I’m very fat and about to have a section. Please help!

[ODFOkaren]

Two weeks tommoro.

This will actually be my 3rd, but I wasn’t fat for the other two. And they were hard enough, so I’m honesty in a panic.

I’m 17stone, BMI is 40. Huge overhang thanks to the other two sections.

Last two they have had so much trouble putting in the spinal anyway and I was screaming in pain both times - nerves weren’t hit and I had lighting bolts down my legs. So I’m concerned about back fat. I spoke to the anaesthetist who was very negative and said yes, they would most likely have more trouble this time seeing as they couldn’t site it properly when I was a normal size. So that made me feel great

I also felt like I couldn’t breathe on the operating table the last time. This time my chest is so much heavier. So I’m dreading that being worse.

I’ve not seen a consultant and won’t - I’ve only seen thier juniors who have nothing to say at all really.

But I’m terrified. I actually lost 6 stone before falling pregnant - it was the weight loss and diet I was on that made me super fertile! I didn’t actually plan on pregnancy again until I’d lost another 6. But here I am.

I didn’t gain any weight at all until 32 weeks. I was super careful not to gain any as I didn’t want to make the situation worse but since speaking to the anaesthetist (they let me speak to them early to see if I could get a consultant anaesthetist due to past problems - it was a no, you’ll get who ever is free) I’ve been comfort eating and I look and feel like I’ve gained two stone. I can gain weight horribly fast. So I feel like I’ve made everything worse for myself.

So can anyone tell me what it’s like to have a section as a large woman? I’d appreciate any help or advice. I really am terrified. I’m so scared I’ll die on the table.

I’ve been told I’ve got a higher chance of blood loss and complications due to my weight. I’m so terrified.

Sorry for all the typos - I’m in tears again.

I've had 2 sections with a BMI over 40. One emergency and one planned. I know you said they had problems with your spinal last time so I'm not dismissing that, but mine went perfectly both times. So third time round it might be ok. You should see someone a few days before anyway to have bloods taken, be given your medication etc (I think it's like a indigestion tablet and anti sickness tablet). So raise your concerns with them before hand. My anaesthetist on the day was lovely and reassured me the whole way through. The chest pressure is odd though, I had that and it's not a nice feeling.

Both my sections were fine, my wounds healed very nicely. When you are back on the ward after, just drink as much as you can while you have your catheter in. And try and get mobile as soon as you feel able to, that reduces your risk of blood clots. You will probably be sent home with clexane injections to minimise clotting, make sure you do these and finish the whole course. And don't forget your sexy stockings! Keep those on as long as you can.

Clean and dry your wound thoroughly. I have a big fan in my room, I would lay on my bed after a shower and point the fan at myself (and hold up my stomach) to make sure it was all dry.

All of the risks that come with having a higher BMI are terrifying but chance are, none of them will happen. But they have to make you aware of what could potentially happen.

I hope it all goes well for you!

@Florencenotflo thank you.

I had blood thinners after my second - I wasn’t overweight but they were standard after a section at that hospital. Horrible bloody things, dreading them!

I’ve been told my pre op is over the phone the afternoon before how the hell that works with bloods needing to be taken I’ll never know.

I was very big when I had my c-section (emergency, not planned). Not sure of my exact BMI at the time, but definitely edging close to 40. Obviously, it is higher risk, but I was absolutely fine and had a very quick recovery also.

I never had bloods taken before either of my sections? Although one was an emergency.

If you are concerned about the spinal, can you ask for a general anesthetic?

@Fatted

I never had bloods taken before either of my sections? Although one was an emergency.

If you are concerned about the spinal, can you ask for a general anesthetic?

My baby might need to go to special care as soon as she’s born - there have been lots of issues. So I want to see her right away.

Plus there are added complications with a GA and being overweight.

I’ve had an emcs and elcs overweight and the talk of fat complications were different to the reality. I know it’s not easy leaning forward with a belly full of baby, but the more you can the easier it’ll be for the needle. And pray you’ve an older, calm and experienced anaesthetist - you know, the difference between a 23 year old doctor taking blood and a 50 year old nurse! 😁

My first baby was abroad and it was over 35 degrees in my flat. Dried all my bits with the cool setting on the hairdryer.

Good luck and congrats!

They might want bloods for any potential transfusion needed - but as this isn’t your first baby, your blood type should be known.

Honestly, sections aren’t the devil they’re made out to be.

@InsaneInTheViralMembrane I’ve had blood taken before both previous sections, even though they knew my blood type. Second time I was told that it was because it was a different hospital. It’s a different hospital again this time so I was assuming they would take it again.

Hi, I'm 48 hours post c section and I'm larger. My hospital were absolutely amazing in the lead up to it , I met the anaesthetist twice beforehand - first meeting they examined my back thoroughly and we practised positions and secondly to do more or less the same but decide wether they'd want to do an ultra sound and some mapping on my back which they decided against as although I'm overweight I don't have very much back fat apparently (I'm not sure how much I believe this ) you need to really push to speak to someone to have these measures put in place , I'm really shocked they haven't done this.

I ended up having a different doctor on the day as my waters broke before my planned c section , I was an absolute nervous wreck but he introduced himself beforehand and again we practised positions. I was so nervous so we decided I'd have gas & air whilst I had my local anaesthetic and spinal which was a life saver because it did take a few attempts to get it in and I did get lightning down my legs which wasn't exactly comfortable but the gas and air made me able to bear it. All went in eventually and c section went very smoothly so please ask for gas & air (I ended up having it until baby was on chest as I was so nervous)

The second thing you need to ask for is a PICO dressing - kept for those with a high bmi. It's a dressing that stays over for 7 days and has a pump/battery pack attached (google it) it prevents the wound getting sweat or anything into it and lowers the risk of infection drastically. I have one of these and don't think I'd be coping in this heat without it.

