Homebirth with a BMI of 30?

[curlygirl]

I am 7 weeks pregnant and have just had my booking with my MW. I really want a homebirth because I had a horrible birth experience last time. I have recieved a form listing criteria for levels of risk in pregnancy. One of the criteria is that if you have a BMI of 30 or above you need to be booked high risk and recieve treatment to prevent thrombosis after delivery. My BMI(I calculated it from a net tool), is just below 30, but by the time I go to the hospital booking in 5 weeks time I suspect it will be 30. I am really worried about having unnecessary intervention again. I sailed through my previous pregnancy and labour until I went into hospital, then it all went wrong. I just want to be left to get on with having my baby my way, anyone got any opinions on this. Am I being stupid?

Does your hospital have "home from home" rooms where you can give birth as naturally as possible? My local hospital has this facility, where it's like being at home (well, sort of) and you can have the equivalent of a home birth with gas and air and midwife support, but no other drugs and no epidurals. The rooms are large with nice coloured furnishings, pictures on the walls, TVs and DVD players. Obviously this isn't as good as actually being in your own home, but it may be a sort of middle way if the medical staff would prefer you to be in hospital.

Yes they do have a home from home room but is not like home is it? My contractions dissappeared completely last time as soon as I stepped into the hospital after I had laboured perfectly well at home, then when they came back it was very quick and I had a decelleration in the baby's heartbeat. The doctors were called in, legs up in stirrups and attempted a ventouse. Doctors then decided baby's hearbeat was fine and asked me if I wanted to push. By that time I was in agony and asked them to carry on. I had to watch my baby suffer ythe consequences of a difficult birth for weeks after, she was irritable and wouln't settle. I was left with an extremely sore episiotomy wound etc that were all completely unnecessary. I am 5ft9 with a "pelvis like a bucket" and had a completely straightforward pregnancy. Why can't I have no intervention unless I deviate from the norm? Isn't that my choice?

I had a homebirth CG, and there was no mention of my BMI! Had I not read your thread today I wouldn't have known! I have recently worked out my BMI as I was wanting to diet (baby is now 7 months old) and it is 30. I doubt it has alltered much since baby was born!

What does your midwife say? I'd say go for the homebirth, do all the research you can so you can give a productive "argument" to your midwife to make sure you get what you want!

BTW No, you're not being stupid, if you were stupid you wouldn't have asked such a question!

Good Luck! Please CAT or email me if you have any questions. kartooning AT ntlworld DOT com

Poor you CG, I'm also tall like you (5'10 actually!) and I know what you mean about your pelvis. My DS1 was born in hospital and we were pretty much left to it, DS1 was on his way out, I told the MW I wanted to push (I was in the birthing pool at the time) and she said "oh no way you're not ready yet" I pushed anyway and then said "its hurting I want to get out and have an epidural" she let me get out, walk accross the corridor, get up on the bed and then said when she examined me that the baby was right there and ready to be born. I was furious, why didn't she check me in the pool?!
Thankfully DS1 was born 45mins later, that MW buggered off before he was born and left me with two MW's who didn't really do the guiding thing of "push now, don't push but pant" etc. I ended up all torn and I'm, sure it was when DS1 got his single suture down his head from me walking from one room to the other!

DS2 however, was born at home with two great MW who were angels on earth, they were fab and I didn't tear at all! He was a big baby all 9lb of him! I'm not planning on doing it again, but if I did I'd be sure to have a homebirth. )

Thanks for the encouragement, I think I am going to insist that they go on the BMI that I am now. My midwife didn't believe me when I told her what I thought I was, she thought I was nowhere near a BMI of 30! I look a bit overweight but I certainly wouldn't consider myself obese. Apparently I am.. I know the sensible thing to do is to eat really healthily but I only feel like stodge at the moment as it eases the nausea. Fruit and salad just makes me feel sick.

Hi,

I have a BMI of 36 and I'm planning a homebirth. Size has never been mentioned. I may be a tad overweight but I'm pretty fit. I wanted a homebirth with my first, but after 33 hours I went to the hospital because they thought it was going to be hours and hours and 4 hours later DD was born. I was gutted as I got no support at the hospital and ended up with a pretty bad 3rd degree tear. Baby no.2 was born at the hospital as I was persuaded it was safest in case the tear went again, but didn't bother to go until the last couple of hours. Birth went absolutely fine with just an hour of gas and air. I'd researched damage limitation on the tear and had a midwife who understood. My 1st baby was 8lb and my 2nd 9lb 8oz but a much better birth. This time I'm planning a homebirth and my consultant has said no problem. Didn't even mention my size and my BMI is circled on my notes. If you want a homebirth there's no reason you can't have one because you're a little overweight.

