pregnancy. Um, and. It's something that in practice, what ends up happening is because there are some very, very broad risk categories, one of which is having a first baby, one of which is having a BMI over 30. So lots and lots and lots of women take aspirin and and some and a few might benefit from that. That's that's what the evidence tells us. So that's what you sort of need to know when you if you decide to take aspirin. Um, it's not that it's going to, you know, it's not something that's going to happen to you unless you take this. Yes. So you have to have, you know, it's it's about getting to grips with that uncertainty, you know. Mhm. Doctors family or a lot of doctors find it much easier to confidently speak about complications and, and risks and what you should do. With great certainty, but in practice, we just don't have that, you know. And if there's a lack of honesty and, um, or even sometimes a, a cruelty around, around and misinformation around, um, what we do and don't know, that's where that's where, that's what is stigmatizing. And that's what, um, causes problems for people. They are hard conversations to have. Like, we just don't we? It's hard, but it's easy, like I say to students and I always say to women, you just need to tell them what we know. We don't know. And then they can make them look it up. It's just the information, right? They can't do science.
Speaker 1
[00.25.48]
I'm I'm on a slight tangent here, but, um, so, um, I think that, um, you know, in terms of if you want, is it a good idea to weigh somebody? I mean, for some women, um, you know, it's like everything else. We have these there's very broad categories and recommendations for populations. Um, but really, that's not that's no good to anybody. When they're individually pregnant. They just want to know about themselves and their own health and what's best for them. And nobody can say that to themselves individually. It might be no problem if someone does get weighed. I look that way. You know, you can look up at BMI. Um, what's the recommendation for taking aspirin and and. Okay. Yeah, that sounds like a sensible thing to do. Other people really, really don't want to get weighed.
Speaker 2
[00.26.35]
Yeah, absolutely.
Speaker 1
[00.26.36]
And at that point, the midwife needs to not say, well, it's just compulsory. This is not
Speaker 2
[00.26.42]
right. Like this is something that we should opt into. Yeah.
Speaker 1
[00.26.46]
Yeah. So I mean, so there are options. So it just always comes down to that individualized approach. I'll just say something quickly though about gestational diabetes. Well not quickly. Okay, so going on private talking. Um, so gestational diabetes because of this cutoff. What there's a very interesting, um, piece of research done and by one of my colleagues. Um, and I'll, I'll send you the link so you can, you can put it in the show notes which looked at because of this cutoff. Um, the GT is offered. So this is offered to people at 28 weeks. Um, really about 26 to 28 weeks. Um, because that's the sort of that's around the time when gestational diabetes can be detected for lots of these other sorts of time when it would have developed. So you might get an offer to have a test earlier on, but that's a slightly different thing. So it's the routine offering is 2628 weeks. Um, and what they found in this, um, in this piece of research and I think it's where it's interesting because it's where the kind of stick I talk to them about, kind of separating out the way that you feel in your health, their interaction, and maybe somebody's not being communicating with you in the way that you would like. Try to separate out the information that they're important to you. Yeah. And not being led by your emotions or what they're saying to you. Because with the glucose tolerance tests, there's very good evidence that if you have a gestational diabetes diagnosis and you have I've and from that are able to, um, have helped to, um, control your blood glucose well through diet or all through medication, either with gestational diabetes, not preexisting diabetes. Yeah. Um, then that doesn't it's almost like your body doesn't really know that you you've got it, you got it. You can control it. So that there are there can't be ill effects on you or your growing baby. So there are there's really good reasons to separate out the stigma, the fear of that diagnosis. But that diagnosis is not to be feared. No.
Speaker 2
[00.29.05]
Absolutely no. But because of the way that we talk about diabetes.
Speaker 1
[00.29.10]
Yeah. We can. It's not blaming isn't it? It's that blaming of, oh, I did this to myself and my baby. And that's just not true.
