BMI Frustration(20 Posts)
I'm 22 weeks pregnant - had a really tough ride so far with constant sickness up (3/4 times a day) until week 20 and still sick once a day most days in the last fortnight.
Every single apt I have with midwife or dr they bring up my high BMI - I have it written in my notes that it was a hindrance during scans even though when I asked the sonographer what this meant, she said 'oh everything was fine, we just have to write that when your BMI is high.' I've had lots of blood tests and everything is normal yet they have referred me for a glucose test (glucose blood test in routine bloods was normal)
I now have to see a consultant - I asked midwife what the apt was for and she said because you need to discuss your BMI and he can go through your labour options
I have a chronic illness and severe anxiety, both that I am really struggling with yet every apt is dedicated to basically scolding me for being overweight. I never get opportunities to discuss other issues, I've asked to be referred to mental health services for support and to see a specialist about my illness but both are met with 'sure, we'll get right on it' and then nothing happens.
I think BMI is bullshit anyway but this is making me so angry. I'm eating as well as I can given sickness, all four scans I've had have shown baby growing absolutely fine, active and strong heartbeat, my blood tests are showing normal in everything (A rhesus negative but that's it) and yet STILL. I am exhausted with it all.
I'm not sure what I want to happen, just needed to vent!
Out of curiosity what is your BMI? If it's over 30 they will be concerned but if it's lower 30's and you are in perfect health then they won't even mention it. They haven't with mine and my BMI is 33. I think the fact you have other serious health issues is why they make it a deal. Of course if your BMI is in the 40's then I understand why they would be very concerned.
I know it's frustrating, but it's standard to have to see a consultant if anything flags up to have the potential to put you at higher risk of complications.
I'm having to see one myself because I lost 3 litres of blood with a miscarriage. It's unlikely to happen again, but I'm still classed as higher risk statistically.
The way I see it is i'd rather be extra cautious than not, even if it's frustrating getting across to the hospital and all the extra faff.
Maybe the consultant will put your mind at ease.
BMI can be bullshit but if you are significantly overweight or obese (I think BMI over 30 is usually consultant led, so quite big) you do need extra support and to discuss birth options because you are at higher risk of GD, you may not be able to have a waterbirth in case midwifes are unable to help you out of the pool if needed and there cam be problems siting an epidural. I would really try to see it as a good thing thay you are getting extra care and not take it personally, though I know that is really hard. And you are 100% correct to push for support with your other issues.
FWIW, my BMI is in the healthy range but I was sent for a GTT for other reasons, as have loads of other people I know, when I questioned this I was told guidelines have changed due to the explosion of diabetes in the general population, and the NHS is now trying to capture all at risk groups as early as possible and this includes pregnant ladies as if you do develop GD you are more likely to suffer from type 2 diabetes later in life so you'd be put onto a monitoring program post pregnancy. In my mind if I'm at risk of GD/type 2, I want to know and be checked so can only be a good thing!
Good luck with your pregnancy
Oh I feel for you, I have been obese with a bmi of 33 during a PG and it is horrid, isn't it? I found the whole thing deeply shaming. And the fact that you aren't getting the help you asked for with your mental health is dreadful. You have my sympathy as the whole thing sounds crap....
BUT if you can take some well meant advice from someone who has been there.....the reality is that a BMI over 30 is a serious consideration for midwives and doctors during pregnancy and they would be remiss (and legally liable) if they did not consider the implications of it.
The GTT test and likewise the consultant appointment are designed to try and offset potential difficulties that could be caused to you and your baby by the high BMI.
The sonographer was probably being kind to you to you and trying to spare your blushes by saying that when she wrote the view was hindered it wasn't true....it is unlikely she would write something incorrect in your medical records, I'm afraid. I had to have a scan a week from week 20-38 in my pregnancy as there was a growth concern and I unfortunately had the experience of waiting whilst they shuffled staff around to give me a more senior member of staff as it was harder for them to get a good view of everything because I was obese so they left it to the most experienced staff. It was not fun waiting in the reception with other ladies who I'm sure could also hearing these discussions about me, but that was the reality, there is more tissue in between the baby and the probe.
I felt very ashamed a lot of the time when meeting healthcare professionals, and it is grim. And I did meet one or two who I felt were deliberately putting me down, but a lot of the time staff weren't trying to deliberately get at me, but it still made me feel pretty shit because I felt deeply ashamed of my weight.
Don't let them fob you off with no mental health help, keep insisting and take someone with you to support you if it makes you feel stronger, but at the same time prepare yourself as I suspect the BMI will be an issue at each appointment.
Mine is 35 - due to bad eating after 4 failed ivf as well as 7 cycles of drugs in 2yrs
Yes I've been told my bmi is higher then they like
But that's it
I get more comments on my age and that I'm geratric - I'm 43
What bmi are you?
I had a BMI of 39 in my last pregnancy and it was barely mentioned, was consultancy led due to pre-eclampsia in previous pregnancy (when I had BMI of 22).
In the end went into labour naturally on due date and on ringing hospital got told to go to midwife led unit instead of consultancy led as they had no concerns! Although to be fair the wards were next door to one another in case of emergency. I was active throughout labour (8 hours) and only needed gas and air and gave birth standing up in the end! I needed anti coagulant injections for a week afterwards which was unpleasant, but I must say I was treated very respectfully by all professionals.
