Dreading hospital birth but high bmi so I "have no choice"

[JamesAndTheGiantBanana]

3rd baby, previous two absolutely fine pregnancies and textbook vaginal labours, in hospital. Two healthy normal sized babies, no induction, no drugs, no assistance. No gestational diabetes, perfect blood pressure throughout. But I'm fat. So naturally throughout they've had me under consultant led care for all three. I've just had my diabetes test and growth scan, no diabetes again and baby is absolutely on the 50th centile line on the chart for growth, same as its siblings who were 7lb.

I'm dreading another hospital labour though, every time they want me flat on my back, constant fetal monitoring, bright lights, loads of people in the room, painful IV in "just in case" etc It's absolutely the opposite of what I want, and in my last labour, I was contracting nicely every three minutes but as soon as I got to the hospital I got so scared everything stopped and I had to have a painful sweep and walk around for hours to get the contractions going again. I put this down squarely to fear of the midwives and doctors. I can't relax in hospital, I feel hugely defensive about it right now, literally worried sick.

All I want is the chance to labour like low risk women do, soft lighting, peaceful, allowed to trust in my body (which is actually great at giving birth, thank you!) move around and maybe labour in water. Instead I feel like I'm facing an uphill battle and will have to argue my corner unsupported and vulnerable against stony staff who view me as nothing but a potential lawsuit.

I fantasise about buying a birthpool and just getting on with it alone, just getting my other half to call them when I know its too late. I know birth isn't without risk but if you'd have seen me last time, all my arms and hands severely bruised from their multiple IV siting attempts, blood all over me from my wrist (they eventually sited the sodding unnecessary IV out the side of my wrist so every time I moved I dripped blood all over the bed) bearing in mind that at no point has anything ever been wrong with me. It feels wrong to let them do that to me again. I just don't trust them! It doesn't feel like they have my best interests at heart, I'm just an unpleasant and inconvenient vessel that they have to pry the baby out of, under strip lighting.

I can't sleep for worrying about this, what should I do?

"Them spouting crap like this 'women with a high BMI cannot birth naturally effectively'"

I didn't say that, nor do I work for the NHS.

You might like to read this.

Also, this topic has been on the local news as I live in an area with a higher than average number of women with a high BMI who are pregnant.

Jamesandthegiantbanana It is now 41, having started the pregnancy at 46. That's how much weight I have lost. A size 20. BMI doesn't account for rugby prop musculature and an abnormally dense skeleton... After much investigation, to get to the overweight/obese borderline, I would have to lose muscle mass (or chop off a limb!)

My BP has not been above 110/60, and yet I'm doomed to get Pre-E.

My blood glucose never went above 6.5 even after the drink, and my fasting level was 3.0, yet I'm apparently a dead cert for GD.

I am told I am weak and unfit, despite a testing HB of 42, being able to walk a 12 min mile, lift 140kg, teach fencing and still teaching full time with anaemia and being this sick.

I went gently gently with DD. I was pressured into an induction after waters broke, and told I would have a HUGE baby and have a c/s. DD was 6lb5oz, in premie stuff for a month as 24 inches long!!! And was birthed as being prepped for a c/s due to decels and 'failure to progress'. 3 pushes. With a spinal in. And no episiotomy. Clearly I'm crap at giving birth. Oh and my BMI then was 57... So I'm much smaller now!!!!

Ive read on here of people in this situation going for compromises.
Tell the HCPs you want a home birth, then try to get them to meet in the middle with a birthing centre?

I think people need to not confuse risk and fact, I am big myself but #increased risk' does not mean you will/do have complications.

I have had 2 babies not so much as a wavering blood pressure,I've been bloody healthy considering SPD and severe morning sickness. DC2 I ended up giving birth alone in a dark room (whole nother'thread) And not even a stitch,I've known Slimmer counterparts have endless problems with pregnancy. Everyone is different.

In many ways NHS has to be one size fits all.

HBs rock!

What in fact happens if you turn up at the MW lead unit in established labour. Do they insist on putting you in an ambulance by force or do they just get over themselves and deliver the baby.

Do they insist on putting you in an ambulance by force or do they just get over themselves and deliver the baby.

I think someone on a thread a year or two back said that they did exactly that in her unit, unless the birth was absolutely immininent.