Speaker 2
[00.29.18]
And once I make a neutral diagnosis, then absolutely. It's so important that you get the help and support
Speaker 1
[00.29.23]
through it and what they and so what this study found. Was that quite a lot of women. So that found that. Get that diagnosis and found that diagnosis and control that you could. You know, it's it's it's an extremely good thing. Um, but they found that, you know, women that were around a lot of women that had a BMI of 28, 29 because we know that it is more likely, um, in plus size women. I mean, gestational diabetes is unfortunately, again, it happens in a, in a, in a reasonably a high not high number, but it happens somewhere between 3 and 7% of pregnancies. Women that are not class size and somewhere between 10 and 20% of women who are full size. But that's very, you know, depends on where you get your evidence from. So, yeah, she's that 80 to 90% of women aren't going to get it. So the majority are not going to have this. Yeah. Um, and it's, you know, it's it's good to have that information. Um, but yes, that around the sort of cutoff because we've got the cutoff and. I, you know, it's just that it's just that binary kind of you're on one side of the being or not. And, you know, it's obvious from just from living in the world, you know, that most women have no complications at any size. And arguably apart from the ones that health care practitioners cause for them. Very well, the interventions that we, um, suggest, um, but, you know, left alone, it would most women just would not, would not have any complications, you know, without interventions. Mhm. Um, and that women also that women of any weight have complications and that which you know, we're trying to sort of also think of the analogy. It's like, I don't know, it's not putting a square peg into a round hole. It's just like it's we're trying to we're communicating to women as if we as if we were making her feel like complications are likely. Certainly, you know, lots and lots of women. Yeah. Um, often when I, if I speak to a new client, it just takes like, like five, five minutes to make them feel better because they've. By the time of. Reach me the so anxious but and their ideas about how complications are so so likely. All we need is to look at some of the statistics and understand that it's, you know, it's almost, um, unbelievable really how how it's presented when it's so clever to say to people, um, you know, the guidelines do say the. Deadlines do say at the start of the information for women if you Google it. Um, most women um, bill plus size in principle have a straightforward pregnancy and birth and healthy baby. Yeah. But then think it's half risk risk risk risk risk or squish risk to you. Right. But very soon you've forgotten that. But
Speaker 2
[00.32.21]
absolutely it's the sensationalized version of it. Right. It is just
Speaker 1
[00.32.26]
with
Speaker 2
[00.32.26]
scaremongering people. And that is just not the evidence that we have to support
Speaker 1
[00.32.30]
the scaremongering that the doctors do now. Right? Indeed. I can't remember what question you asked me actually today when I thought it was about being wage, wasn't it about this? But do you think it should
Speaker 2
[00.32.40]
be weighed? Yeah, absolutely. And
Speaker 1
[00.32.42]
so the last thing I would say about that is because, because I think that, you know, lots of people do, um. That person meant to support you. And and you'll get a very quick picture of whether you're going to get that support from them. Yeah. And if and you know, you do have options if you don't want to be weighed because, you know, nobody can force you to be weighed, but you can, you can you can tell someone. You can tell somebody what you what you think you weigh or what you do weigh. If you if you happen to weigh yourself, um, or between you, you can just sort of have a guess. Yeah. Or
Speaker 2
[00.34.34]
just, you know, say no. It's like. Yeah,
Speaker 1
[00.34.38]
like, I don't think you
Speaker 2
[00.34.39]
can see somebody's body. And if you think that they benefit from having aspirin or having a just, you know, a glucose star and stuff, but those are the things that you should be talking, you know about. And you don't need a number to tell you whether you think those things are going to be useful or
Speaker 1
[00.34.52]
important. Right. And I mean, I think that's the sort of she, she last night she told me, I'm sorry, but she might be she she's quite condition, you know, she's quite conditioned as a midwife. Um, and so it'd be enough for her to say, look, these are the guidelines. The guidelines say, um, that it's recommended for you to have a glucose tolerance. Um, at 28 weeks, if you have a BMI above 30. So that's what the you know, you don't want to be weighed in. That's fine. But you know, what would you like to do about that? Yeah, that's an
Speaker 2
[00.35.23]
easy, easy conversation to have. Right. Like give them all the information and let them make that informed decision based on all the, all the information that they need to make. Yeah, it's it definitely feels like they're taking some of that power away from folks to be able to sit and make those decisions for
Speaker 1
[00.35.39]
themselves. Yeah. And I think it's, um, I think it's a, it's a, it's it's like stigma at every level isn't that. It's like a, it's in the structure. It's in the setup. Oh. So that's the way that that person was, was taught to, you know, that's the way that that's the way the student midwife would be at. Hundreds of booking appointments during that training. Yeah. And those from different networks, they're going to do, they're booking. But probably nobody ever said and. Well you don't need to. You know, you don't have to be afraid if you don't want to do this. Yeah. Oh there's certainly. I've seen many examples of that. Yeah. Um, so but that just means that you can, um, help to if you get the, if you get that, the sort of good communication channels and you can just help to give them pause and reflect on, you know. Actually yeah. That could be, um, something that could be a bit more flexible. Why do we need to calculate someone's BMI every time? Yeah.
