BMI confusion(21 Posts)
My BMI at booking was 33 which whilst above 30 wasn't over the threshold of consultant care which is 35. Nothing else was said about it.
Today when I asked about the birth centre referral (which I'd always been led to believe was fine) I was suddenly told that they need to weigh me again in 2 weeks and if my BMI has gone up then I wouldn't be allowed in. I've put on about a stone in total so not a lot and within the guidelines for my weight but this is more than enough to push me over the threshold. How does this make sense? Was I meant to put on no weight at all? And if so why wasn't i told this?!
Has anyone else experienced this?
My bmi was 35 at booking and it's 38 now at 38 weeks pregnant. I had to wait until 36 weeks until they told me whether I could use the birthing centre or not, depending on how much weight I had put on.
Each hospital has a different cut off for the birthing centre and mine was 39.9
As I understand it though, like the above poster you can refuse to be weighed and use your booking in weight however I highly doubt you will put on that much weight to stop a birthing centre labour. I would ask what the cut off is
I was never told any of this either until I asked when I would know when I was having my baby at 36 weeks!!
Thanks both. If I refuse to be weighed would they not just say no, can I insist they use the booking in weight.
What's made me more angry was that very early on I asked advice about guidelines for the amount of weight I should put on and was categorically told they didn't advise on this anymore, I wouldn't be weighed again and not to worry about it.
I asked the MW today what the cut off was and she didn't know. Maybe I should crash diet for the next two weeks.....(not really considering this!)
I would just say "you've told me that I wouldn't be weighed again" if they ask you to hop on the scales. I did because I didn't know any different but they are so shit at being consistent I would stick to your guns you can definitely insist they use your booking in weight. But honestly even if they did make you get weighed I can't see them not allowing you to use the birthing centre.
I think you can find the cut offs online somewhere. I'll try and find out. What set me in good stead (and what I was going to do if it turned out I had gone over the limit) was speak to the supervisor of midwives and ask them why every single hospital has a different bmi cut off. I'm in the northwest and my hospitals like I said was 39.9 but a hospital 10 miles away is 45....there's no consistency it's all different even though you'd think it would be the same under the nhs umbrella
I'd try and get a straight answer as to what the cut off is and if they can refuse to take you if you decline to be weighed.
I was refused at the birth centre after my due date (baby two weeks late) when I was led to believe all along that I would be fine (I was overweight and over bmi). It was all a bit of a shock to me and I'm sure it contributed to a traumatic birth.
Oh june2006 you have worried me. I was told at 36 weeks I won't be weighed again and that I'll be able to have my water birth. Were you weighed again in labour?
If you decline to be weighed, then they can simply refuse to let you use the birthing centre, so I'm not sure how that would help you.
Did you make it clear at the beginning of the pregnancy that you wanted to use the birthing centre? If not that could explain why they weren't a bit more pushy.
I do however find it ridiculous that you were told that they no longer advise on weight gain. That is absolutely absurd. I would definitely report whoever told you that. You could also ask to see your medical notes.
However, at the end of the day, there is a reason why they won't allow certain women to use the birthing centre, so even if someone has cocked up along the way, they do have your best interests at heart.
I did make it clear as I was asked at first appointment where I wanted to give birth and they raved about the centre. It's in the hospital so only 2 minute transfer time in case of complications
I'm also not actually that big despite higher BMI - I have massive boobs and big bones/ feet/ hands. I was told at the beginning it would hardly be a problem and not to worry.
this has confused me a bit too. so the cut-off BMI - do they take that at your initial weigh-in, or as you are about to give birth? as I was 32.5 at weighing-in, I think it's quite likely I'll be over 35 by the time the bean arrives!
This is the issue scarednoob - they told me it would be fine as my initial booking was 33 and now they are saying they need to weigh me again to check I am still under threshold (although MW didn't know what that was) - took me completely by surprise
gosh it is confusing. and even more so when every area seems to have different guidelines!
also how can your mw not know her own trust guidelines? gah!
OP - It sounds like you need to ask for an appointment with the senior midwife, or whoever is in charge of the midwife department.
