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?

of course you dont ever have to consent to being weighed ever either

just decline and then they cant use it against you!

Ill have to remember that Nanny!

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.

That isn't true, I know someone who had a baby 2 weeks over that was not even 6lbs and had several scans and all concurred low weight and growth, poor oxygen, and Had a horrendous labour probably because the baby was so weak and didn't have good momentum.
Threat of miscarriage is very high, actually tbh the risks are similar,

I wonder what they'd do if someone like me went to book in and just refused to be weighed and measured? Would they really have to put you through normal midwife led care? or would they just write "big massive blimp" in the bmi section and shove you into the consultant led pile? lol

I mentioned the homebirth idea to my other half last night, he didn't look too happy, I know he understands my fears about another hospital birth, and seems to agree that much of the monitoring and precautions are OTT but I want more than just sympathy afterwards when I'm bruised and upset about the bullying treatment I've received. We can do something about this!

Jamesandthegiantbanana

consultant led care is another "service that is offered"

just because they offer you the service you are still well within your rights to decline their "kind offer" and say no thank you.

You dont have to see a consultant either

sorry to hijack - but nannyl did you post a link recently about guidelines if waters have broken but labour not started? I can't find anything on the internet! This happened to me with DC1 and I'm nearly 40 weeks with DC2 and concerned it might happen again. I do not want to go on the drip!

OctopusPete8: I think you may have misinterpreted what I said. I did not say that being underweight was risk-free: it is indeed higher risk than optimal weight (eg for oligohydramnios and associated conditions), but the risks from being obese are far more numerous and equally severe, hence the point that the risks faced by women in each category are not the same, and the obese are at much greater risk. They are not alike, either in PG or (as I said above) for delivery.

I do not know in what terms the risks are printed out to the underweight (never having been near that category). But I dare say an HCP with a poor bedside manner could make both under and overweight feel bad.

James mine was horrified when I first mentioned a homebirth and smugly asked my MW about it and she said "it is the safest place to deliver your baby", he looked a bit stunned.
Obviously that was for me in my pregnancy does not apply to everyone.

Did not make any mess, got in my own bath, ate my own food; lovely.

I realise you did not start out wanting a homebirth but think it may be a way to get nearer to what you do want by asking for it. If you do want one then go on book in for one and you can always transfer at any point. You will be monitored (hand-held Doppler) and have a MW all to yourself, surely that is something worth considering, someone focussed entirely on you and your needs/health and your babies.

info for DH

Good luck

I've had no weight related problems in pregnancy.

I don't like how they seem disappointed when my blood glucose and pressure keeps coming back as normal every time they test it. I swear it feels like they want me to fail these tests, to prove a point about obesity in pregnancy. The midwife accused me of cheating the glucose monitoring by reducing my carbs - well that was the whole point!!!!

The consultant said he was concerned as my mother has high blood pressure in pregnancy. Well she didn't, it doesn't say that in my notes, this was a complete fantasy on his part. But I still must have weekly monitoring and a stretch and sweep at 40 weeks!!!

Sunflower - you do know that you can no to weekly monitoring and the stretch and sweep - and any other test/procedure.

Just thought you might like an update. One month on from this thread, my home water birth is all booked! I contacted the supervisor of midwives, she arranged a home visit with herself and some kind of midwifery manager, they brought a lot of written info about the risks of home birth, what can go wrong, what they recommend etc but to be fair they weren't too negative.

They do want me to have an IV cannula in which I found myself agreeing to but I might decline it on the day as I can't find any evidence anywhere of a woman labouring in a birth pool at home with a cannula in.

I signed the papers to say I wanted the hb against medical advice, she mentioned they would need a pool check, a growth scan and a blood test before they were happy to proceed. Growth scan came back fine, baby is head down and average sized. So we're all set! Got my la bassine pool, declined unnecessary consultant appointment (he'd only try to talk me out of it) had several doctors and midwives try that at the antenatal unit yesterday but I just said "No thanks, I'm happy with my choice and I've signed the paperwork" and they weren't too pushy.

I couldn't have done it without your advice and that of a few independent midwives I spoke to, so thanks! I'm so pleased it'll be at home, I've now stopped dreading the birth and I feel really open to it which can only be a good thing. Fingers crossed it all goes well now! :-)

Congratulations on getting the birth that you want. I think you are right to be wary of the IV cannula - could be the start of unnecessary interventions. If a paramedic can get an IV into a woman in the back of an ambulance travelling at 100 mph and rocking from side to side, then I think a midwife can get one into your hand if an "emergency" comes along .

By the way, I noticed the Duchess of Cambridge managed to give birth without an IV, so why can't you!!

Good luck james!! I had a pretty stressful birth at hospital last time around but going to a diff hospital this time and because it's second baby and I am low risk I've been assigned to caseload midwives and they have been so reassuring throughout whole pg (only 2 weeks til EDD!) that I am feeling so much more positive and confident about this birth. It's really important to be in the right frame of mind and since having a home birth seems to be the right thing for you I'm really glad midwives have agreed. Hope all goes well!

James that's excellent news!

Just wondered whether there was any update OP? Really interesting thread

I really wanted an unassisted birth, as in no one there at all,I wanted it to be something I did all by myself.

