Bmi birth centre/pool confusion

[Luckyjune2013]

Almost 28 weeks pregnant and all was going really well. Until yesterday - we have moved to a new area so had first booking in appointment with a midwife at our new hospital.
All in all it was a bad experience - so far I've felt really good about how it's all going (first baby) but I left feeling awful yesterday.
What's bothering me most is towards the end of the appointment I asked what people wear to give birth in the birth pool at their centre.
She replied and casually added 'of course they may not let you in the birth centre due to your bmi'. This was a shock as previous dr/midwives said throughout they were happy with my weight so I assumed all was well.

In a nutshell current bmi is 35, and was 31 at my first booking appointment when I was 10 weeks.
When I explained I was really keen to try the pool if possible she was really unhelpful - I asked was the 35bmi threshold taken as your pre-preg bmi or bmi at time of labour? She shrugged and said she didn't know, try asking at the antenatal classes (which I may be too late to do as they book up early).

In short, does anyone know which bmi the 35 threshold would apply to - my pre-preg bmi or current or at birth? Going to call dr on Monday to try to get clarity and completely accept if it is not safe for me, just feeling shit right now as she dropped what felt like a bombshell with no tact or ability to answer basic questions.

Given that the reason I've been told is that it's because they're worried they won't be able to get you out of the pool, and that that should surely be just weight, not BMI, I would just keep nagging on the matter until you get in.

You are entitled to make an informed choice around your care, you are on the threshold, and you'd like to use the pool.

For what it's worth, I had a BMI of 40 throughout my last pregnancy (I didn't put on any weight), but in Canada they were happy for me to go ahead with a home, water birth (didn't happen in the end for unrelated reasons at 40+10).

They were definitely more willing to give me the information and let me make my own decisions than they seem to be here though.

My BMI was 34 at my booking in and they never weighed me again. Was consultant led for a while as 1st DC was 9lb 8 at birth. Consultant signed me back to midwife led at 20 weeks and I was able to have a home birth. He said cut-off for BMI was 35 so 'I was lucky'!

I now you've said you're looking at the birth centre but it might be worthwhile looking at some of the home-birth information sites. They have arguments to use if they try to deny a home birth for various reasons, i.e. overdue, BMI. You might find the arguments/information could be useful for you with the birth centre and pool.

My BMI by the birth was around 38 I believe.

'I know' not now!

At our local birth centre you wouldnt be "allowed" with either of your bmis. The cut off is 30. My bmi was 31 at booking in first time around. If I had been determined to go there I would have had to have approval from a consultant first. My midwife thought it was ridiculous since I was fit and healthy with a straight forward pregnancy. Just a wee bit tubby. She actually wrote an official complaint to them apparently.

Second time around I had a home birth and no one ever mentioned my bmi.

Its bmi 30 or less at time of delivery at our local hospital. Excludes a lot of people!

Thanks everyone. Spoke to a different midwife today who seemed much more sensible and feel a lot better

Daft. Surely "actual weight" would be more appropriate? Cut off here is 100kg. A 4'10" woman with a bmi of 35 is very different to a six footer!

Surely most people have a bmi of 30 by delivery. Slim women tend to put on more weight and should put on weight. My booking bmi was 22 with bpth pregnancies, it would be really concerning if it stayed 22!

bmi sounds like a very strange measure to use for a 9 month pregnant woman- surely they mean bmi at booking? I agree it just sounds as though they're cooking up reasons not to allow women to use low intervention places of birth. I would imagine the clinical reasoning would be the amount of fat in and around the uterus- obese women are more likely to need intervention because their muscle fibres don't tend to work as efficiently. So unless one gains a large amount of fat in pregnancy (not everyone does- I end pregnancies with a bmi of 26- weird body works better when pregnant than not ) it must be the booking BMI that's relevant, surely>?

In Scotland a high bmi automatically puts you on a different care pathway along with going very overdue etc.

This different pathway doesn't allow you a water birth etc due to the higher risks involved.