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Have to see consultant due to Bmi.

(34 Posts)
louloutheshamed Fri 08-Feb-13 17:35:51

I am really upset about this. Am nearly 9 weeks and had booking in appt last week. My midwife said on the form that it was a 'low risk booking' but calculated my Bmi as 31. She didn't say anything about this though.

Today I have a letter for my scan appt in 3 weeks time but also for a consultant appt. I rang up as I was worried when I saw the consultant appt and the person answering phone said it was due to my Bmi. Wouldn't you think the midwife
Would have mentioned this??

Now I know it is too high and I have struggled with my weight since having ds 2yr ago. I really do want to address it but at the minute I am feeling so nauseous that I seem to be munching on stuff all the time to relieve the sick feeling. I just can't see how it is going to get any better now that I am pg and am feeling really Low about it.

What will they say to me at the appt? Does anyone have any advice/ experience?

HavingALittleFaithBaby Fri 08-Feb-13 17:47:00

My BMI was borderline when I got pregnant - actually it was 29.5 because I'd lost about 9lb the month before - but by my 12 week scan my BMI was just hitting 30! The only thing they did was check my history and give me a glucose tolerance test for gestational diabetes which was normal. Other than that, they said its a low risk pregnancy.

Your midwife probably should have mentioned it really....less of a shock for you! But try not to worry too much. Many bigger people than you have had healthy babies smile

Longfufu Fri 08-Feb-13 17:50:04

I'm 14 weeks and my gnu is 33, midwife wasn't concerned at all. She said they only start worrying when it's over 35.

You may jus get tested to GD, nothing major.

Longfufu Fri 08-Feb-13 17:50:40

bmi autocorrect

I don't know my BMI but I was about 30lbs overweight during both my pregnancies- I was tested for Gestational diabetes and, when that came back negative, was considered low risk. normal straighforward pregnancies and births both times. smile I'd just keep active and not worry too much, tbh .

Don't worry. You may well be offered a glucose tolerance test but you don't have to accept that. Plenty of women with higher BMI have perfectly normal pregnancies. Monitoring of women with higher BMI is standard with additional tests and appointments offered- but like every intervention offered in pregnancy it's up to you to decide what you want to accept. There's no such thing as 'you MUST do ........ Just see what they want to discuss and then go from there. Do not spend time feeling guilty about your weight but if you want support managaing it whilst pregnant ask at the appointment.
Personally I've had two pregnancies with consultant input at an earlyish stage due to BMI. I have listened to their suggestions, refused a GTT and then had a perfectly normal pregnancy an delivery managed by midwives - and my BMI was higher than yours.

Flisspaps Fri 08-Feb-13 18:22:14

You are not obliged to see a consultant.

louloutheshamed Fri 08-Feb-13 18:22:53

Ok thank you for the reassurance. So does it mean I will be under consultant for whole pg? Or will it depend on gtt?

talulahbeige Fri 08-Feb-13 18:33:17

Same situation for me, saw the consultant who didn't really say anything and discharged me back to the care of midwife, its just a precaution (covering themselves)

I had gtt at 28 weeks and am borderline gd but finding out can only be a good thing as its made me more determined to conquer weight battle as with gd you are more at risk of developing type 2 diabetes later in life

Kilkers Fri 08-Feb-13 18:36:15

Hi lou, sorry to hear this has upset you. I am also going to be under a consultant due to my high BMI (34!). I think my MW said that if the GTT test comes back normal then there's no need to see the consultant again, I'm sure someone will put me right on that if it's not correct.

I was lucky in that the MW explained everything very carefully to me, I knew I would be anyway as I was for my last pregnancy (sadly ended in a MC). Try not to worry too much x

They are just taking care of you, it's a good thing. Chances are you will have one appointment with the consultant who will then discharge you back to midwife led care. Don't stress. Having a consultant aware of your existence is no bad thing as if there is a problem further down the line you won't be at the bottom of a long waiting list.

