Living Life in Bloom

Most of the time, babies in utero turn head-down, or cephalic, before they are ready to be born. But sometimes they are breech, with bottom or feet down. In the United States, nearly all breech presenting babies are birthed through Cesarean section (surgical intervention). But it doesn’t have to be this way. Breech presentation can be viewed as a variation of normal – occurring in about 3-4% of term pregnancies – and there are ways to safely support vaginal breech birth. One way to support breech birth is to ensure that birth attendants are trained in physiologic breech. Unfortunately, residency programs in the US are now rarely training obstetrician physicians (OB doctors) in physiologic breech birth. Physicians may be trained that it’s so dangerous it should never be offered as an option. There are some OB physicians in practice who have the skills and the comfort level to support vaginal breech birth. There are also many midwives who are skilled and can support out of hospital breec...

Birthing women and people of size deserve no less than to be respected, honored, and wholeheartedly supported during their pregnancy and postpartum experiences. Pregnant women with higher body mass index (BMI) may be discriminated against. They may be presented with a barrage of anticipated risks rather than getting individualized support when seeking health services. BMI has (finally) been taken down a notch in the medical community, at least “on paper.” The American Medical Association published a new policy in June of 2023 that aimed to clarify the role of BMI. They called out “historical harm,” “use for racist exclusion,” and other limitations of the measure. In BMI We Trust, Reframing the Body Mass Index as a Measure of Health , medical sociologist Iliya Gutin argued that we should use BMI as only part of a holistic view of health, recognize its limitations, and be more flexible about its interpretation.  But how do people of size actually feel when seeking health services? I...