I'll try and find more out for you if I can. My friend is a midwife and she has a pretty high bmi (around the 40 mark maybe? - less than me!) and she gave birth to her third child at home. She had such bad times in hospital she wanted to get on with it. They let her have him at home because she had proved she could deliver ok, and she was absolutely fine at home.

I had a home birth nearly a year ago and my BMI nor my weight were even mentioned. I was only weighed once during my pregnancy and that is to do with working out your risk score for downs. Why should it matter, I agree with what someone else posted - get as informed as possible, make sure you have your partner on side when you speak to consultants, that really helped me, and if you have a community midwife who is positive about home birth latch on to her like a limpet!!

i am sure that they only count ur bmi at the start of pregnancy...i was just under the recommended bmi for a normal delivery(or homebirth had i chosen that) and i was only weighed the once but i made a concious effort to eat a bit more and of the wrong things to boost my bmi. I am sure that they can't count bmi during pregnancy because its forever changing and getting bigger!! After all its not fat its baby!

I would say that if u are under the high risk bmi then you should still ask for ur home irth but i am not a mw x

Hi,

I used to be a midwife and I can't ever remember the BMI being that significant in where a woman gave birth. It IS 5 years since I've been a midwife so they may want to check it for some understandable reason but I can't, for the life of me, think what this would be.

If you want to have your baby at home just tell them "I am having a homebirth". End of discussion. You are having antenatal care in pregnancy and this should give you a pretty good idea about whether you are staying healthy or not.

It's all relative anyway - they cannot possibly stop you from having a homebirth just because one of their criteria doesn't fir with you - if you had all the problems on the list then maybe I'd suggest that hospital might be the best place. However, a BMI of 30 is not a reason to say "no homebirth".

Check out Angela Horn's homebirth site (with loads of info regarding "You can't have a homebirth because...") Her site is here

Hope that's useful

Mandy

I know someone who had a home birth who had a bmi of over 30. She had to fight for it though

Oooh, don't get me started. I'm a big lass, with a BMI of 37 when I asked to be booked for a home birth. I was sent to a consultant, basically so he could try and intmidate me to changing my plans, but I insisted pointing out that I wasn't in any other risk group and that was that. BMI is only measured at the start of your pregnancy though, so I wouldn't worry.

The midwives kept looking for reasons to prevent my home birth all through my pregnancy, I remember the glee on the face of one of them when my BP seemed high, but thankfully I'd read up on possible pitfalls and the problem wasn't my BP but too small a cuff. A large cuff was ordered and my BP remained normal despite the hassle I had to deal with.

Another issue I had to wrestle with was the "big baby" problem. I have a theory about this- I'm a big girl so all the medical professionals assume I'll have a whopper. My fundus kept measuring big. I personally think fundal measurements are incredibly inaccurate, particularly when your midwife expects a certain reading, seek and ye shall find syndrome. So after much doom saying about the terrors of shoulder dystocia and wild speculations on what could be wrong with my baby I was reluctantly sent for a scan at 36 weeks. Baby measured in the 99th percentile- a whopper for sure! Surely you'll reconsider your selfish desire for a homebirth now, exhorted my midwives. My DD measured in almost exactly on the 50th percentile when she was born- 7lbs 14 ounces. Not exactly a whopper. No problems with shoulder dystocia as well, in fact, the midwife who attended the birth of my daughter complimented me on how well the second stage of labour went.

If you do get any hassle about your BMI, which I doubt you will, just stick to your guns and check out these websites

Junk Science about Obesity and Childbearing-
www.gentlebirth.org/archives/junkObesity.html

Home Birth Reference Site-
www.homebirth.org.uk/

The Plus-Size Pregnancy Website
www.plus-size-pregnancy.org/

Just to add, CG, BMI is a pretty crude tool. It takes no account of the division of weight between muscle and fat, I find it surprising that men and women are put on the same scale, and discussions I've read in New Scientist recently point out that BMI measurements are sort of skewed, so that you are more likely to have a higher BMI if you are taller (basically because weight is divided by height squared, rather than cubed, effectively assuming only 2 dimensions) - the example given of this was to calculate the BMIs for the last oxford boat crew - all the rowers were overweight/obese, and the cox was underweight by the standard definition.
If you're mw thought you looked healthy, then you probably are, and I suspect you have nothing to worry about.

Thanks to everyone for the advice. Sorry it has taken me a while to reply, I haven't really had much time to log on recently. I have just read through all of your posts, some really interesting points of view, I will certainly check out some of the recommended websites. Thanks all, I now feel empowered to stick to my guns. Obviously if anything deviates from the norm I will do the sensible thing.