Rooble Fri 08-Feb-13 18:49:38

Please don't be upset by it - they aren't doing it to "cover themselves", or to get at you about your weight, it's to make sure you are as healthy during your pregnancy as you can be. Ultimately the hospital's goal is to have a healthy mother and a healthy baby. If there are any risk factors they need to be aware of them. I was same BMI at the start of mine, so had GTT test and was fine. Had v healthy pregnancy until the very end when a number of things went wrong - unrelated issues. But because I was under a consultant I was having a closer eye kept on me so everything turned out ok and I now have a very healthy almost-6-YO.
Please don't worry about it. It's in your interests for them to keep an eye on you

TinkyPeet Fri 08-Feb-13 19:20:03

Don't panic. My bmi on booking in was 37 (Im a s16 but have absolutely solid legs! Lol) and had to go see the consultant, and honestly I didn't see the point, I waited in a room for her to breeze in with my notes, ask me some questions about my notes, which the answers for her questions were Infact written Infront of her! Then she asked me if I felt ok an sent me on my merry way! smile xx

Supergal Fri 08-Feb-13 19:20:21

Sorry that it came as a surprise that you were referred to a consultant. You should have been kept informed.

They will discuss any factors that could affect your and your baby's health during pregnancy, including bmi, and ways that these firstly can be addressed and secondly managed safely.

You will have an active part to play in this by deciding how much to take on board what is said and what plan is being suggested once this has been discussed fully with you.

Congratulations on your pregnancy and good luck!

louloutheshamed Fri 08-Feb-13 20:15:03

When do you take the Gtt? Is it at the 12 week appt or later on?

Just wish I had taken control of my weight before getting pg. so cross with myself.

HavingALittleFaithBaby Fri 08-Feb-13 20:23:40

Hey, don't beat yourself up! You only posted this three hours ago and already look at how many people are in a similar position!

My GTT was booked at my 20 week scan and I had it at 27 weeks.

Yes GTT is in the third trimester but it's not compulsary.

Pleasenomorepeppa Fri 08-Feb-13 20:42:32

Don't worry.i had DD2 2.5 weeks ago. Due to BMI (35) I had to see a consultant. It turned out to be a registrar & a totally pointless appointment!
My MW kept saying it was ridiculous as apart from my BMI I was fit, active & healthy.
I was told that I'd have to wear stockings through my labour, be monitored, not go in the birth unit etc.
I was 42 weeks overdue, had an active birth, barely any monitoring, went from 3cm to birth in 28 mins, no tearing, no drugs! More importantly not one person mentioned my BMI & it had no impact on my pregnancy & birth whatsoever.
I had a normal BMI with my first pregnancy & this one was no difference at all, apart from my maternity leggings being large instead of medium!!
Good luck & enjoy being pregnant grin.

grainmum Fri 08-Feb-13 21:15:27

I'm interested to know why you were so keen to decline a gtt northern? surely it's better to be aware of and treat/change your lifestyle for GD, to reduce the chance of any complications? I thought it was quite often asymptomatic?

I declined twice smile. In both pregnancies I was fit and well with no indications of GD and no risk factors other than weight (I was under 30, white, no family history, reasonable sized previous babies not HUGE, no signs of GD in previous pregnancies.) I thought it was therefore a unnecessary test and the process of doing it was both anxiety inducing and also in practical terms difficult for me as I was nauseous and sick every day, even in the third trimester. Had I fasted and then consumed a large volume of glucose drink the ONLY thing that would have happened would have been me throwing up. I didn't feel I needed that test at that point. I was right.

Oh and in lifestyle etc terms - I was consciously trying to eat sensibly anyway, partly because of the nausea and I was determined to deliver in a non-supine position - which I did. The risk that our consultant laid particular stress on was that of shoulder dystocia - which wasn't helpful because dystocia cannot be predicted in advance and is about a lot more than the weight of the baby. Didn't inspire me to follow his recommendations.

grainmum Fri 08-Feb-13 23:44:26

When you put it like that sounds entirely reasonable to decline smile . I guess the thing about medicine/tests etc is that guidelines are developed on the basis of populations, but in reality decisions are taken by individuals.

We declined NT screening, and then had the midwife/sonographer double checking that we really wanted a 20 week anomaly scan - different decisions are right for different people.

