Induction at 39 weeks for high BMI with no other concerns

[Bottlefeed]

Hi everyone, I had an appointment this morning with my consultant who has offered me an induction at 39 weeks. I’m currently 37+4, first baby, 37 years old, High BMI. Only reason I am under consultant is because of my BMI. No other health issues with me or baby.

Baby was estimated showing as 7lb 8oz at 36 week scan and I was told this was slightly on the larger side for how many weeks I was. My pregnancy has been (apart from PGP and sickness) very healthy and plain sailing, blood pressure always fine, no gestational diabetes etc.

Im torn between letting my body do what it has done so brilliantly so far right to the end naturally or am I putting my baby and myself at risk and possibly needing more intervention by not getting her out sooner.

I know no one has a crystal ball and everyone is different but I would love to hear advice/experiences/reasons of anyone who decided to go for or not go for an induction in a similar position to myself 🙂

What did the consultant advise? I would be guided by them.

what are the risks if you don’t?

I would ask them to be very clear- is it things like Iv or epidural placement in an emergency? Anaesthetic risks?

find out exactly what problems your high BMI may cause and decide from there. It may be you simply can’t mitigate and they need to induce to avoid a worst case scenario happening if you need anaesthesia or something.

but the should be talking you through the risks- they need your informed consent

I have been consultant led for both of my pregnancies due to my raised BMI. Having a high BMI is not in itself an issue, however, it can lead to various complications (gestational diabetes, high blood pressure, preeclampsia etc). As you don’t have any of those issues, I would ask your consultant whether in his view there is a medical necessity for induction and why.

Both of my pregnancies and births were textbook with no complications (spontaneous unassisted labour). I said that I would not accept an induction unless in their view it became medically necessary. While everything is ok with you and baby I cannot see the reason to intervene. The other thing to consider is the rates of successful induction in a first pregnancy, and the impact an emergency CS could have on subsequent pregnancies.

Inductions often lead to a cascade of interventions and rarely lead to the type of labour most women are looking for.

Have you had a conversation with an anaesthetist? I met with one during both my pregnancies to feel my back etc to see if there would be any issues with epidurals if required.

There is a midwife on TikTok called the The Heavyweight Midwife who talks a lot about this, might be worth a look!

Oh also, you can ask if they are happy to refer you to midwife led care for your birth if there are no concerns with mother and baby. This was something I was really bothered about with my first but not so much with my second.

Have a look at Dr Sara Wickham. She had some great resources and a book all about plus sized pregnancy.

Also, the great birth rebellion podcast.

High BMI (alone) isn’t really a reason to induce at 39 weeks.

Have a read and listen and then speak to
your consultant. Ask questions, ask them to relate the risks to your situation. Things like ‘the risk of x doubles if you do y’ is meaningless if you don’t know what the starting point was or how that relates to you as an individual.

Thank you for the many replies! ☺️

The consultant was very much “it’s up to you, no pressure” and only mentioned my BMI being the reason for the induction being offered. He said the water surrounding baby was fine, placenta blood getting to baby was in his words “excellent”.

I have seen an anaesthetist, he was happy when he felt my back etc to make sure I would be ok for epidural if needed.

I have a scan that is booked for 40+1, it’s made me think should I hold out for that and see if the baby has grown massively from the last scan then make a decision but obviously by then the risk is higher than it would be at 39 weeks.