Speaker 2
[00.36.39]
And obviously if you're teaching people then they're getting this at the beginning of their careers. Right. Like hopefully having lectures from you is meaning that they're getting some insight into that from the beginning.
Speaker 1
[00.36.50]
Yeah. Yeah it is, but that's not what I did. So actually the first lesson I teach about maternal weight, right, is in year two, year two medical students. And I do that at the beginning of the session. I do a little I do a little quiz because everyone loves a quiz, don't they?
Speaker 2
[00.37.05]
Yeah. Um, that
Speaker 1
[00.37.08]
I look at and the one of the questions is, um, how many? Plus those women develop their social diabetes. Um, and they're always overestimated. They always. And it's multiple choice, right? Um, but they always overestimate it because they're already sort of indoctrinated.
Speaker 2
[00.37.25]
They're seeing that it's already in layers and they're already like, caked in. So
Speaker 1
[00.37.29]
that's what would have been there in clinical practice for about a year during their life. Yeah. Yeah.
Speaker 2
[00.37.35]
Do you think there'd be scope in the future for you to get a new one? Get in straightaway. Right at the beginning. Yeah, I mean definitely I think and I do, I teach um, I mean, I have contact with them all the way through and I, and I think they, I think they sort of again, talking about when they talk about something. Yeah. Yeah. But they do even though the, there's the sort of semantics around fire risk and lowest if you, you won't really see it written down in guidelines. I change it to like complex care and things like that, but kind of means the same thing. And also just in everyday communication. That is absolutely. So what what it means is what is used. Yeah. Yeah, yeah. I mean, I think you're still completely right. What you said earlier about how it's that sort of chipping away at your confidence if you get that referral to a consultant, even though for a lot of them nothing really happens there. Yeah. So I've got that message that, oh, they had to kind of take over to see that, to see if everything was okay. And now I feel reassured because they said everything is okay. You know, everything was okay before. But, um, yeah, that certainly confidence. Um, you know, and I hear lots of talk talk about um, there isn't um, there isn't in the guidelines a structure around when that a pilot with a doctor should where's, where's the optimum time. Because there isn't really. If there's nothing wrong with you, there isn't. There is an optimum time. It's not necessarily.
Speaker 1
[00.39.10]
Yeah. So but some women are like, oh, I thought I was something, I was totally I was consultant led. Right. This is what I see a lot um, from my experience, members told us that. But now I'm a bit confused because I'm 30 weeks already. And. I haven't seen a doctor. So when it's not going to happen, um, because, you know, depending on what trust you're at, where you are, and it might happen just a few weeks after your booking, you might still be waiting and wondering, um, and then some doctors will talk about you might need an induction and some doctors, um, might say that even if that appointment at 16 weeks. So you might need an induction and even a
Speaker 2
[00.39.52]
year that it's like there's no choice for you. This is just because it was necessary. And that's just not the truth
Speaker 1
[00.39.57]
either. You might, you know, you might need some. You might have a big baby. Um, um, and then they might say something like, oh, well, you know, but there's absolutely no reason for concern at the moment. So I'll just send you back to the doctor by the midwife and we'll maybe see you again about six weeks. Yeah. So I can just destroy it.
Speaker 2
[00.40.20]
Check it out. I'm just. Yeah. I mean, we can
Speaker 1
[00.40.22]
talk about induction. Yeah.
Speaker 2
[00.40.24]
Um. Is that fair? Isn't it? It's that I'm supposed to be a consultant, but I haven't had a doctor's appointment. Like, is there something wrong that had been missed? Me and I, you know, like, it's something going to happen and it's not going to be picked up because I haven't had my doctor, you know, like this again. It's that. Yeah. Managing an expectation. Right. Like they should be giving this a really clear guideline and outline of how it's going to
Speaker 1
[00.40.46]
look. And it'll be fine. But I'm hiring so I'm worried you know.