OP it's a shame you're having this extra stress which could have been avoided by the midwife just explaining at the time. I'm sure you'll be fine.

smile Yes exactly. Some overweight women will have a higher risk pregnancy but not all. However all women should be making decisions about their care and not feel they only can to do as they're told. If I was pregnant now (aged 35) I might think differently about a GTT for me now. Might........ grin

They really seem to have zoned in on risk factors for those with raised BMI since I was last pregnant 2.5 years ago. It's all just precautionary and allows them to make sure your pregnancy is healthy. I did have the GD test, came back clear and have had a very simple healthy pregnancy.

I took part in research during my pregnancy for women with high BMIs. My reason being if they can accurately start to predict who is more likely to have problems rather than a blanket "High BMI = possible problems" then that can only be a good thing. My booking in midwife was awful, made me feel awful for having the nerve to be fat and pregnant. The fact I had lost 2 stone in the run up to falling pregnant was lost on her.

Anyway, OP many other women are referred for this exact a same thing, hopefully one day they will have the knowledge to specially select those who are genuinely high risk.

Btw I had 2 GTTs as 16 and 28 weeks. I also had extra scans for the research at 24, 30 and 36 weeks, which were a lovely bonus. The research also involved them taking a sample of flubber from my tummy and part of my placenta, and a day on a ward on a glucose drip having blood taken every 30 minutes. I enjoyed the lie down that day! smile the drs and Mws at the tommys clinic were totally non judgemental and lovely. I ended up transferring my community care to them because of awful booking in MW, as I was seeing them more anyway.

Good luck with your pregnancy! smile

louloutheshamed Sat 09-Feb-13 08:38:56

Thank you these experiences are helpful. Northern I sound similar to you I am 29 and ds was 8lb 7oz so not huge. At the minute the idea of the Gtt makes me want to cry but hopefully that will change by the time I am in the 3rd tri and the sickness has stopped.

The weird thing is I have 2 friends who have had gd and they were not overweight at all??

Supergal Sat 09-Feb-13 12:42:07

But it's only a fast, glucose drink and a few blood tests. I don't understand why it's such a big deal honestly. If it can help you and your baby by earlier diagnosis then I'd do it.

Just my perspective mind you and I speak from the position of having a baby who died neonatally so I'm more cautious and will take anything that's offered.

Everyone here gets offered a GTT at 28 weeks regardless of BMI.

Supergal I'm sorry to read of your loss and of course that influences how you would feel about proposed interventions. We are all informed by our experiences. I was very keen to avoid induction with dd3 and refused to be booked for at least 14 days after term. 10 days was the stadard on our trust at that time. She actually arrived at +8 so it wasn't an issue. Since her birth a friend has lost a baby to stillbirth. She wasn't quite at term when that happened but still - I think if I was going past dates now I would be happier to accept induction. The point is that every pregnant woman - overweight or not - should be able to make their own evaluation of the risks and benefits. Very few decisions are as cut and dried as 'this will save your baby, this will harm your baby'. Mostly it's about 'this might give us some information that might change your management and that might have a good consequence or a bad one and you might be anxious about a or you might be anxious about b...' It's just very hard sometimes and so it can be hard to understand each other's reasoning.

Bluemonkeyspots Sat 09-Feb-13 13:43:32

Is it different in different areas?

Mine was 34 at booking but because I'm tall she said it was fine hmm not sure what she was thinking as bmi takes height into consideration.

Anyway I've needed a few extra checkups because of previous problems with being pg (none weight related) and my weight has never been mentioned by anyone.

I may need a cs this time though and am worried I will get a bollocking then If it's needed.

Supergal Sat 09-Feb-13 15:21:23

Northern, you're right. I think that what I was trying to say was that we all need to make informed decisions - be aware of all the facts, the risks and benefits of action or inaction - to make what decisions we feel right for us and our babies.

I had a cs after a failed induction and the amethyst it's said she was surprised at my BMI and said her personal view was BMI is a flawed system to calculate obesity. I am very short which is what she said skewed my results.

Anaesthetist hmm

PickleSarnie Sat 09-Feb-13 20:24:05

It must be really random in different areas. My bmi was 31 but I never had a GTT and was low risk all the way though. Had a homebirth and my bmi was never mentioned as a concern at any point.

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