Told to lose weight by midwife

[Paradii]

My BMI is 26 so I am classed as overweight.

I train horses for my job so I have a lot of muscle mass, especially in my legs. I have a flat stomach and definitely don't look overweight. I told her this but she insisted that I'm overweight and should aim to eat less calories/ more healthily.

Aibu to think I shouldn't try to lose weight, particularly when pregnant?

[5128gap]

People will tell you to ignore her, but I'm not sure its good advice to just ignore health care professionals when we disagree with them, as after all their job is to advise us. If you think her advice is wrong I would suggest trying for a second (professional not MN!) opinion rather than just disregarding it.

[ArblemarchTFruitbat]

To answer PP; yes, she advised me to eat fewer calories as I must be eating too many presently, "or I would not be overweight."

I don't think that's the same as telling you to lose weight, though. I would interpret it as meaning you should avoid gaining excessive weight during your pregnancy.

She was very very overweight herself, not that it matters to me at all, just to answer pp.

HCPs have tick-boxes of lifestyle things to warn you about - weight, drinking alcohol, smoking etc. - they won't amend this to reflect the lifestyle of each HCP.

[saleorbouy]

The midwife has seen many people experience pregnancy and is giving you advice to help you navigate pregnancy in the best of health for you and your baby.
Whilst you might not agree with her assessment she is thinking of your best interests and you should try hard to maintain a good weight and fitness as this will pay dividends during giving birth.
Reducing the health risks during pregnancy is her prime motivation and excess weight can lead to many.
Obviously continue with your active healthy lifestyle but be mindful not to allow weight gain not to be unchecked.

[Somersetlady]

Another horse rider here who has been told the same I am 5”10 and wear size 12 clothes

I was actually told this in hospital by about 5”4 clothes size 20 nurse

The good news is my consultant says riders find both natural and c section easier as they have such great core strength! Best of luck with the pregnancy and ignore the BMI eat healthily for you and your new arrival and enjoy the next few months.

[PurpleDaisies]

@5128gap

People will tell you to ignore her, but I'm not sure its good advice to just ignore health care professionals when we disagree with them, as after all their job is to advise us. If you think her advice is wrong I would suggest trying for a second (professional not MN!) opinion rather than just disregarding it.

Looking at what the NHS says is a good place to start.
There are good reasons to think that this midwife didn’t know what she was talking about based on lots of reputable sources.

[Franklyfrost]

I think the midwife has a point. Even assuming that when you say you work with horses you mean you do hours of vaulting a day and so exceptionally muscular that BMI is meaningless, you’re going to reduce the amount of gymnastics you do as the pregnancy progresses, muscle will turn to fat and it’s worth keeping an eye on that. I don’t think the midwife meant to offend you or suggested you should loose weight, just to keep healthy eating in mind.

[5128gap]

The weight of your health care professional is completely irrelevant to the validity of their health advice. They are advising you based on the findings of medical research and health policies, not on the basis of their own lifestyles. Its not a personal relationship where it would be a bit cheeky for an overweight friend to comment. The advice is objective and doesn't change depending on the weight of the adviser.

[DeclineandFall]

The scale thing of the BMI range is misleading as there is no way to determine where on the scale a person of a certain height should fall to take into account frame sizes or muscle mass.

2 people of the same height Person A small framed, small bust, little muscle mass and person B large framed, busty, more muscle mass both have an ideal weight that is different.

The BMI chart means person A has 2 stone to play with before they are officially overweight, person B may only have a few pounds. So at a BMI of 25 person A maybe seriously unhealthy and person B maybe be at their most healthiest.

[amysaurus87]

I hate to think what she would have said to me then! I'm 38 weeks with my second and at my booking appointment my BMI was 33.6!

I don't think telling you to eat healthy/less calories is asking you to lose weight though.

I ended up losing weight in the first trimester due to morning sickness and a total lack of appetite...even now I've only put on just over half a stone!

[Campfirewood]

Are you sure your BMI is 26? I can't imagine any midwife caring about 1 point, maybe it's higher and she told you accidentally the wrong number, or there was a typo?!
I mean she is right, under 25 does lead to better health outcomes, but 1 point seems odd.

[heathspeedwell]

BMI is more critical than some people realise. Being obese (a BMI of 30 or above) when pregnant comes with an increased risk of miscarriage and twice the risk of complications during birth or of stillbirth. It carries a 2-4 times higher risk of pre-eclampsia.

