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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

Home birth for first time mum with high BMI

34 replies

PinkStarFish15 · 29/08/2018 14:39

Hi,

Sorry this is bit long, I tried to keep the waffling to a minimum...

This is my first pregnancy (I'm 20 weeks) and I would have really liked a water birth, however I am consultant led care as I have a high BMI. I have spoken to my midwife and she has said although they might consider allowing me to give birth in midwife led unit (next to the main ward in the hospital) they wont allow me in the pool. When I asked her if there was any way round it she said I could consider a home birth and have a pool at home, the consultant may advise against this but ultimately its my decision and she would support me as long as I understood the risks and would take their advice if I did need to be transferred. This really appeals to me, as I really don't want to give birth on my back in a hospital bed.

I've looked in this a little bit and and I understand that around 40% of FTM's who attempt a home birth end up being transferred to hospital. Also although I'm having a good pregnancy so far I understand that I have a higher risk of pre eclampsia, needing a C-Section / induction so I may well end up in hospital anyway :(

My main question is if there is anyone who has been in my position and tried to have a home birth, and for those who did and ended up going to hospital are you glad you tried at home or would to recommend going straight to the hospital.

Thanks

OP posts:

coffeeforone · 29/08/2018 18:16

I'm pregnant with DC2 with a high BMI.

I would have loved a water birth with DC1 and that's what I had planned (in MLU). They didn't actually pick up on my BMI at booking in first pregnancy so was considered low risk, midwife led care. I ended up being induced with a drip (on my back, continuous monitoring) because my waters broke but labour didn't progress.

They have picked up on my (very similar) BMI this time round so I'm under consultant, had GTT and growth scans (all fine, I'm 36 weeks now). I've also been strongly advised against MLU as risks of raised BMI. If they won't support MLU, I doubt they would support Home Birth, so it looks like labour ward again this time round!

If they are happy to support a home water birth I'd go for it! Good luck!

wonderstuff · 29/08/2018 18:25

I was under consultant care for a low bmi, I was keen on water birth right up to when I was in labour and at that point I had no interest in it. I gave birth in hospital but not on my back, on my knees leaning against the headboard of the bed, mooing like a cow which was unexpected!

Just wanted to say that how you feel at 20 weeks and how you feel in labour can be different, I think the best thing is to be informed, have a plan b and be prepared to go with the flow a little. I think feeling confident is useful but giving birth is such a shocking and bizarre experience, you are best to trust your body will get that baby out somehow but don’t fixate on a really specific plan.

Hideandgo · 29/08/2018 19:30

I wouldn’t, even with low risk and normal BMI. But I know of two people with brain damage and one death from home births. So I just couldn’t take that risk. I’d be even less likely to with a high BMI. I’ve had 4 ‘uncomplicated’ labours and none of them felt like anything less that a hair away from an emergency.

Hideandgo · 29/08/2018 19:31

Just to clarify, the brain damage incidents happened during Home births, I can’t say for sure they wouldn’t have happened anyway. The death would likely not have happened in a hospital.

bengalcat · 29/08/2018 19:34

What's your BMI ?

RedPandaMama · 29/08/2018 19:35

I would love a home birth - I just don't feel comfortable in hospital. However giving birth is a major thing, so much can go wrong and I just wouldn't want to risk not being in hospital. I was low risk.

greendale17 · 29/08/2018 19:38

You are already high risk. Why risk it even more by having a home birth?

wonderstuff · 29/08/2018 21:34

I thought home births carried a slightly lower risk than hospital?

wonderstuff · 29/08/2018 21:37

Just looked it up I’m wrong, slightly higher risk on first birth, equal to hospital for second births.

Mach5 · 29/08/2018 21:41

I was high BMI in my first pregnancy, but allowed in the MLU beside the delivery ward. Just wanted to say that all the hopes I had pinned on water births easing pain, being lovely etc were just not there for me when the time came. It was hugely more painful in the water!! I jumped straight back out and got back onto the fit ball. It's hard to plan for labour. My advice is not to get too attached to any particular approach, as babies can ruin your plans (transverse with cord presentation, like stubborn DC2 for example...)

BlueBug45 · 29/08/2018 21:47

@wonderstuff only if they aren't your first pregnancy and you don't have any other risk factors.

DieAntword · 29/08/2018 21:47

Honestly I wouldn’t. I thought about it, but then a colleague of my husband gave birth in the MLU not attached to a hospital and had a hemmorage and had to be ambulanced to hospital while husband took a taxi (only mother and baby allowed in the ambulance). And I thought that the transfer time and everything that could go wrong - I’d rather be in the hospital where the NICU is.