Speaker 2
[00.40.49]
So of course there's that fear. Yeah. I mean I went through two pregnancies as a plus sized person. So I absolutely understand that risk and that anxiety like it is something that can take over your whole life
Speaker 1
[00.41.00]
and then, you know. Everybody is prone to that, as you know, in pregnancy. Yeah. I
Speaker 2
[00.41.07]
mean, you know, time of life,
Speaker 1
[00.41.08]
right? Yeah. But I think if you have that, you know, but there are and I do like to sort of emphasize in that way that there's a lack of a sort of reminder to women like the plus size women. Just because women use pregnant women, besides, pregnancy is just pregnancy. Um, and you share a lot of those things in common sizes, and you also share pressure to have it an induction, you know, like the induction rate now is just phenomenal. And, you know, yeah, it's scary because you think if you are waiting, are you waiting for a doctor to reassure you that everything's okay? Kind of later on you have this idea that you're high risk. It's very inaccurate, but it's just very pervasive and damaging. Um, because it's, you know, you know, it's very important that you feel that that confidence that your body is your body and your baby know what they're doing and they're just going through a natural process. Um, the natural endpoint of which is, is birth. Pregnancy, birth and pregnancy are part of the same continuum. Mhm. If you have a complication free pregnancy, there isn't really a reason why you should expect complications during birth. And that's what. And, you know, just and at that point, I always say that being plus size might be a consideration for your pregnancy. It might be, but it's not a complication. And
Speaker 2
[00.42.38]
there's underlying things going on. Like sometimes, you know, being plus size can come with other things like thyroid issues or PCOS and like, you know, they can be, you know, things that happen. So then we'll be looking at, okay, root causes like PCOS, that could be an indicator that you're more likely to get gestational diabetes. Like there are things going on there that one of the side effects could be that you're in a bigger body, but we should be looking at the root causes and seeing like medically and physiologically what's going on rather than just going, oh, you're in a bigger body. That means x, y, z about you because it doesn't.
Speaker 1
[00.43.10]
Yeah, exactly. Oh, and one thing that's, um, that's very difficult communication around. And um, this is again, I'll be succinct here because there's another whole episode in and of itself essentially, um, if scans. So having a scan when you plus size, um, and there's a lot of chatter in our community about this as well all the time. Um. So lots of women worry and like, you know, I've got a big belly, I've got I've got an open belly. I'm worried about this, um, scan coming up. Are they going to see the baby? Are they going to be able to get a good image of the baby? Well, is that a picture? Um, and I always encourage women, again, take that same approach as when you get, when you're, um, meeting any health question. But what will you talk about now about your bookings? I would go into all the thoughts and say, um. It's if during the day, if I can, if, um, my big belly is, is is making it more difficult, can you please talk me through that? If I can move in any way or hold my tummy in any way, then please just make it easy. Then please do ask me. Um, you know, I really want this to be successful. Um, if it is difficult, please tell me that. Please tell me the reason. Because there are a lot of reasons that scams can be difficult. Yeah. And and that that can be, um, because you've got a bigger tummy, but, um, it's it's complicated. It might be because. Because of the individual. It's not that I'm absolutely you. I didn't know this for many years. Right. But a lot of it told me, um, not that long ago, that. That she doesn't know until she puts the scanner probe onto somebody. What the view will be like. She doesn't. She doesn't look at someone walking through the door. And I think, oh, that's a big person. This will be more difficult because she says, it absolutely isn't the case. Oh, absolutely. Because it's the I don't really know how this works, but because I don't I'm not. Well, yeah. I don't do those complex scans and it's a type of tissue. So some people's tissue and not fat tissue. Tissue like all bodily tissue is like denser than other people's tissue. So and there are a number of different reasons. But again, communication just can just fall down because um, and I would, I would say to be kind to stenographers, let's say it's because they don't they don't they don't say what they should say because they don't want to risk causing offence. Again, I think that's a mistake. It's misguided that they don't communicate openly. Um, in a, in a, in a compassionate way. Um, and and you'll, you might recognize the punchline coming up in a minute. So, um, so, yeah, tissue individual practitioner scanning is very much as it's scanning is complicated. And, you know, some people are better than others at scanning. It might be to do with your your anatomy, the position of your baby.