Explain to them what has happened (but stay calm and don't get pissy with them) and ask them to explain what is going on. If you aren't happy with the response, tell that that you would like to lodge a formal complaint as to the handling of your care. HOWEVER, that won't make a difference in whether or not they consider it safe for you to use the birthing centre.
It sounds like you have just been unlucky enough to have had a totally useless midwife.
I think the issue is that I have seen about a million different MW's. It's in my doctors surgery and I rarely see the same one twice. The one that told me I need to be weighed again I have seen before and she is nice but seems very new and doesn't seem to know a lot of stuff....
How would I get to speak to the senior midwife? I am not sure who that even is?!
Ask to speak to the head of Midwifery at the BC you're due to give birth at. I'm not sure that this hasn't changed fairly recently, the later weighing i mean. With ds (who is only 18 months) I was booked in with a BMI of 30, told that the MLU was fine, low risk etc, never weighed again. This time (I'm 36 weeks) I was booked in with BMI of 30 again, same as before, told low risk etc same as before but told that I'd be weighed at 36 weeks. We've had other problems with the baby's growth etc so it may all be besides the point now but I think perhaps they're starting to weigh at 36/7 weeks now.
I think, confusing and misleading as the info you've been given has been - and I understand your frustration - you have to remember that the medics do have the health of you and your baby as the absolute top priority here.
As someone whose birth went from fine and dandy in a water pool to full-scale emergency very quickly, I can only vouch for how critical it could be to be in the right place at the right time.
It might be difficult to hear, but the fact is that there are significantly more complications associated with birth when the mother falls into the obese category.
The threshold is there for your safety and, if I were to end up in your position - having had the birth I did with DS - I'd be doing all I could to co-operate with the medics, rather than considering refusing to be weighed etc.
Before I gave birth to DS I was hung up on having the pool, having the birth being midwife-led, no interventions, soft music, low lighting etc. I was in my 20s, a marathon runner, healthy bmi, no other factors that suggested there could have been a problem .
But - and I hate to sound as if I'm scaremongering here - when things go wrong, all that matters is getting out of there safely.
If I were you I'd do some proper research into the risks and make the most informed choice you can as to what you want - apologies if that comes across as patronising and you've already done so.
Thanks for the response, I haven't considered refusing to be weighed that was just what other posters have suggested.
I guess I'm most disappointed that if my current weight is a big issue which could affect my birth and health that this hasn't been brought up with me. My weight has honestly not really been mentioned so far by any of the MWs or doctors. I was asked right at the beginning if I wanted to see a dietician - but it was offhand. That same MW described me as being 'only a bit over, don't worry'
Now I'm not only worried about not having the birth in the nice centre but also that I've put my baby in danger from your post....
OP - what on earth makes you feel like you've put your baby in danger? By having a high BMI at the time of conception? It's rare that people know exactly when they're going to get pregnant, so not sure how that's your fault. Likewise, you say you've only gained a stone during the pregnancy, so obviously big kudos there. You have never said that you plan to totally disregard the medical advice (and it's not like you could force your way into the birthing centre anyway!)....
I assume you are talking about runnings post, but I can't see anything at all that seems to be attacking you. All she is saying is that if the medical advice is not to use the birth centre, then it's out of concern for you - not just to be wankers.
I just wanted to update this in case anyone reads in future. I finally got some clarity and my MW was wrong - they don't re-weigh you at the birth centre, they just use your booking in weight. They said it would be impossible to rework out a BMI when pregnant and unless you looked like you'd put on a load of weight then its fine!
Thanks so much for updating OP, I was worrying about this.
Personally I'm looking a booking BMI of 30ish although my pre-preg BMI was 27 (thanks to booking in late, at 12 weeks, and quite a bit of weight gain in weeks 6-10), and I thought it wasn't beyond the realms of probability that I will be nudging 35 by the end, but I bet loads of people are in the same boat! It seemed a bit much that they'd calculate a BMI at the birth centre using the normal people's tables.
No worries. I hope I haven't got my MW in trouble as the matron at the birth centre kept apologising for the misinformation and said she would speak to her!!
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