HOME BIRTH LOW BMI

[user1489190513]

Hi there
I will be giving birth to my first child in April. I have asked for a home birth/ Birthing center because I don't want to take an epidural. I really want a natural birth. However it seems my BMI is low. Which is not unusual because i am from east Africa and we are quite a petite people. I'm finding it outrageous because the BMI guideline is not accurate and i feel like i don't have a right to demand home birth/ birthing centre.
HELP PLEASE

You can have a home birth - there is no allowed or not allowed, despite what they might be saying. A MLU might have their own guidelines regarding BMI but they also can't offer you anything a home birth can't in terms of pain relief / water birth if you buy a pool etc.

I would do your own research into why a low BMI might cause issues or complications, talk things through with your MW and make your own risk assessment. They cannot force you to go to a labour ward - but it is also prudent to understand why they might recommend it. Always try to make an informed decision

I am at the opposite end of the scale - too high a BMI for the MLU but this is my third child, having had one induction and one HB. They did say they wouldn't allow me into the MLU but I made it clear I would be at home and only going into the labour ward if I needed additional pain relief (i.e. Epidural) or there were complications. Therefore completely bypassing the need for the MLU. There is a great book called Am I Allowed? and all about risks and benefits of home births, how to handle health care professionals, scenarios you shouldn't ignore and situations where you can make your own risk assessments. When looking at home birth transfer rates, it's worth bearing in mind a lot of women transfer in because they choose to - i.e. Not coping at home/ have had enough/ want more pain relief rather than because they have to i.e. Transferred in due to emergency complications.

Good luck. Keep talking to your MWs and try to understand why a low BMI is an issue for them. Make yourself comfortable with your choices.

Hi there. I totally second red crab. I had my first two at home and did a lot of research on my 'risk factors'. If you understand why you are at risk, what the risk really is (i.e. The chance of something going wrong, and what the 'wrong' actually is), then you can make an informed decision.

Oh, and they can not 'let' you into the mlu, but they can't stop you from having a home birth! ((Tho is not recommend it if the risks are high; I succumbed and has dc3 in hospital)

I had a low BMI with my first (also petite - ridiculously small bones but healthy) and so was consultant lead throughout. They monitored the growth of the baby and all was fine and normal and just before birth they put me back to midwife lead, so I went to the birthing centre. Hopefully they'll see that all is good and you won't have to worry or 'fight' for what you'd like.

Providing your baby is growing normally (they may want to do a couple of extra scans) I have no idea why you couldn't have a home birth just due to "low BMI". There are no specific delivery risks I can think of

thank you everyone. yeah making my own risk assessments and understanding the risks sound a wise idea. When I request for a home birth will I still be supported by a midwife during delivery even if its against their advise?

Of course, yes. They can't refuse you a homebirth and nor can they refuse to attend your homebirth. What have they actually said? Was it just that they made noises about BMI guidelines or did they start to strongly advise you against a HB?

I would research the hell out of this just for your own peace of mind. What your rights are generally with regards to where you choose to give birth, what the risks and benefits are, and what has made them cite low BMI as a reason to not have a HB. The NICE guidelines is probably a good place to start, as is Birth Rights - sorry, don't have links. I think it would also be useful to start thinking less about what they will "allow" and more about what would be the most optimal place for you, all risk factors considered.

Well my midwife talks strongly about alot of things. I mean we talked about having the birth in a birthing centre but now i think they will refuse me that because of the low BMI. But I still want to go along with having a home birth and I know she will advise me as if it's not possible as if it's not an option. We have discussed about flu injections and and tests and I refused them but she kept insisting on reconsidering at every appointment. I'm sure she means we'll but I don't want to have a disagreement with her incase she takes it personal and it's just no the way to go. But I know for sure will try to tell me to reconsider and I'm afraid that will not take my decision seriously.

Your decision has to be taken seriously. They cannot refuse you a HB. You could perhaps end up having a long and involved conversation about her concerns and your reasoning but ultimately the decision is up to you.

They can refuse you access to the MLU but to be honest there's not much they can offer you there in terms of pain relief, pool, midwife attention that you won't get at home.

All you can do - and it's not all really, it's empowering - is research, be firm in your reasoning and information/ knowledge and be prepared to have to make it firmly made clear that you know your rights. It might just be this MW and that when you investigate it, low BMi isn't an issue at all. Or it might be that the MLU has valid reasons but you're prepared to accept the risk because you understand all the elements to it. It's about your comfortable level of risk and acceptance of likely outcomes.

But no, she cannot refuse you a HB. It's not really a request though they do tend to frame it as such and use language like "allow", which can make it feel like you need permission.

Thank you everyone for your advice and support. I will post an update after my meeting with the midwife.

Hi OP, hope your meeting went well. Midwife here - firstly to say that in the U.K. you have an absolute legal right to a home birth and they have a legal obligation to provide you with midwifery care at home. Health care professionals can advise against one and explain in detail (in a way which may seem upsetting or even potentially coercive to you why - it is not intended to be so but simply to ensure you are making a fully informed choice) but if you wish to go ahead then you can. They can however deny you use of a midwife lead unit.

I would ask to speak to the consultant or consultant midwife to discuss options. Depending on how low your BMI they may well be happy to put in place a few regular growth scans and then proceed down the normal route if all is well.

Good information here: www.tommys.org/pregnancy-information/i’m-pregnant/weight-management/underweight

An organisation called 'Birthrights' may be helpful to you if you don't feel listened to.

The repeated questioning about tests/ flu jabs must be annoying but please know that we are usually obligated to do this (and document that we have done so) for legal reasons both for ourselves and the hospital. Sadly on the unusual occasion that babies are born with problems or whooping cough/ flu etc happens there are often problems with people claiming that they were never offered interventions. It's not nice at all to feel like the the midwife isn't on board with you though