Childbirth when obese

[Rollermum]

I'm a large Mum to be - size 18/20 pre preg and weighed about 15.5 st prior to pregnancy ( no idea what I am now because dont want to unleash the toto dieting crazy). So I'm classed as obese by my BMI 34. I'm relatively strong and used to exercise.

I'm 34 + 2 and trying to think through a tentative birth plan, though aware it may go out the window. I've just realised I may not be able to use a birth pool because of my weight.

Are there any other weight related limitations for birth if pregnancy has been straightforward? Also I'm sort of scared of hospital staff being harsh about my weight and not letting me have an active birth which is what I have been hoping for.

Stories shared gratefully received!

Also I thought there was a larger mums to be section on MN but can't find it.

Yo yo dieting not toto!

I think they like you to be monitored at all times which may district some of your movement, but you can say no to this.
Have you been tested for GD? This would have a big impact on your birth plan.
I was almost exactly the same size and bmi as you pre preg and was really worried about attitudes of docs etc, had a couple of arseholes before the birth but none during or after.
I had GD though so my birth was not what I wanted it to be. My ds was safely delivered though, so the outcome was perfect.

I have no idea - but I wanted to say 'Congratulations, well done & good luck!!' :)

I am also BMI of about 34, I was induced with DS and had constant monitoring, but that was nothing to do with my weight (waters broke but nothing happened, pessaries didn't work so induced by syntocinon). I laboured on my back, but 7 hours for a firstborn whose head wan't engaged was ok with me

I had to have CS for DD1&2 but again nothing to do with my weight.

It can be much harder to have an epidural as it can be hard to locate the spaces to go into, but I still had epidurals for both my sections.

Right now look - you're the one giving birth. Nobody will 'let' you do anything. It's your body and your birth. You've got to be firm about that because there is a tendancy in the medical profession to over-medicalise larger women.
I was probably a stone or so heavier than you when I had my last baby btw. I had a 'natural' birth with just G&A. Best thing is to think about birth positions that open the pelvis up as much as possible. I knelt on the bed. You do NOT want to be flat on your back - and that in itself is a reason to avoid an epidural. If you're a healthy and active larger woman there's no reason why you won't have a healthy and active birth.
Re birth pools - the issue is could they get you out if you collapse. Now tbh it's not that easy to move any pregnant woman. Somebody who's 6ft won't be a breeze either and there's no policy that says you're too tall to use the pool . If you think water would be helpful then say so and stick to that. Frankly your BMI isn't horrendously high. My experience would suggest you won't have much difficulty but you do need to be clear about what you want and not apologise for your size. You can fit through doors after all. You're really not a 'problem'. You're a pregnant woman expressing what sort of birth she wants. Like all women should be able to.

Hey all, thanks for fast responses. Have been getting in a tizz about this.

I had GD test at 28 weeks, all clear. So hopefully that should help.

Kotinka - v wise on flexibility and anxious midwife. Hadn't thought of it like that before.

Completely agree with what kotinka says too.
It's really important to have a good idea of what you want and to be confident in expressing this but equally as important to be able to listen to the hcps and be open to change if needed.
Remember that a good outcome is what's most important and although it is very easy to feel singled out/blamed/attacked by the hcp and their suggestions during birth, try to keep in mind that what they want most is a good outcome for you and dc, so you're both working towards the same goal!

Took so long have x posted.

A ciuple more points - Gestational diabetes - thin women get this too and older women and women with no risk factors at all. You may be offered GTT but you don't have to take it.

Monitoring is worth thinking about carefully. Why is continuous being suggested - and go from there. Fwiw I would decline this if I was doing it again (which am not!) because it restricts your ability to move and for me moving and being upright was key to a progressing labour and birth.

There is a real chicken and egg situation here - big women have more difficult births therefore we need epidurals in case of theatre and we need monitoring and we need births on dry land all so we can deal with the problems OR is that we get the problems because of all of the above plus stressed out mums made to feel guilty?

Also agree with northernlurker one could argue that all pregnancy is over medicalised now, but especially those of overweight or obese women.
Definitely don't let yourself be bullied. Be as confident and assertive as you can and make sure you have clear ideas about what you want and have done your research, but at the same time listen and consider the opinions of the hcps.

I'm bigger than you. My first was a 3 hour induction with 3 pushes...

This time I plan to have an active birth. I was made to have 3 GTTs. I weigh 4 stone less at 35w than 4w pregnant. When it comes down to it, I won't consent to anything that isn't medically necessary; ie the anaesthetist wants me to get an epidural on arrival to save 'faffing about later when begging starts' - erm, no! Told him where to go!!!

Midwife knows I am well read, as does consultant. Have explained my plan and been told we'll go with the flow.

Hope everything goes well for you. It is doable.

Northernlurker - thanks for that. You're v right and I needed a pep talk. Being overweight and hypothyroid since 18 means I have come to expect healthcare professionals to patronise me and assume the worst. I will make my preferences clear.

Kotinka - same I am scared of an epidural and don't love the idea for various reasons.
I've been going to Lazy Daisy natural birthing classes and have no intention of being flat on my back.

Thanks for sharing RNJ3007 - wow I had I idea they would try to pressure you re epidural. What did you read to be able to stand yr ground?

Various stuff online plus a midwifery textbook from a friend.

I don't want an epidural because I hate needles, have back problems and if I didn't need it during a synto induction where I react with contractions that broke the monitor and lasted 8-10 mins at peak, I don't think I need one this time. Also, I'm on clexane, so can't have one for 12 hours post injection. The pressure was because it'll be difficult to administer and apparently obese women can't deliver easily and I'm bound to end up with an EMCS. Prior performance means nothing, clearly...

I also pointed out that with my SPD, a lithotomy delivery would be hellish, and that water and a birthing ball are clearly better options, and recommended by all knowledgable sources on SPD.

Thing is, I'm an ex-rugby player, I'll never have a 'normal' BMI. I have such a high bone density and muscle mass that to get to the overweight/obese borderline, I would have to lose muscle or remove a limb. Unfortunately, that's not taken into consideration by most medical professionals!!

RNJ3007 - thanks, that is helpful. I hear you on the BMI - I (until pregnant) play roller derby and am a big blocker which is similarly full contact to rugby. In fact I was looking into joining the local rugby team when found out I was pregnant. I have bone density and muscle mass too so I look better than my BMI. There is a great website - cant remember name - showing people next to their BMI classifications. Looks quite nonsensical.

Rollermum, if you can have a frank talk with your community midwife, you can put some helpful stuff in place. Mine remarked that, though I had a high BMI, I was one of the fittest, most flexible very pregnant women she'd dealt with. She put a recommendation in my notes that I be allowed to use a birthing pool, even though I was above the weight limit normally allowed.

Plus, what aturtle said. Good luck!

I think it depends on the hosp. My midwife is letting me have a water birth an I'm sure my bmi is 34. She said they usually say over 35 but it depends on the mum I'm only a 14/16 so she's confident I can get in and out of pool ok so have a good chat with your midwife see what she thinks :)

Thanks for sharing Miaow. Wow, second time sounds amazingly speedy!

Gonnabmummy & Shrugged - I think that is partly why I freaked out over the weekend. I've moved house and have to re- register and don't know where I'll be giving birth yet. I see MW on weds so should have a better idea.

Kotinka - missed yr q. Yes, will have DH there.

I thought water birth would be out of the question because of my weight. But I checked with the hospital and they'd allow it if I can demonstrate getting in and out unaided. So worth checking when you know where you'll be. Hospitals all seem to have different rules.