Speaker 2
[00.46.14]
Yeah. It's like all kinds of stuff.
Speaker 1
[00.46.16]
Right? Wind is apparently. And this actually. Well, I was chatting to Tommy. Yes she did. Could you think about. Blah blah blah blah blah blah blah blah blah. You know, worrying about that. Actually, the wind is the enemy of the snot. Okay. So and she said she was so embarrassed because when she was broken, her brain was like, you know, when. She was like, oh, it's felt really bad. So. Just think about what it sends to you in the 24 hours before your scan.
Speaker 2
[00.46.45]
Yeah, and try not to.
Speaker 1
[00.46.48]
But I think there are lots of things. Yeah. And that kind of thing that's down. And that's what you know. And it's not. Well, now, is it? Because some of us know that. How about when they know that they don't tell us something. Yeah. So communication is really important. And I would say what you can do to get that communication back and forth, you know, is really is really important. And then you also ask, and what are you going to write on my scan reports. And we'll say anything about my BMI, on my weight, on my habits. You know, the ones that I use to like, codify that you're just like fat,
Speaker 2
[00.47.28]
for God's sakes, right?
Speaker 1
[00.47.29]
Oh, you know, it was such an interesting chart. I'm just getting so and so essentially, just in chat with this, let's knock off a little thing that she told me, but she still doesn't. I mean, I just I just think all the Latin, all the Latin words that we use in medicine is finally it just goes down. Sugars go. So habit habits. Apparently it's a scanning term and it just means body. So I thought for a long time that it was a kind of code word. So yeah. Yeah, they were trying to use instead of BMI or fat tissue or whatever. But she said that, um, if she, if she's scanning somebody's leg with bones in their leg, she will talk about habitus. So is this a term for a body? It's stupid, but it's stupid. But it's interesting
Speaker 2
[00.48.15]
to me. I think I understand, but I would encourage because to many people. So again, in a mirroring of this booking appointment experience, too many people have the nerve to stand and go to the stand. Oh, the scandal is great. They get a nice picture, they get home and they look up a look on her nose and it says something about adipose tissue or how it says or restricted view due to, uh, BMI. Now, the discussion that was discussed so many times in my community, and there's always a, um, was it, um, uh, a suggestion that maybe it's because they put something like that to cover themselves? Yeah. To view the thing is like a cop out. Why? Well, yeah, the thing is that, um, the what they should do is just tell you whether or not there was a restricted view, because what happens to so many women is that they, um, they're told everything's fine. I visualize, and particularly I did something like 20 weeks down that has got something like 60 odd measurements that they need to do and they need I think it's a it's detailed on completion. So, you know, women will have that sometimes complete and it'll still say something about their BMI. Yeah. But it causes that anxiety and that confusion. Yeah. Was there something there that you didn't tell me about that was missing. So there's that. So that's one reason why it's just really unsatisfactory anyway. But actually all standards were say and all standard departments and NHS trusts, they don't they're not um bound to it's a screening. They're not bound to see everything on a scan. Right. For a woman. Yeah. And I guarantee that they will cover themselves in that way. So maybe, maybe some of them think that they are covering themselves in that way. But I don't think that they are. They certainly don't need to because they, you know, the scanners aren't completely perfect, and that should be explained to you in the consent process to have the scan. So that doesn't kind of hold water either. So I just think that I think that that is something that really needs and but again, you can be in control of that. You can ask them what what will it say in my notes. Mhm. Um, and then the other thing I say about all these kind of. Confidence building things and and these things that put you in control is that it's not easy. It's not easy to say, excuse me not to. To me, it's not fair. So I just I just it's really important. And you feel so much better afterwards. So I just suggest things like writing it down and rehearsing, just like practicing, saying it at home and stuff. But it honestly, it's just so helpful. Or, you know, you go along with, with whoever you whichever lovely person you're taking with you and they can they can say it all they can so they can remind you, have a little go, go. Wasn't that something you were going to ask. And then, you know, you were going to ask.
Speaker 1
[00.51.16]
But yeah. Yeah. But it just it's so it's just so empowering to have those little those little details to be aware that that those are the pitfalls that you can fall into.
