Childbirth with high BMI

[UsernamesHarderThanBabyNames]

I'm pregnant for the first time and have been told I have to give birth in the hospital labour ward rather than the lovely midwife led birth centre because of my BMI.
At my booking in appointment my midwife was quite gutted about this because until she weighed me she thought I was a perfect candidate for the birth centre as I am otherwise low risk (not due until June so this could change!). My BMI is around 39/40 which sounds massive but I am "only" a small size 16 and would say I look overweight but not obese. I've always weighed a lot (even when I lost a lot of weight years ago and was a size 10/12 with a 27 inch waist my BMI teetered on the border of overweight and obese) but feel reasonably fit and healthy so it's very annoying when I get a computer says no situation. I am very curvy (J cup boobs and a shelf like bum!) and I think my womanly bits must weigh a lot! It's always been a thing I'm aware of - I have friends who are a similar dress size to me but more apple shaped who weigh at least two or three stone less. Annoying.
Anyway I've come to terms with the birth centre thing especially as my midwife said they can create the birth centre experience on the ward and I can still have a birthing pool etc which I'm hoping for. However I'm scaring myself with stuff online about women with high BMIs being refused water births and generally being treated like a very ill person and getting unnecessary c-sections etc which is my worst nightmare! I'm basically worried that the hospital will take one look at my BMI and strap me down or something! I'm beating myself up about it a bit and wishing I'd gone on a crash diet before TTC although from previous diet experiences I'd really struggle to get a BMI below 30 without starving myself!
Can anyone say anything reassuring?! Or not...

[mrsnec]

I was a little overweight before I was pg and a bit now. I think it depends on the doctors in your area. I saw about 5 different ones throughout my pg. I did have a cs but it was nesscesary and in my case only one of the doctors lectured me about my diet. I didn't agree with everything she said but I did try to cut down on sugar.

I was very closely monitored for gd but apart from that I don't think my treatment was any different from anyone else.

[MostHighlyFlavouredLady]

What did you get on the scales for?

[MostHighlyFlavouredLady]

I have a similar BMI to you and I think similarly built. I had a home waterbirth for my 3rd birth and a standalone MLU birth for my 2nd.

There was some grunts but honestly, if you refuse to take no for an answer it is amazing what can be agreed.

[MostHighlyFlavouredLady]

Being on the labour ward alone increases your chances of a CS.

[UsernamesHarderThanBabyNames]

Your experiences sound reassuring MostHighlyFlavouredLady, thank you - in my case the MLU is inside the hospital so I'm hoping I can beg my way in there and if anything goes wrong it's a 30 second stretcher ride to the ward anyway!
I was feeling really relaxed about giving birth (actually weirdly looking forward to it) until I started worrying about this. Really want things to be as natural as poss but maybe I'm naive. Because my weight doesn't feel like an issue for me day to day it was a shock to find out that, on paper at least, it is as far as pregnancy is concerned.

[Thehedgehogsong]

I'm similar to you in that my BMI is high but I am healthy and a size 12/14, I just have a lot of muscle from a previous life in sport weighing me down! I had a home birth a week ago. I just refused to discuss any other options and made sure I acted like it was completely in my control. I used 'I am having a home birth' not 'I'd like a home birth'. At no point did I imply I was asking permission. I am fairly scary though so that helped I'm sure!
It's your right to choose where you give birth. Don't forget that.

[MostHighlyFlavouredLady]

I was very mobile during labour. I don't like people touching me so if they asked to change position or whatever I'd do it quick as a flash. They wanted me to get out of the pool to deliver the placenta. When I asked why they said that if I lost a lot of blood they wouldn't be able to lift me out. I told them that should I begin to feel feint I'd tell them and get out before I passed out, with DH's help.

It is always worth asking them what exactly they are concerned about and then addressing the individual problems. Being overweight wasn't the potential pool problem for me, losing blood and being too heavy to lift out was, and I had a solution iyswim.

[InanimateCarbonRod]

Please scoff at any healthcare worker that still uses BMI as a real thing ... health.heraldtribune.com/2014/04/21/body-mass-index-flawed-measure-obesity/

[MostHighlyFlavouredLady]

I used language like the previous poster too. I am having my baby in the MLU for the 2nd. I am having my baby at home for the 3rd.

At one point a midwife told me that some paperwork had to be done so that I wouldn't be refused a homebirth. I laughed. If a lack of couple of pieces of paper could shift my arse out of my house then I really wasn't very heavy at all.

[anothergenericname]

Remember these are protocols and guidelines, not the law. Your body, your baby, your birth. You are allowed to say no to anything they suggest. Please question them and their authority - they are using very general guidelines, not your exact person and situation to make plans. You can listen to their advice, but that's all it is and you don;t have to follow it.

Best of luck - you sound like an ideal candidate for a MWLU to me

[Peaceloveandbiscuits]

I was very concerned about being strapped down immediately and being forced into a CS due to my BMI. However, my midwife has said that the best thing for me is an active birth, and to be stood up and moving around as long as I want to be. I was surprised as it feels like every door has been closed to me, but this was really important and I'm pleased she has been on-side about it. My BMI was 43 at booking-in and is 47 now at 38 weeks (and I've only put on 6kgs. I'm very short!).

[MrsCakesPrecognition]

Our hospital has a Birth Choices service where higher risk women can talk through all their options with a specialist midwife. It might be worth asking to speak to a Supervisor of Midwives for advice.

[PenguinsandtheTantrumofDoom]

"Remember these are protocols and guidelines, not the law. Your body, your baby, your birth. You are allowed to say no to anything they suggest. Please question them and their authority - they are using very general guidelines, not your exact person and situation to make plans. You can listen to their advice, but that's all it is and you don;t have to follow it."

I am sorry, but unless I've totally misunderstood what you are trying to say, that isn't accurate at all.

Yes, you are allowed to say no to any treatment option that they suggest. But you aren't allowed to pro-actively demand (except that you have a right to say you're having a home birth). It isn't 'advice' that they won't allow you in the MLU, if that's their decision, it's their decision. If they won't allow you in the pool, that's there equipment and their decision also.

[uurrghhhhhh]

I have found my experience has been exactly what you
fear.

[MostHighlyFlavouredLady]

You can increase your chances of access by being firm though. I knew there was nothing except an immediate emergency that would bring me anywhere near a labour ward. The 'negotiation' was about how best to give birth with that as an absolute non-negotiable.

Sticking to the words 'I'm having my baby in the MLU' seemed to convince my caregivers that it was indeed true regardless of my previous PPH, high BMI etc. Same with homebirth even with suspected GD and history of PPH.

[anothergenericname]

It's amazing how much more receptive to an MLU birth they become if you mention the words 'home birth'...