It was a long time ago for me - but I found that being Mrs Reasonable got me nowhere. When the 'consultant' i.e. the junior taking the clinic made the comment 'well if you don't care about your baby' far from being cowed, something snapped and I told her exactly what I thought of her and the poor care I had received up to then. Best thing I ever did. I only went once more, and they bent over backwards to explain things and treat me like a person and not a piece of meat. I found myself wondering why oh why I hadn't put my foot down sooner.

I had a home birth for the second. If there was a medical need I agreed I would go to hospital, but none of the 'just in case' or 'if, then and maybe' stuff.

I feel that being overweight/obese/fat

They don't treat thin people as 'one size fits all' so why non thin people?

Dunno about that - there are a certain number of HCPs who seem to think that any pregnant woman's brain has switched off. (Not all, but sadly one bad experience can outweigh a dozen good ones.)

Bunbaker what was the point in sharing that link? Do you not think every single high bmi lady on this thread hasn't been forcefed that bollocks since their first booking in appointment? I could have dictated all that for you. We know it's not optimal to be overweight while pregnant. We are asking to be evaluated and treated as individuals, not herded into one type of highly medicalised care based on dodgy statistics, and told that if we question it we mustn't care about our babies.

Read the very first comment at the bottom of your link: "chandlercampbell said on 17 November 2012 - I am a size 20 and 8 weeks pregnant. I am now really frightened after reading this article."

Yep, that's how they want you, scared, apologetic and compliant. I've heard of overweight women who have actually considered having a termination because they were so frightened by the doctors scaremongering, which is utterly disgusting. Here, have a read of my link now, and try to see our point of view.

I wonder if underweight mothers are made to feel as bad, if so then fair enough.

I am not the voice of experience here, but why not labour at home for as long as possible then go in when you think you can't take anymore - it will give you some control back, although runs the risk that you'll end up delivering your baby on the side of a road!

Being underweight doesn't carry anything like the risk of being obese in pregnancy. And unless it is so severe that muscle wastage is occurring, it doesn't really impact on labour.

I have to say I thank heavens I've had a good experience so far with the midwives and consultants. Even my GP said that the dietary stuff was mostly b*llocks. I was referred to the consultant as my pregnancy was "high risk" as I have a 35 BMI and asthma.

I'm 32 weeks, not had one bad BP/glucose scare/and the GTT was perfectly normal. I have lost weight during the pregnancy but not intentionally. Junior is a normal size, not large etc as the health warnings say.

It is bonkers that the hospitals don't take all of this into account when telling you where you have to give birth.

I don't mind hospitals, and quite frankly would rather be near the drugs/doctors/theatres if anything does go wrong touch wood, but scaring women who are otherwise perfectly healthy is F*CKING INSANE.

My SIL is a normal weight but had a v traumatic first birth and then too much amnio/borderline pre-eclamsia for the second. You aren't immune from complications just because you are thin.

Jamesandthegiantbanana
I was not allowed a HVBAC as I was consultant led care due to issues with my multiple second pregnancy which resulted in an emergency section.

I negotiated with my consultant down to MW led care, he was not happy with this but said "I can not make you do anything but I strongly advise you to deliver in consultant led care".

I then said that if that was allowed MW led care then I will have a home birth thank you very much. I had two midwives for me and my baby all through labouor and felt secure and safe all the way through. As I had a VB first time round I knew I could do it (as do you).

I had to have a risk assessment done by my community midwife where she explained all the options to me and I agreed that if there was any risk at any time during labour I would transfer immediately to hospital , we both signed it and that was that.

I had DC4 at home.

I would push for a home birth and then concede that you will accept the MW led unit (if you would be happy with that). Good luck.

I'm sure women who are underweight face their own set of problems when it comes to dealing with the doctors during pregnancy.

Boosiehs you're due about the same time as me then! Glad everything is normal and clear for you, too. Is it your first baby?

I'm loving the AIMS website, I feel like writing to my consultant asking for a homebirth, just to see what happens. I love the thought of wallowing in a birth pool in my conservatory under the stars!

Thanks for that Charleymouse, good on you for pushing for what you wanted. If your second birth was multiples how can they compare a subsequent singleton pregnancy in terms of being too risky for a vbac? it's apples and oranges surely. What do you mean by risk assessment? Like a home visit to check it was suitable?

asking for a homebirth

You don't need to ask - it's not up to them to give you permission. You say that you are planning it. It might be a good ploy - it might get them communicating properly with you as to what is really important, taking your health as the starting point, rather than protocol or this is the way we have always done it.