Speaker 2
[00.51.26]
Yeah. And that five minutes of discomfort means that you're kind of saving yourself hours of anxiety afterwards of like what to expect and what's coming. And like it's it can be really powerful to have those conversations even though you shouldn't have
Speaker 1
[00.51.39]
to. Now I know, but you shouldn't have to. But there is if you if you're sort of pointing it out to sort of to a practitioner, you do you know, we do to be fair to all practitioners, many of whom are just they're just doing their best. And we are in our training and all the way through our careers, we are taught to be reflective practitioners. Um, lots of lots of healthcare practitioners demonstrably do not do that. I absolutely know that. Um, but, you know, that's that's the best thing you can do. You can because you might then in this case, give them pause to reflect. Yeah, absolutely. Okay. So another question I've got for you. What has been the most rewarding aspect of doing the job that you do with creating the heavyweight in the life? Um, I think it's probably when people say, but, well, I mean, I would, I would, I'd use the example of water birth actually, because water birth is something that, um, it's funny when it's funny when you, um, you'll probably know a bit, a little bit about this, because when you, when you, um, go from a job like mine in the public sector and you start doing something like that, the way that they drive on social media and you're a little bit of a fossil, as my daughter rudely calls. Um. She does not. She she. She added some programs for me. While shouting at me the whole time. So I was like, that's like, that's true. I mean, okay, yeah. I also have to get shouted that being a fossil. But when you go from I had this idea, um, in 2022 to, um, because I was working as a lecturer and, um, a researcher and I just, I just really I didn't miss nightshift anymore. I didn't miss being a midwife, but I, you know, I had this passion, but I haven't completed my PhD. Then, um, I just I know I was on social media a bit. I think I had an Instagram, uh, dog who had, like, eight clothes. Um, and we just follow the, the, the golden retriever accounts, you know? Um, so. Yeah, so, so that's kind of kind of this journey. I'm still very much on this journey. And, and I think one thing that you do when you're setting up something that's like you might say as a business, as a business, um, it's a service, it's a business. And if you think about who your client and your client is, right. Who's your ideal client? Where do they hang out on social media? Um, and it took me quite a long time to realise that my ideal client wants a lot of. Ooh. And that was. That was only just going through, like, all the clients that I got. Yeah. So I, you know, I didn't I didn't I wasn't too clever with that didn't work out. That's
Speaker 2
[00.54.35]
what got me to looking at the research on my very first. So Serbia's 11 now. So 11 years ago, it was one thing of water birth that led me to figuring out, holy
Speaker 1
[00.54.46]
crap, like,
Speaker 2
[00.54.48]
I can do this. I can educate myself. I can figure this research stuff out. Yeah.
Speaker 1
[00.54.53]
And again, as an aside, again, you've got a lot of, you know, you it's the same for everybody. Um, you know, women of all sizes are fighting for for all of us because just because of the cost of services and, um, especially, you know, particular trust, but lots of trust that kind of those services are struggling and, and actually that does feed into looking for ways to kind of restrict access towards the web. I think it's just basically it's bad for it's just bad for women wanting ones first. Yeah. The fact that it's hard for all of us. Yeah, absolutely. It's the fact that we all need to fight together and. Right. So I think I think it's that when I, when I, I've now got, you know, I've got, I've got people at work in my team for me who were clients of mine, who I helped navigate to have a water birth. I had a water birth and who and you know, who want to work with me because they just, uh, see the value of what we do. Mhm. You know, I guess that's it really. I mean, I've got a couple of particularly strident members of the team and I suppose when they tell me about the things that they've said to consultants in their appointments that that that was a particularly satisfying moment. So when she's, you know, when I don't think I'll be, I don't think I'll be called her consultant, a donkey to his face. But she did. She always called him like a donkey or a donkey, which I wish happened to you because it's not me saying it. I suggest. Is that power dynamic? Right. So often we put consultants, doctors on a pedestal and actually, you know, we should be equal in terms of our power to influence our care. So I think that's a really, really powerful way of rebalancing that that power