My BMI is now over 40 and yes its bull shit but you know what...im pregnant. You know what else was bullshit, it took me over 6 years to get pregnant.
Being fat is shit but i blame myself.
I saw the anaesthetist consultant yesterday because of my BMI, he explained how much more more greater risk i am due to BMI and how important an epidural is during labour etc. I came away thinking how lucky i was being supported by professionals and how they want to ensure i have a safe labour. I also have to monitor my blood sugars due to borderline gestational diabetes. Its all done to ensure baby and you are safe.
If you feel they are being personal, just tell them and ask them about all your other concerns...
Strange how it differs from place to place. My bmi was 39 when I had DD, and I was 40 yo. Apart from being weighed and having a GTT, it was barely mentioned - or not in a pejorative way anyhow.
It did mean that good scan images were harder to get for the sonographer, so 'maternal
adiposity' was mentioned in my notes, and I did get referred to a nutritionist when my GD was diagnosed and, yes, I had to have a chat with the anaesthetist as I was having a c-section (unrelated to my weight). None of those things offended me though, I just felt like I was receiving good care.
I would just ask them to change the subject, you are allowed to do that, you don't just have to sit there being told off like a naughty child.
*should also say that I was only weighed once, at booking in.
smoky mountains is completely right, they have a duty of care to you and would be legally at fault. That said they should be supporting you and helping you, maybe raise it with PALS or the midwife team if there's a form for annoymous feedback?
It's 34, but even if it were 54, it seems ridiculous to bring it up at every meeting to the detriment of time to discuss issues I'm struggling with? BMI as a tool to measure well being and health etc has been widely discredited, and that along with every blood test and scan showing things are fine seems awful to keep making everything BMI focused?
Are any of your other illnesses weight related? That might be why they are mentioning it. Or are you sensitive to the issue? My BMI is 33 but I eat healthily and gym twice a week. They can usually tell your overall fitness by things like BP and hair/skin health as well as blood. Is there something else they are picking up on?
BMI isn't discredited. It's not perfect, but that's different from useless.
A lot of women don't ever lose the extra women they gained in pregnancy, will also be part of their concern.
High BMI does carry a greater risk of pregnancy complications though even if you feel its not an overall good measure of health. Anyone who is at higher risk for any reason gets consultant care. One of my friends has a chronic pain condition and even though her pregnancy is progressing normally, she gets consultant care because her pre-existing health issues class her as medium risk.
Many trusts (mine included) are making the GTT standard for all women so try to see that you get to take it as a positive as its a great screening tool. In the US where I'm from a version of it is administered as standard to all women. Being overweight does increase your risk of developing gestational diabetes even if you have no other risk factors as does being Afro-Carribean or South Asian; its just a fact not a judgement so try not to see it as a negative.
I agree your sonographer was being kind and trying not to upset you. Having extra body fat makes it harder to get a clear image and she wouldn't have written it if it wasn't the case in your official medical notes.
Besides making referrals for tests and appointments with the consultant how have the midwives treated you? What you've described so far seems just standard protocol but if they are lecturing your or demeaning you then you should make a complaint. You should definitely also keep the pressure on them for the referrals for your mental health and other medical issues.
I've got a BMI over 30 and it was barely mentioned in my first and third pregnancies.
In my 2nd pregnancy I was consultant led from the start (due to issues with the 1st pregnancy, not obesity).
In the first consultant appointment the doctor had a talk about the extra risks caused by me being obese. Fine, that's just them doing their job. Off I went and made a big effort to eat healthily etc. My next consultant appointment, I got a massive lecture about my obesity and how irresponsible I was being putting on weight, which made me think I must have been piling on more weight despite my healthy eating efforts. I checked my notes when I left that appointment - I'd actually lost almost half a stone between the first consultant appointment and the second. That really annoyed me, getting a massive lecture about being obese, when a 30 second look at my notes would have shown the doctor that I'd been making an effort to avoid putting on weight after the first talk.
Thank you all for your comments and points - I will look at the GTT as a positive and not worry too much about being referred for one!
re. The sonographer trying to just be nice, the scan photos are great and midwife says they are so clear it's like baby is posing! All scans, inc a private one have been fine with no issues seeing baby or getting photos so I'm not sure that she was saying it to be considerate.
I'm really not precious about my weight, I'm very body positive and happy to be this size - my issue is more that every apt is spent telling me off rather than handling the very real, worrying issues I have.
My chronic illness is absolutely not weight related
It's annoying to feel singled out for this, but do try to see the GTT being offered as a positive. I asked for one in my last pregnancy after a private scan showed that the baby had a worryingly large stomach. (I had also gained much more than the recommended amount by 25 weeks, despite starting off at a low-normal BMI.) I didn't have it but it was a relief to have all the information. (Baby just ended up being big.) On the whole I think the risk is that the NHS offers too little antenatal care, and I am much happier being in a higher risk population in my current pregnancy (older, previous c-section) -- now feel much safer and better cared for!
PS can you ask your GP to do a new referral letter to perinatal mental health? It is awful if midwives are ignoring you there, but maybe you can bypass them via GP surgery or by asking a consultant (if you see one).
I'm definitely going to see the GTT as a positive thing, although not looking forward to it!
I have asked GP to refer me, he said midwives must do it. I was very teary and anxious in my apt today and said I was desperate for the referral I've been promised since week 5 and midwife said it would def be done so fingers crossed.
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