I had 2 babies in that hospital. Neither were had “on my back”, second one they didn’t even use the fetal monitors (our hospital used wireless monitors so you can walk around with them on). First time I gave birth on my knees and second time standing up with my leg elevated - was completely able to choose my positioning and change it. I did the vast majority of labouring at home, came in at 5cm dilated and progressed rapidly the first time and at 8cm the second time and the second time round I got to leave after the birth and avoid a stay on the maternity ward (which I was very keen to avoid). First time I did hemorage and lost almost but not quite enough blood to require a transfusion (my iron levels were just above the cutoff). I was glad I was there not at home.

If you don’t have a big baby, diabetes or pre-eclampsia the big risk of high bmi is post partum hemmorage. So think about where you’d rather be in the worst case scenario as well as the best.

Sandstormbrewing · 01/09/2018 17:50

I'm not sure why you'd risk it to be honest. You have no idea if you'll like a water birth and could be placing your baby at risk. It'd be different for something that will actually affect you longer term, but justbecause you want a water birth seems a bit silly to me.

Can you articulate why you want a water birth? I find for most people it comes down to the fact that hearsay and media suggest it's the 'perfect;' birth.

snowone · 01/09/2018 18:10

Op can I ask what your BMI is? Om 13+4 and I'm being treated as high risk this time as I'm over 35 and my BMI is 30......I am being "consultant advised" but hopefully not led. I'm hoping they will let me crack on like I did last time,

I went in the birthing pool with my first DD and whilst it was lovely and warm I didn't find any benefit to being in there. I gave birth out of the water in the end

snowone · 01/09/2018 18:11

Ps I had a lovely birth experience last time and even that wouldn't make me say yes to a home birth. There is comfort in knowing that medical help is near by if needed

lambdroid · 01/09/2018 21:21

You could always book a homebirth (as you have to book one in) if your midwife supports it, hire a pool and labour at home with the intention of transferring in later. Obviously depending on how far you are from the hospital etc. Could be worth looking into?

I had a home waterbirth for my first, but was low risk and live less than 2 miles from the hospital. I don’t think I’d have done it if I was high risk.

Littlefish · 01/09/2018 21:24

I had a high BMI when pregnant with Dd and was under consultant care. I ended up having a waterbirth in hospital. It was wonderful!

Are you sure they don't offer waterbirths in the main hospital?

ohnothanks · 01/09/2018 21:32

I think it might depend on how high BMI and the results of any GTT. BMI above 35 or gtt+, I definitely would not. Not worth risk of shoulder dysocia or a massive baby. Only marginally high BMI and clear gtt, yes. I woulf definitely opt for homebirth if I ever had a 3rd (unlikely).

PersianCatLady · 01/09/2018 21:33

Are you sure they don't offer waterbirths in the main hospital?
The OP said that they won't allow her in the pool

Littlefish · 01/09/2018 21:36

PersianCatLady She said she couldn't have a waterbirth in the midwife led unit. That's why I wondered whether they offered waterbirths in the main hospital.

skunkatanka · 01/09/2018 21:40

Why risk the life of your baby when you're already high risk? Why make the risk greater?

With my first baby I was on my back and in stirrups. If you'd have asked me before I'd have said I'd hate that position but actually, after a long labour, it was comfortable.

Jt123 · 01/09/2018 21:44

Hello,
I can’t answer your question completely but I have had a home birth which was beautiful and a year ago had a hospital birth as I had low iron and bmi of 30 I was so annoyed I didn’t look into my rights - it was horrible as soon as I had ds they told me to have a bath and get my stuff ready to go on ward. The ward was awful I couldn’t sleep for the nurses coming in the curtain and trying to take blood from my newborn - would never have another hospital birth! I hope u get ur homebirth and enjoy every minute xxx

Tetri · 01/09/2018 21:46

I can't imagine having a home birth and I had a very healthy pregnancy, healthy weight etc. Ended up being a complicated delivery requiring 8 people (doctors, consultants & midwives), after induction, episiotomy, and ventouse suction- it scares me to think what might have happened if I was at home.

SDTGisAnEvilWolefGenius · 01/09/2018 22:01

I had two home births, with ds2 and ds3, and I was overweight at the time - I’m not sure what my BMI was, but I was a size 22.

I had two completely successful deliveries, no problems at all.

I had community midwives who were very pro-home birth, and who I trusted implicitly. I knew they were committed to me having the home birth I wanted, but equally committed to it being a safe delivery for me and the baby, so if they had said I needed to transfer - even if it had been because they were getting a bad feeling (I am a nurse, and believe in nurses’ instincts) - I would have gone without a murmur.

I was less than 10 minutes drive from the front door of our local maternity unit, so I had no worries about th distance, if I had needed to transfer.

All in all, both births were brilliant experiences.

PersianCatLady · 01/09/2018 22:03

@Littlefish
I see what you mean.

So even if the MLU said no waterbirth, do you think there is a chance that the main labour ward would say yes?

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