Speaker 2
[00.56.35]
dynamic. Yeah, I mean, I think so. It's just that there are some really, really important. I mean, there are there's loads to it. Just appointing somebody to advocate for their work. But one really key thing is that that women don't often don't even realize. And why would they is that it isn't up to the consultant. You know, they might they might be under a consultant that told their consultant, left that off. They go to that point that we discussed at the beginning. Um, and then at some point I told that, um, they're not recommended to have a war, but, I mean, there's a lot there's lots there's lots to it and lots to the sort of discrimination around it. Um, but what they don't they don't realise that. Then they just say, well, I don't want to see you anymore. And, and you know, when, when you're, when you're having a discussion with someone about a lot, but essentially you can't have a war with solely because of your BMI. Um, all that means is that you're talking to the wrong person. This is what that means, I love that, so it's not the end of the conversation. It's the end of the conversation with then. Yeah. But there's, you know, there's just it's just a project, you know, that you can't start too early. Um, I just I just had somebody this week who I was talking to. Who? Yeah. And she's, she's just, she's so, she's so got, like a mini, uh, a little mini, a first semester mini course. I do, um, an online one. Um, and she contacted me after that. She said that her booking because there's quite a lot of prep around booking in that, and she said, um, she told her midwife that she wanted her booking. I was like, great, because people think people are like, oh, you know, I don't need a booking. I feel a bit daft. It's too early, not too early, and it starts to start to feel out. Because NHS trusts are very different than different facilities. They've got very different cultures around what birth or, you know, is their approach to birth as a as a normal event. Overall, it's really, really good to start early on to find out what you need to have a team. A midwife is like local to you and and what's the thought you're going to get and who you need to talk to. And yeah, what the what the facilities are like and culture. So she said, oh yeah, once I've told them if I want a birth. And she and the midwife said, um, but I will, I wouldn't be allowed to have one because they don't do them for anyone over 100kg. And I was like, right, okay, this is why I love this. Because because you're 12 weeks and this is going to be fine. Yeah. So, um, so yeah, that's that's that's my that's my favorite things. Really. But yeah, I just yeah. Someone that just are in a, in a kind of a more micro sort of building because I think traditional birth preparation is, um, sort of based on that ethos, you know, the, um, the ethos. So I think I'm just kind of preparing for an intervention. Free birth. Um, we all understand the value of being calm, being in control, the hormones that underpin, um, physiological birth. Um, but my belief is that you need to be thinking about that earlier than, whatever, 32, 34 weeks and doing the prep, but all the way through pregnancy as well as the decisions you make in terms of being plus sized and things that might be recommended and how your confidence might be eroded. You know how you feel is physiologically important, as well as psychologically as well as you're getting your confidence up, feeling in control of it. Absolutely. It is. Again, it's part of what the birth is. The is the end of that continuum. It's part of the pregnancy. It's all part of that one. Yeah. And these are
Speaker 1
[01.00.06]
all process tools.
Speaker 2
[01.00.07]
They're all skills that you're building and learning through this pregnancy that will last you forever. Right. Like supporting your health care, navigating, advocating. All of these things are going to be so powerful for the rest of your health care. Never mind just through pregnancy and
Speaker 1
[01.00.21]
birth. Yeah. Yeah. So, yeah. Go on. Go, go. There you go. I was just going to wrap
Speaker 2
[01.00.28]
this up. So if you want to just jump in with that first.
Speaker 1
[01.00.32]
Know what I was going to say. I mean, one thing that I. I did when I was doing my PhD. I did I did have a hypnobirthing practice. Um, and part of the reason that I developed it and it's about ten years ago. So things have changed quite a lot now. Um, but there was, I think, in the early days when it was in the UK, that what I was uncomfortable with was this idea that if you sort of practice hard enough with your hypnobirthing, you'd have a, a physiological part of your dream birth. Mhm.
Speaker 2
[01.00.59]
I mean, it doesn't always go that way. Yeah.
