Devastating water birth news! Please help

[Tracey92]

Hi Ladies,

This is my first post so I am v. nervous and hopeful that I have posted in the right place!

So I am currently 31wks + 3 and doing well. I was living in Falkirk and so all my antenatal care was through forth valley royal hospital. I have since moved doctors and hospital as I am living in Glasgow. I am now registered with the Princess Royal.

I had my first midwife appointment today at the Princess Royal just to go over my notes and to be introduced to the team. I had been planning a water birth at FVRH which I was very excited about and so I mentioned this to the midwife. She then called down to the birthing area to confirm and told me that this was not going to be an option at Princess royal due to my BMI. My BMI is 43 and the limit is 40 for water births there. I am not going to lie I am absolutely devastated! I cried and cried (hormones) and to my utter shock the midwife said to me " Don't worry we have baths available on the ward so you can have a nice bath after the birth." What? I have no idea why she thought that anecdote was relevant!!!

Anyway I am now in a position where I have no idea what to do. I know I have to be flexible when it comes to labour but do I have any other options? Could I have a home birth with a pool or would they take issue with this too? I can't go back to FVRH as I have moved to far away.

Any advice would be helpful!

Also, due to PCOS I struggled to conceive for 2 years +, during which time I was trying to get my weight down and I did manage to lose some weight and whilst being pregnant I have lost a further 22 pounds. So although I know my weight is the cause of this problem I am now just trying to find the best way forward.

If the OP had come on and been told she'd been refused an epidural or a c-section because of her weight and was devastated because she felt that these were needed for her to have a bearable childbirth experience, people would sympathetic and falling over themselves to commiserate.

OP - get an appointment with the Supervisor of Midwives to discuss a care plan for you as you may have to rethink your plans for pain management.

My personal feeling about how women with a high BMI are cared for is that there seem to be double standards when it comes to risk. Birth pool in an MLU too risky, but having you lying on your back on a bed in the CLU with an epidural is fine, despite this increasing your risk of forceps delivery or a c/s (by dint of being in a CLU) both or which are riskier because of your weight (forceps because of link with shoulder dystocia and c-section because of DVT's). And the recommendations aren't evidence based either - nobody has ever done a large enough study of birth outcomes for women with a high BMI which examine outcomes according to birth setting and use of water. BirthPlace 2011 has done some secondary analysis though for higher risk women, many of whom are higher risk of the basis of BMI alone. Might be worth a look. Google 'Burthplace' and 'secondary analysis' and see if there's anything interesting there which would be worth discussing when/if you decide to talk to the SOM.

Do ask exactly what the risk is. I wanted a water birth but was in a wheelchair unable to walk for the last few months of pregnancy. A senior midwife said that while there was a hoist, not all staff had been trained to use it and they'd prefer not to. However when I demonstrated my arm strength and explained I'd have at least 2 adults with me who could help, they agreed it might work well.

Which it did for 8 hours before everyone concluded it was actually slowing down labour and I had to get out and then had an epidural. Still glad I tried it, but even more so that I viewed my birth 'plan' more as a flowchart: if X, then Y.

Wow, I thought something genuinely devastating had happened. Glad it hasn't.
Best of luck with it all.

I cannot believe the continued rudeness of people posting telling the OP that she has no right to feel how she feels.

Sorry as I have not RTFT but they may still let you labour in the pool/bath?

I wanted a water birth. Dd1 it was undergoing maintenance. Dd2 was too quick, they didn't have time to even turn taps on. Ds was supposed to be at home but had to be induced. Some ideas for how you might want labour are great, but I would focus more on the baby you are going to meet. Ask them the rationale but if it is for your safety or baby's safety then I would go with their advice. Honestly doesn't bother me now that I never got my water birth, having happy healthy dc is what matters.

Wow people are being very harsh to the OP. She's not done this before and has pregnancy hormones - that can make the smallest thing seem like a disaster!!

Firstly, ask to have a chat to the supervisor of midwives. Not all rules are set in stone and a conversation with them may mean they can accommodate your wishes.

Secondly there are lots of other options, you could consider a home birth maybe and hire a pool? Hypnobirthing could help you (if you've not looked into that yet) I found the breathing techniques very useful. Also a tens machine was excellent.

Do try and bare in mind that it's likely your birth won't go to plan. I wanted a home birth in the pool - I ended up induced and on a ward with continuous monitoring. Practically everything I didn't want! Our babies sadly don't read our birthing plans and may have a completely different idea of how head like to come out.

My top tips would be to think through all your options and always question the hospitals policies - there is a hell of a lot of box ticking and not much creative thinking in the NHS. Also try not to set your heart on anything, there are so many variables that you'll probably end up disappointed. Instead give yourself lots of options of things you'd like to try.

Really shocked at the harshness and dismissal of this poor women's feelings, who are we to say whether someone should feel devastated or not. If I were you I would talk to the Supervisor of Midwives and they will help you create a birth plan safe and in line with your wishes. Good luck and you deserve to labour in the way you want too just like every Mother does xxx

Op, not sure if you're still on the thread but here are my thoughts:

A birth plan is really your preferences. Unfortunately (and I say this with kindness) when it comes to birth, the best laid plans of mice and men oft gang awry as it were.

I thought a water birth would be lovely. When I asked for one it turned out they don't do them in the county I'm in because they de them unsafe. I'm in Sweden which is about as hippy dippy as it gets with regards to birth, so that was a surprise.
Anyway, I ended up with an elcs because I had placenta and vasa previa, so it all went out of the window anyway.

Secondly, it's not just a case of presenting your evidence and arguing your point. Maybe you're fit, healthy and have a water birth be a great success - but the guidelines are based on evidence. If I'm brutal, one of the main factors is that if something goes wrong, as it can do (birth is inherently unpredictable and risky) then the doctor who authorised this against guidelines could be in serious trouble
Obstetrics is very risk averse, for very good reasons. Anyone who deals with birth regularly will see how quickly things can go wrong and how serious things can get. For a non essential preference like water birth, the benefits don't outweigh the potential risks.

Op, I'd have a calm discussion with your team - ask them to explain their rationale but be prepared that they are unlikely to change their minds. Then I think it's worthwhile focussing on the real goal of a good birth - mother and child intact and healthy. Hope it goes well for you, but you may have to let this one go.

I know it's not the same as being told you definitely can't have a water birth but, unless you're having a home birth and hire your own, there's never a guarantee at a hospital or birth centre that a pool will be available. I'd love to have a water birth if I can (and low-lying placenta means I might have to have a C-section anyway), but am trying to not hang my hopes on this as it may not be possible. She possibly mentioned the bath as it is sometimes possible to use a shower/bath during the early stages of labour for pain relief even if you can't give birth in a pool x

The some of the trouble is with that high a BMI is getting someone back out of the pool should things go wrong.

At home this could potentially be worse.