I agree you say you want a home birth ams they may well offer you midwife led unit as a co promise, but if you want a home birth and are happy that you understand any risks applicable to you then its your choice. You have had two normal, straightforward deliveries DESPITE begin strapped to a minister and flat on your back, so not optimal so you are a good candidate for a home birth. Of you can have good labours under crappy conditions, you should lab our fine in optimal conditions at home :)

Good point LaVolcan, I am interested to see what they'd say because having had all the scans, tests, checks etc three times over now, it does seems like everything is perfectly fine. My blood pressure is consistently 120/70, I'm losing rather than gaining weight in the pregnancy, the gtt showed my fasting blood glucose level at 4 mmol rising to 4.6 mmol two hours after the glucose drink which I think is pretty low. I've never had any illnesses, they've seen that the baby is a perfectly normal size (It'll be around 7lb) and healthy. I mean what else can they come up with?

Basically James it was them waiving my rights to complain if anything went wrong as it was of my own making.

My MW had a check list of issues which she had to explain then I had to say I had understod them and was still happy to go for a HBAC. To be honest most of the issues were things that can/do happen in any labour.

LaVolcan is right you don't have to ask. Where you give birth is up to you, but they will scaremonger you with allsorts of (often incorrect) 'facts.' The risks of a uterine rupture were quoted as 5% to me when it was actually 0.5%.

I offer buddy services via the following web site you could contact them to see if they have someone in your situation to give you a bit of moral support.

tell me a good birth story

Good luck.

If you want a homebirth (and it's not clear to me that you actually want one, but you want a MW led birth I think?) Then do not ask. Permission is not theirs to give. You inform them that you have chosen a homebirth, please make arrangements to facilitate this. They cannot stop you from giving birth at home, although they can refuse to let you use a MW led birthcentre. They may negotiate the birthcentre as a compromise if you start planning a HB though

With 2 spontaneous deliveries behind you, there is an excellent chance you will give birth perfectly well again. FWIW, I booked an HB with first baby, after very long latent labour and PROM I agreed to hospital and ended up with an EMCS (textbook pregnancy/lowrisk)

2nd time I booked an HB again. Again this didn't work out, I transferred in willingly for an EMCS.

No regrets at all, both times I was in hospital for hours and hours before the sections, I made informed decisions and both times I felt by attempting the HBs I had maximised my chances of having a normal delivery. Sadly, I am utterly shit at giving birth

I have supported several people with getting their choices and also with making complaints, do pm me if I can help at all.

Basically James it was them waiving my rights to complain if anything went wrong as it was of my own making

They can't abdicate their duty of care.
I didn't have a problem with having the risks explained - I wish they did that for hospital births. I also had no problem of them noting in my records if I declined a test so that they could cover their own backs if something went wrong. I thought that was fair enough - they are bound by the protocols and their jobs could be on the line if they fail to spot something which later caused a problem. I was ready to agree that in certain conditions I would go to hospital. I wasn't prepared to accept a 'just in case' booking, and as for the emotional blackmail - there is absolutely no place for this anywhere.

Oh and BTW do you know about Mary Cronk's helpful phrases? (Even if you don't want a homebirth the rest of the website is useful because it answers a lot of questions.)

you have every right to have a home birth (no matter what the staffing levels are)

they can not let you use their facilities (ie MLU) but they cant make you go to hospital, and when you call saying you are in labour they are obiiged to come to you. End of.

The only exception is if you are not mentally sound (ie have been sectioned for mental health reasons)

You may find that if you choose to homebirth they might compromise and let you in MLU.... if you want to be there?
OR you might think actually you would like to be at home, in which case so long as you are in the UK they have to support you.

Im overdue and waiting my second home birth and the only requirements are that you have some form of heating, running water, and they prefer there to be a landline in the house too, though if there isnt, then there isnt

The stupid thing is where I am they weigh you at 12 weeks and put that as your BMI. The women that put on 3 or 4 stone during pregnancy are still judged to be at the weight they were at the beginning when they could well be into the 'obese category'. It's madness.
My SIL was told by her consultant that she didn't deserve gd as she was thin unlike the other overweight people in the waiting room. I was shocked at that but not surprised.

Just to say I agree with the posters who say that you are in charge of your birth. The language of "let you", "allow", "you must", "high risk", "failure to progress", "poor maternal effort" is disempowering.

You can have the birth you want. You tell them what you are going to do. They cannot force you to do anything. When you are in labour at home, leave it as long as possible, call the hospital and tell them to send you a midwife. They cannot refuse your request.