Speaker 1
[01.01.01]
Because again it's like you don't, you know if you, if you're um if you're plus size, you know that as we've discussed the system is can be kind of stacked against you or there's, you know there there there are pitfalls and obstacles and just this idea that, you know, if you, you know, unfortunately, complications do arise in some pregnancies. Um, and the idea that you can sort of practice hard enough that I was sort of uncomfortable with. So I did I did my, um, I did my training kind of with a midwife. So it was sort of mixed in with lots of not formal, but more kind of antenatal midwifery. So the way it's like in the birthing, what we're talking about now here, starting this time for good reason. So. Um, I think that it's not about you having a water birth, because it's. It may be that you have a lot of birth. Um, and it may be that you don't, um, but you can feel really good afterwards, you know, if you prepare, if you advocate for yourself and you are empowered because if it becomes to the point where something happens and it's not a good idea for you to be in water like your baby doesn't continuous monitoring or, you know, so you need a caesarean section. Um, my goal is that you feel good after that, but you understood everything that you asked, all the questions that you needed to, that you felt in control of that process because you have to sort of get to grips with that. As I was saying, that the psychology around and that's what doctors find it hard on the other side. But as a as a pregnant person, you need to get to get to grips with it is unknown. You can't lots can't be controlled. Um, and so navigating around that and and and protecting your things. Protecting your emotional and mental health and controlling the things that you can control, um, are the key, key things that I do. Also make it the most likely that you'll have a water birth. Yeah,
Speaker 2
[01.03.01]
that's it, isn't it? It was ultimately just being able to make those decisions for yourself, with the support of your team, and be able to feel like you've got that choice and you can decide
Speaker 1
[01.03.10]
what's you know. And that's the thing is that with the water birth is that you need to feel that it's an option for you, because that's the other thing is, like at 12 weeks when you're booking, you might do I don't I'm not even sure that you want to know it's there if you want it. Yeah,
Speaker 2
[01.03.24]
absolutely. Absolutely I love that. Okay. So you've mentioned the mini, like first trimester course. You've mentioned your community. How if somebody is listening now and they would love to come and join you and work with you, what is the best way for them to find you and how to how can they work with you? Well, if they want the interaction and the vibe and the the community is and is an amazing, um, supportive space. Um, and there's, there's touching 3000 members now, so and it's just, I mean, we, you know, we mean it really carefully to make sure it's a, it's a brilliant place to be. But honestly, we don't need to do that very much, isn't it? Yeah. It's just such a wonderful place. Everybody just kind of needs that same vibe. It's really. It's really fantastic. There's loads of input from me in there all the time. Um, and then there's just the kind of the chat that you need from the other, the other ones in there that are not, not fossils like me, you know. But that's the young, um, and yeah, the other team members as well. So, you know, they've kind of gone through that. I've gone through the entire journey. And so I have online courses. I've got a first trimester and a second trimester and a third trimester. Kind of amazing.
Speaker 1
[01.04.32]
So there's a lot of chat about what's working there, as you might imagine, but also other all the other stuff, like if you have a caesarean section or the pain relief options just and everything that you might need to consider reassurance, all those what ifs that kind of keep you awake at night when you're pregnant and and you can you can have a I do reserve my Tuesday afternoons for 1 to 1 with clients. So if you if you don't want to do any of that and you just wanna have a chat for me, then you can do that. You can put me up for a chat and you can do all that at the Heavyweight midwife.com, and you can check out my podcast. And there was a very. Interesting and illuminating recent episode with one Nicholas Hamilton from Philadelphia. It is. But anyway, it's there as well. We had a fantastic
Speaker 2
[01.05.18]
chat and I will pop all of those links in the show notes so you can go and check them out if you're interested in working with Alice. Thank you so much for spending this time with me. It has been wonderful and I am so grateful that you are doing all this work so that people who may get pregnant can have an amazing and incredible pregnancy and birth through that time. So thank you.
Speaker 1
[01.05.38]
Thanks so much for having me. I absolutely love everything that you're doing as well, and it's been an absolute pleasure and a privilege. Thank you. Thank you.
Speaker 2
[01.05.47]
Thank you so much for joining me today on Fat and Fertile. I hope you found encouragement and support as you navigate getting pregnant in a bigger body. If you're looking for more resources. Don't forget to grab your free Fat Person's Guide to Getting Pregnant. And if you'd like to support my work or connect with a loving, kind, fat, positive community, join me over on Kofi as a member, you'll get the chance to ask me anything and I answer all of your questions personally. There's exclusive bonus podcast episodes every month answering some questions. A supportive place to connect with other members who are also navigating the same issues that you are, and access to some of my most loved courses and tools. So whether you're trying to get pregnant or just want to support fat positive fertility advocacy, then we'd love to have you over there. The links to everything are in the show notes. Until next time, take care and remember you are absolutely worthy of all of the support and love that you need in order to grow your family.