High Risk? Birth options

[MrsMonkey13]

Hi everyone.

So, I was overweight pre pregnancy with a BMI of 38 at my booking appt (it’s now 36 and I’m 23w+5).

I was told I would be under the care of a consultant throughout and that the pregnancy would fall under the bracket of “high risk”.

I have seen multiple posts say that this would restrict my options when it comes to how I give birth, specifically in my wish to use a birthing pool.

I understand that if the pregnancy has a high risk of complications it would be safer to remain in a position where the medical staff will have better access. My point is, since this initial booking appt I have had an absolutely flawless pregnancy. I had very little sickness and in general haven’t suffered at all. There has been no bleeding, no abnormal tests, I have remained active and have actually lost some weight (currently still 7lb below start weight at nearly 24lb).

I have a Glucose test booked for 1st June, along with three growth scans throughout the last three months of pregnancy; if the results of all of these show no reason for concern will I still be limited in my birthing choices?

If any other bigger mums have any first hand experience, or if there are midwives etc on here that could offer advice I would be so greatful.

I really don’t want an overly intervened birth.

In your post you mention the use of a birthing pool, think about how the staff would get you out in an emergency, ie your blood pressure dropped and you collapsed. It would put the staff at risk of injury, and any delay could endanger you and/or your baby.

So there are two reasons why birth centre/ water could be a problem. 1 is risk of complications which are statistically higher for high bmi,

Second set of risk is for how the staff would be able to work with you if for example you became unconcious, and also because high weight can make it hard to monitor baby.
This will also depend of how much you actually weigh (big difference between a bmi of 36 on someone who’s 6 foot vs someone who is 4 foot.) and also how much additional weight you put on in pregnancy.

If you have a generally smooth pregnancy a number of the things that could happen may be ruled out along the way. Also worth keeping discussions open with midwives. They may well decide you are ok for a water birth later in pregnancy. (Did with me... and then baby decided to stay breech so back to high risk square 1!!!)

Good luck!

As with much of the nhs, while for efficiency they may start with ‘ticklist says no...’ there may be room for discussion as you progress.

I’m 5’6

I was (am) 5’4 and i think they were ok with my bmi of 38 because i put on no more weight (actually finished off lifhter than i began) and don’t carry my weight around my middle (enormous thighs...) so easy to scan.

I have a raised bmi but my hospital was more than happy for me to be in the birth pool... The issue was monitoring the baby but they had ones that could do continuous monitoring In the pool so we're happy to let me use it. I also had multiple complications throughout the pregnancy so definitely worth discussing.

Ah, I do carry weight around my belly. I’ll speak to the midwife about it. Absolutely do not want to be limited to laying in a bed for the whole event. Worst nightmare

With my DD my BMI was 38 at my booking in and my weight went up less than 1 stone overall.. I told every midwife who would listen that I wanted a waterbirth and it wasn’t until I was at arriving at hospital that I was told this would never have been an option for me because of my high BMI.. (I am 5 3”)

I wasn’t necessarily restricted to the bed either though and had the option of birthing ball/rocking chair for birth and bath for the earlier stages.

I am currently 36w with dc2 and my BMI at booking in was 30.6... I have been told by the midwife that I could still have a fight on my hands as the cut off is 30. (I am in Northern Ireland so it’s probably different for each trust..)

I really want to have an active labour but I am not setting my heart on the water birth this time around as I was so disappointed not to get it last time..

Absolutely do not want to be limited to laying in a bed for the whole event. Worst nightmare

Why?

We’re all different but I can’t think of anything worse than being in pain and unable to move around to get more comfortable. I’ve always known I won’t be giving birth on my back. Gravity is our friend.

Having just given birth to a back to back baby after. 49 hour labour, I can honestly say contractions on my back were the worst pain I have ever endured.

They were bad enough anyway, but when I was on my back so the midwives could check how dilated I was, it I had a contraction I genuinely wanted to die.

Some people can labour on their back, some can't, but it's always good to have options

What do your midwives or consultant say about a pool? If they say no can you move to a different trust who will say yes?

If they say no to the pool I’ll be disappointed but I’ll get over it. If they say no to an active birth I’ll look into it

Most hospitals have the portable monitors you can use but you may have to very firmly ask for them.

What does your consultant say? Have you met them yet?

I met her very briefly at my 12 week Scan but won’t see her again until 28weeks. If the decision is down to her I doubt they’ll be listening to anything I say :(

The decision isn't down to her, nobody gets to make your medical decisions for you. If you wanted to you could suddenly say you're having a home birth with a pool, they have no way of stopping you and they would have to attend. Obviously don't do that if you don't want to, but you are in charge, not them.

Please make sure you get someone assertive as a birthing partner.

Thanks @gummygodess

I only wanted my husband there but he’ll not take my side and I know I won’t be up for arguing. I think I’m going to ask my mum to be on hand

Good plan, it might help you relax a bit more too if you know she's able to voice your wants for you.

The choice does not have to be between a pool and lying on a bed. Even if they say that the pool is out, you will be able to use the ball, have a shower, be on all fours, squat etc - and sometimes the bed isn't so bad, I really thought I'd have an active birth but in the end with dd2 my most comfortable position was in fact lying on my back, it was a fast and very straightforward delivery. Good luck!

That is fine and I am honestly open to whatever my body needs during labour, even if that includes medical intervention. Honestly not a natural birth warrior. I just really don’t want to be told I HAVE to do one thing etc. It will stress me out more than the labour itself to not be able to move into the most comfortable (and efficient) position possible.

I’ve just spoken to my sister in law who recently had her baby and she’s put my mind at ease a little by telling me the mobile monitors are readily available at our local hospital. So hopefully I should get a reasonably free range labour fingers crossed

They just check intermittently with a Doppler IME. And if their policy is continuous you can still request intermittent.