I ended up delivering at 32 weeks and weeks in hospital

No advice OP, but I understand how you feel especially if you've done it before.

you can go against their advice it is your birth they can only advise you not force you id speak to your head of midwives at the hospital in my second pregnancy i was overweight with a bmi of 36 i think it was i got told i had to have consultant care because of this and extra growth scans and the GTT test which was perfect baby was born at 41 weeks weighing a healthy 7.8 ounces which was small then my 1st baby how ever i was never once told to stay on the bed to stay on the bed to labour i could move around as i wished and remained active as i wished i think their being way over protective of you and being unfair esp as youv had no problems before best of luck hun take care

Oh that'll teach me not to read the whole thread!

Nice one OP

I'm so glad the SoM came up trumps. As someone up thread said there are more risks when you have a BMI over 30 but that's just it, they are risks - not dead certs. Your body has birthed beautifully before so go with it and all the best for another beautiful birth. I'd go for the cannula though, if you bleed v heavily after the birth they might need to get fluids in very quickly. Time is of the essence. You are more at risk of heamorraging with a high BMI, or subsequent pregnancies. But there is that word again risk...

Hi, I'll update but there's no baby yet things turned a little sour after last update. I was being told one thing by the SoM and another by the actual mw's who I was having checks with, as in would there actually be mw's on call ready to attend me (SoM said yes there are no other hb's booked, mw's said "it's August, everyone's at the seaside" and "if anyone else is in labour at home or in mlu you'll have to go to the hospital")

Every mw I saw seemed to take an "I'll scare her out of this nonsense idea" attitude and laid it on really thick that they weren't happy at all, and basically tried to make me lose faith in my body which is unfair. I was still (and am still!) getting perfectly normal results in my antenatal checks.

The last straw was that I turned up for a check and the mw was one I had reported for being rude to me a few weeks earlier, and she was rude again, and very discouraging about the hb. Then she booked the rest of my care with her and said they couldn't find the aqua sonic aid. So in other words you can't use your pool (despite me paying out for a decent one in order to make them happy) and I just thought "it's all lies, you never had any intention of letting me labour in a pool at home"

My faith and trust in them was gone, I was really upset and scared about it all, and then an IM I had contacted suddenly got in touch and said "Let's sort this out" - she came round, we talked for 3 hours, agreed on a reduced fee, she was completely happy with the water birth idea and has worked with high bmi ladies before with no problems.

She's done three AN checks (twice a week) on me so far, met my dp and dc, leant me a tens machine, hypnobirthing books and cd's, done acupuncture on me, dealt with the hospital for me, she's arranged a backup IM, and I totally trust her to do right by me, (which includes get me to the hospital if there's a problem!)

So I'm mostly relaxed and ready now. Overdue and a bit daunted about the birth but at least I can focus on it now instead of fighting the bloody system. Thank god for independent mw's! Will update on how it went after the birth, thanks for all your advice/comments.

Best of luck with it, hope everything goes brilliantly.

When were you actually due if you're over? I read your thread from the pov of someone who always goes overdue and has battles with consultants who treat you like a statistic or a medical issue not as an individual. I always find it very encouraging to read about other mums to be who aren't afraid to stand up for themselves.

Not sure if that makes sense. So very tired today

Hi snork, I'm 41 weeks today, my other babies came at 40+5 and 40+11 but I do question the accuracy of the edd of the 40+11 one as we were using an ovulation predictor testing kit so I know when I conceived, but their dating scan put me forward by a week. So by my dates she was roughly 40+4 ish.

They did put a lot of pressure on to induce when I got to about ten days over, I was adamant I didn't want induction at that point (obviously if it carried on and on way past 42 weeks I wouldn't be stupid about it, I'd agree to be induced) and I went into labour the next day after a sweep and dtd. They did talk about the risks of stillbirth and placenta failure etc a lot, at that point I had no-one to advocate for me so it was scary and they did imply that I didn't care about my baby. I hate confrontation but as they had adjusted my dates I stuck by my guns and asked for daily monitoring instead, which they weren't happy about but would have happened if I hadn't have gone into labour the next day.

Incidentally dd came out weighing 7lb, very petite with lanugo all over her, no sign of dry cracked skin as you might expect in a fairly overdue baby. I just don't believe they get everything right! And they definitely don't treat people as individuals, it didn't matter how many times I told them that I knew when I had conceived, they just ignored it.

This time round with the IM, it is different, I told her I have long cycles and tend to go overdue, she was fine with that. I don't think she gets concerned until 42 weeks although she does check me twice a week to make sure baby and I are ok, and I have her on email/phone 24/7 for if I do feel there's a problem. The hospital which I would be transferred to if there was a problem have asked her to tell them her plan of action for if I go "past dates" she said that up to 42 weeks she could look at holistic methods of bringing on labour such as acupuncture, clary sage baths, a sweep etc if there was clinical need or if I requested them. After 42 weeks I'm not absolutely sure what the protocol is. I don't want to take stupid risks with my baby.

She did acupuncture on me yesterday, I declined her offer of a sweep (squeamish!) in favour of dtd, it hasn't worked so far but I feel like labour will happen in the next day or two. Really hoping to avoid induction as it will inevitably be highly medicalised for me.

Well done OP for sticking to your plan. Sounds like you found out it time that the MWs that you were seeing had no intention of "letting" you have your home birth. The old "bait and switch" routine. How cruel and unkind of them - but not unexpected as they have "guidelines" you know and these have to adhered to at all costs!!

I pity any woman who has to put up with bitchy, rude and uncaring MWs. Sadly there are a lot of them around.

Good luck with your birth.

Good luck!