My blood loss has been normal / minimal in comparison to my vaginal delivery 2 years ago. The experience isn't even comparable , i feel as good as I could do this time around. I haven't had a shower yet but it's on the agenda for today and I am a little nervous for that but will see how it goes.

The fear is unreal it's like nothing I've ever felt before so I totally understand, sorry you're feeling that way too. Please excuse the awful grammar and spelling

I haven't had a section (I am preg though) but I had two spinals recently for a broken leg. I was already pregnant so had to have spinal blocks rather than GA.

I understand what you mean about it being hard to breathe, but without intending to offend or patronise I realised it was actually in my head. It's a weird feeling where you're numb from your chest down, so it feels like when you breathe your chest isn't inflating as much as it should. So then you think you can't be getting enough air in. You can but it just doesn't feel like it is. My anasthaesiologist (sp? 🤷🏼‍♀️) said he would give me an oxygen mask if I needed it but I ended up not - but you should have that option if you still feel like you can't breathe.

It was also painful for both of my injections because of my chubby back, but I also found it depended on the skill of the person doing it. Speak to them, let them know your anxious and they should be as supportive as possible.

I'm afraid that's all the advice I can give, but very best of luck and congratulations in advance for your little arrival 🎈

@CantKeepSecrets wow, I’m so glad they were helpful.

Part of the reason I’m so scared is that I won’t see the anaesthetist Face to face until the day. I’d feel so much better if I could see someone, but they keep saying no because of covid measures.

I asked about gas and air and they said it wasn’t possible!

I told them how anxious I was, they just kept brushing me off.

@CooperLooper when I spoke to them on the phone they honestly couldn’t care less. Just kept saying I’ll get who ever is free on the day and that yes, there would probably be an issue because of my weight.

I’m just feeling so down about it. No one seems to want to address my concerns at the hospital at all.

Midwives have been next to useless as well. They just offered to refer me to the mental health team if I wanted - I
Don’t need that, I Just want to speak face to face with an a doctor who can help come up with a plan. All I’ve had is jr doctors shrugging their shoulders each time I ask a question and one practically useless anaesthetic review over the phone

Gosh it does sound terrifying. Could you quickly find a hypnobirthing specialist who could coach you over Zoom, to help you relax and breathe and learn mantras to stop you panicking ? I found it wonderfully helpful for my terror about my second induction (the first was a pretty awful experience).

I remember reading a fascinating article once about certain operations for which the patient has to be awake, they found that patients who were very happy and relaxed reported far less pain and recovered faster than those who were frightened. You can't control what happens on the op table but you can control your response to it.

@HathorX I really tried in my last pregnancy. But it just didn’t work for me. I pulled out some of the resources this time. There were some affirmation cards and one said “I trust my care providers to give me the care I need” (or something along those lines) and it just made me cry because that’s the last way I’d feel about them!

I’ve just had two awful experiences without the added complication of obesity. From the care I’ve had so far, I really don’t have high hopes this time.

I’m actually in later today for a scan to check on baby's heart. Due to see the consultant (well, one of their ever changing team of jrs) afterwards.

I’ll try to speak to them again. See if they will actually engage with me this time. They usually just stare at me blankly, say they are not sure if I ask anything and tell to ask my midwife if I have any questions - who then tells me to ask the doctors - hand me back my notes and I leave the room (I wish I was being glib but that’s how all the appointments have gone).

They’ve just moved it forward to next week.

I have no advice op but I just wanted to say good luck and I hope everything will go smoothly

I have a BMI of 48 and had an emergency c section which went fine. Spinal block went in fine - took a.while to kick in so the anaesthetist kept spraying the cold spray oj my shoulder then on my leg and took quite a while for me not to be able to feel it . Well I say quite a while not that long but I think longer than he expected. Only lost 600ml of blood which I think is fine.
Wound healed fine although was infected at two weeks but took metronidazole.
Was obsessive with keeping it clean and dry though. Would shower, lift tummy up and dry with hair dryer and still do now 11 weeks pp. Did wear a pad against it until it fully healed

Stockings and injections for six weeks .

Another big mum here, ELCS was fine. Recovery was interesting but not made worse by weight.

All the best for you OP. You are almost there. It'll be ok.

My bmi was 38 pre pregnancy. Luckily have put on v little weight, but was 4 stone lighter when I fell pregnant with my first!

I'm actually having the baby privately, and my consultant has been so, so reassuring. I was worried about all the weight related issues, but she has totally reassured me that it is very unlikely to cause any problems.

My NHS experience re: weight has been very negative, and have been made to feel pretty shit and anxious.

Looks like I might be having my section tomorrow so will report back!

My bmi was 27 at booking but thanks to a lot of weight gain and water retention it is now 38, I have my pre op appointment for section next week so will be interested to
See if my weight is an issue- I was similar Size at time Of my last emcs and nothing was mentioned and no issues with the epidural etc. I Hope all goes well for you!

Thank you all.

I just can’t shake the feeling that something terrible is going to happen. I’ve not stopped crying today.

I’ve got a week.

@Sipperskipper hope all goes well tomorrow x

I’d also told my Dh that I didn’t want family/friends to know the date. It was so much pressure last time. I just wanted to let them know once all was ok.

But he’s told everyone. Said he couldn’t help himself. I’m so upset with him.