high bmi and childbirth

[buggerboooo]

I had my first meeting with midwife. I am really upset to find my bmi is too high and the water birth I hoped for is not an option. I am not able to birth at the midwife lead center, but at the hospital. She told me I WILL have an epidural, the way she told me was like I had no possible option.

I have been so upset since our meeting. I wanted a very relaxed, natural calm birth, in water. It is my first, so when It comes down to it I might be screaming for an epidural anyway!- but I'd like the option to do it my way.

Generally a bit sad and unsure. It isy first and I am not really clued up on the risks/options etc.

Dont know why I am posting really. [Sad]

Hey :), congratulations on your pregnancy, sorry your first midwife experience was so disappointing.

I don't know your BMI, but I do understand that if it is very high they might want to keep more of an eye on you and the baby to make sure all goes well. They may just be trying to keep you and baby safe. I also missed out on my chance of midwife led labour as I was induced. I was gutted and I still feel sad that I will never now have a 'natural' midwife led birth - BUT I do have DC, he is here safe and healthy and ultimately that is all that matters. I don't regret my unnatural birth, but rather regret my dream of a natural one, if that makes sense. We are encouraged to want a natural birth these days, and made to feel that we fail if we don't have one. It's unhelpful. I think medically assisted birth should be celebrated, when it is needed. It's a triumph of modern medicine.

I would ask more questions of your midwife and try and get her to explain a bit better why these things would be needed. I don't really understand why you would need for sure an epidural, to be honest, however high your BMI might be... If she is unable or unwilling to explain, or you feel your concerns are being dismissed, then I would request a change. Your midwife is there to relax and reassure you, as well as keep you healthy, and if she isn't helping you to understand how best to have a healthy labour, you need to find someone who does. It doesn't sound like she has tried her best to help and reassure you. Midwives are only human though, and she may have just been having a bad day, so give her another chance and ask for clarification.

A high BMI doesn't make you a higher risk on its own. I have a high BMI and have had a MLU birth and a home waterbirth, each time with a higher BMI.

I'd personally go for a home birth or at least start that way. You'd be surprised what can be negotiated from there.

My bmi is 45. Tbh the midwife annoyed me from the start. Everything she told me was her opinion- rather then the guidelines. Re drinking- I dont drink anyway but was under the impression the odd glass doesnt hurt- she just said no, no drinking at all. It is irrelevant in my case because I dont drink anyway but still!

I also felt she was trying to convert from vegetarian. Telling me her daughter used to be a veggie but switched to organic meat for the baby, because she was concerned about vitamins etc.

She just generally irritated and rubbed me up the wrong way. Then to top it all off basically said because im so fat it is just safest to epidural me up and lie me on a bed to get the baby out? Because in an emergency situation my back might be too fat to get an epidural in. So it would be safer to do it before the rush of an emergency.

I don't think that a healthy baby is ALL that matters - mums matter too.

No one can tell you what you are and aren't allowed to do. You need to be informed and make your own decisions. If I were you I'd request another midwife and ask what risks your BMI carries both in pregnancy and childbirth. I'd also ask how birthing in a hospital setting will help monitor/manage and/ or mitigate these risks. You should be able to find some stats online too.

Good chance to practise saying 'and what happens if I don't do that?' And 'what happens if I delay doing that?'

It sounds like a crap meeting with the midwife. Don't let it get you down, get informed and get straight talking.

Check out this article - I wish I'd read it before my births.

Good luck with it all.

I feel funny asking for another midwife. I live in a very tight nit area. I dont know, she seems like the only one. Id worry about asking to change, being told there is no one else and then being stuck with someone who knows I dont like her!

The problem with asking my current midwife about "what would happen if...." is I fear she will just give me her opinions again rather then fact.

Thank you for that article. I shall have a look

Of course its up to you what you do. She won't be the only midwife by a long shot though, people give birth all year and all day long - pretty sure she has holidays and time off to sleep! ;)

I'm sorry you had a bad experience. At my booking in appointment my bmi was 42, so hopefully my experience should be informative for you. I had to see a consultant to discuss pain relief in labour and he checked my back to see if I was suitable for an epidural (they need to be able to feel your spine to be able to place correctly). He said I was fine, but did advise to have it early as it would be easier to place than in a rush at the end. However it was clear I didn't have to have one (no one can force you to have it if you don't want it),

Labourpains.com has information from doctors on pain relief and a section on raised bmi, I found it helpful to have the specific evidence based advice and then can ask questions of mw or whoever.

In most places you'll see someone else when you are in labour not the mw you've seen for your antenatal care.

Feel free to pm me if you have any other questions, I'm now 38 weeks so done most of the pregnancy stuff but not the labour bit yet!

Sorry your first appt didn't go so well.

The Issue with BMI is often due to the equipment on the MLU...a lot of it only takes certain weights, including the hoist which would be used to remove you from the pool if you collapsed etc.

Also are you taking fragmin/clexane injections? That is quite common with BMi over 40 due to the increased risk of DVT. This would also put a barrier Infront of you for the MLU due to the increased risks associated with the injections.

Raised BMI is also associated with increased risk of post partum haemorrhage and therefore falls out of the suitability for MLU.

You shouldn't require continuous fetal monitoring in labour as there are no extra risks associated for the baby in labour.

However, if you are wanting to use the pool/MLU, when you see a consultant discuss it with them. You also should utilise your supervisor of midwives which you can get a gold of via your midwife/hospital. It's all about being given the guidelines and evidence, pros/cons/risks and you making the decision based on the information.

You cannot be forced to do anything and nothing HAS to happen because a doctor/midwife says so.

Good luck with whatever happens for you

I am not being given anything else expcept larger dose of folic acid and asprin.
The only good thing that comes out of being fat is I get a couple of extra scans.

I will speak to the consultant. I just dont believe a word the midwife says. She has lied and twisted facts and guidelines to her personal views that I dont trust her to tell me the truth about other things. I think she will just lie to make me feel I will kill my baby unless I do things her way

All MLUs across the uk have a cut off of BMI of 35 at the highest, so she would be right regarding your suitability to use it.

Hopefully you have a consultant appt soon so you can get the ball rolling sooner rather than later

How do they know what your BMI is anyway. I refused to get on the scales in early pregnancy.

Because I did get on the scales! When should I get a consultant appointment?