Planning for a water birth when it's not advised

[MrsCK]

So I'd love a water birth but the two consultants I have seen have strongly advised against it. I haven't had one consultant throughout just the odd appointment here and there with whoever had me. Therefore they weren't really interested in me.

Today I was asked if I'd got the idea of a water birth out of my head yet. I said I was still considering it. I'm booked in for a final consultant appointment at 38 weeks no doubt with someone different again.

my question is....do I just say on my birth plan I still would like a water birth? is it as simple as that? The risks are just weight related due to high bmi.

Watching with interest as I was under the impression it was out of the question due to my BMI.

You can argue the toss. My chum recently got a water birth agreed in hospital despite her bmi and the consultant being adamant it was a no. As it was, she birthed at home in the end with no issues. So you'll have to take your plan to the head of midwifery and get it agreed beforehand as they will just say no otherwise.

Her BMI was over 40 just btw

If the consultants don't think it's a good idea why don't you just listen to them & look forward to having a safe delivery. After having this baby lose weight, get down to a healthy BMI and have a water birth. The important part of pregnancy & giving birth is having a healthy baby at the end of the process.

I changed hospitals as one has pools on a consultant led ward and they were quite happy for me to birth in water (and it I did - I don't know how I would have coped out of water!!) I had a couple of meetings but no problems. The only issue is if they need to get you out quickly. Check other hospitals locally as it might be possible.

I do take the point about risk with bmi and I know a lot of people may feel I don't have the right to have a water birth due to my weight.

But

A baby is more likely to be born safely if the mum is comfortable and relaxed. Risks are always there no matter what. I'll talk to my midwife when I next see her.

I wish I could remember my weight when pg with ds2 - I was huge & I bet bmi was high. I was size 18 to start. I had a water birth. I didn't plan for it - when I turned up at the midwife led unit a midwife said "fancy trying a water birth" and I said "yeah go on". I did & it was great.

Although I was overweight through pregnancy it went like a dream & I had no risk indicators other than weight - bp fine, bloods fine, urine fine etc. Is that same with you?

The hospital where I work you wouldn't get a hospital water birth if your bmi is over 35. Doesn't matter what you wanted, doesn't matter if you said you accepted any risks. It wouldn't happen.

You'd be able to have a home pool birth though.

I don't understand why every hospital is different...I know the guidelines have just been changed for water births so I'll have to find them and see if there is anything changed about bmi. also odd you can birth at home in a pool...surely the risks are the same?

Yes my pregnancy has been textbook so far apart from a touch of spd which I've heard water would help.

BMI sometimes has little to do with fitness and ability. I may be a monster on paper, but I have a very active lifestyle, walk everywhere, and can even get myself in and out of the bath (shock horror)!
I appreciate that a safe delivery is the most important thing, but I do take umbrage with my lifestyle never having been assessed and my fitness levels assumed to be less than those of someone with a lower BMI. Why am I a greater DVT risk than someone who drives to work, sits at a desk for eight hours, drives home and then sits on the sofa before lying in bed? Before I went on ML I spent eight hours a day on my feet, going up and down stairs, carrying and lifting bags and boxes, and then I walked home.
I don't know if I'm strong enough to argue for a full-on water birth (I think the labour ward I'll be on only has one available, anyway), but I'll definitely be asking to have baths because warm water is the only thing that eases the pain for me. I suppose I could just refuse to get out of the bath, ha!
Good luck.

If you faint the pool with a BMI of 45, how do we get you out? Foetal monitoring is often really hard with higher BMIs. It's logistical issues rather than risk. Birthplace found raised BMI was as much of a risk factor for severe morbidities and mortalities as being a first time mum.

The rights thing - you only have negative rights. You have the right to decline. You do not have positive rights - the right to obtain. So you can't use the hospitals own equipment unless THEY consent. You do have the right to decline to come to hospital though, and it's on that basis you can have a homebirth.

What is your bmi? Is your pregnancy normal otherwise?

Does your birthing unit have a consultant midwife or a normality midwife? If not ask your community midwife to put you in contact with the supervisor of midwives you can discuss your birth plan. Her job will be to help you have the birth you want and put a plan in place to achieve it.

Good luck, if bmi is your only risk factor. Stand your ground

I have no idea why you would risk the health of your child by refusing to follow medical advice. Also if you pass out or need to move in an emergency, some poor midwife will have to try and lift you or call for help, delaying getting help.

I truly sympathise, you must feel you are being penalised without being given a fair assessment. However, the consultants and you share a similar and most important goal - a safe delivery. You should listen to them. They are advising you, and they are highly trained experts who have your health and the health of your baby at the forefront. The birth is a very small part of having children so try no to feel cheated out of your ideal experience, it's all a crapshoot anyhow!

It is about risk to the staff as well as to you if they have to get you out of the pool in an emergency.

I would follow medical advice. They are not being obstructive for the sake of it, they are doing it to ensure you and your baby are both safe.

Thanks for your comments they are appreciated.

I agree about a flat weight limit being better rather than bmi. I had a friend whose booking in bmi was 34. she was allowed a wb but put on 5 stone in her pregnancy. I have put on a stone and my bmi now is less than her final bmi yet she was allowed one.

I do get that risk is due to passing out etc. sounds like I may have to stay at home as long as possible in the bath!!!

Regarding home birth, it is because you hire the pool and it is your equipment, so they can advise but not instruct. In hospital it is their equipment and their call to allow you to use it or not.