We need far more research into what causes this and far more funding and support to help women gain a healthy weight before trying to conceive.

www.rcog.org.uk/en/patients/patient-leaflets/being-overweight-pregnancy-after-birth/

[SpindlesWinterWhorl]

@Franklyfrost

I think the midwife has a point. Even assuming that when you say you work with horses you mean you do hours of vaulting a day and so exceptionally muscular that BMI is meaningless, you’re going to reduce the amount of gymnastics you do as the pregnancy progresses, muscle will turn to fat and it’s worth keeping an eye on that. I don’t think the midwife meant to offend you or suggested you should loose weight, just to keep healthy eating in mind.

The OP says in her first post, "I train horses", so presumably not the sort that are large wooden constructions with secret escape tunnels being excavated beneath.

[Starcaller]

I'd have gone home and had a Twix

[yellowflowersintherain]

I don't agree that BMI is meaningless (as some PP are saying), but I do think that this was ridiculous advice from the midwife and a complete overreaction to a BMI of 26.

[Franklyfrost]

@SpindlesWinterWhorl
Eh?

[PurpleDaisies]

You are the best qualified to make decisions over your own health and body.

People make rubbish health choices though. I’m not saying that’s the op but plenty of people really don’t know what’s best for their body over what an appropriately trained person is advising them.

People can make their own choices obviously but let’s not pretend that they make the right ones all the time.

[Skysblue]

In general trying to lose weight during pregnancy is a terrible idea. I know someone who has bone problems because of how her morher ate during pregnancy.

Your bmi is fine. A bigger problem is that your midwife has bad judgement. Even if you are slightly overweight, getting you stressed about it during pregnancy was terrible midwifery. Request a different midwife, you have a right to do this (I did).

[Mumoftwoinprimary]

@Franklyfrost

I think the midwife has a point. Even assuming that when you say you work with horses you mean you do hours of vaulting a day and so exceptionally muscular that BMI is meaningless, you’re going to reduce the amount of gymnastics you do as the pregnancy progresses, muscle will turn to fat and it’s worth keeping an eye on that. I don’t think the midwife meant to offend you or suggested you should loose weight, just to keep healthy eating in mind.

Muscle can’t “turn into fat” any more than a carrot stick can turn into a 6 inch pizza! Muscle can become less toned but that is very different.

It’s unusual for muscle tone to mean that a healthy person has an unhealthy BMI but it does happen. Dh is an ex international at a sport. His BMI is surprisingly high for what he looks like. But he has arms like popeye, legs like Chris Hoy and a stomach that is a wall of steel. In the nicest way, he is a freak.

[Ceecee30]

Just ignore her, if she mentions it again tell her where to go. Imo bmi is total rubbish and even if it was useful, a bmi of 26 really isn't that bad.

[Everydaylemon]

@SpindlesWinterWhorl PP means this

britishvaulting.org/

[Ceecee30]

To add, my Dp - male is 5 foot 9/10ish. He's 11.5-12 Stone, in men's size small and 30 inch waist jeans. He is borderline overweight by bmi. If he went over the 12 Stone mark he would be considered overweight. So imo bmi is utter rubbish and outdated.

[Franklyfrost]

@Mumoftwoinprimary

Yes, it doesn’t turn to fat but the muscle cells shrink and the fat cells grow so where there was muscle there is now fat. Technically muscle is replaced by fat but that doesn’t make any difference to the point I’m making: exercise less but eat the same and you will gain fat and loose muscle.

[katem1990]

Sounds like she believes BMIs are the be all and end all. They’re a guideline and not one size fits all. You definitely shouldn’t be dieting while pregnant.
Tell her to sod off - and if she presses the issue, go to your GP for a confirmation (read: proof) to use against her.

Could you ask for a different midwife? Not sure I’d like someone like that ‘supporting’ me through pregnancy and birth.

[ArblemarchTFruitbat]

@DeclineandFall

The scale thing of the BMI range is misleading as there is no way to determine where on the scale a person of a certain height should fall to take into account frame sizes or muscle mass.

2 people of the same height Person A small framed, small bust, little muscle mass and person B large framed, busty, more muscle mass both have an ideal weight that is different.

The BMI chart means person A has 2 stone to play with before they are officially overweight, person B may only have a few pounds. So at a BMI of 25 person A maybe seriously unhealthy and person B maybe be at their most healthiest.

I agree with you - but I have always believed the BMI window is more about risk than ideal weight.

So Person A in your example may be over their ideal weight at the top end of the range, but they won't be overweight to the degree their health is at risk. Similarly Person B would be underweight at the bottom end of the scale but not dangerously so.