SO ANGRY!! Just been told I'm so fat I can't give birth at home.

[ruthmollymummy]

And I'd like to start by admitting that I am overweight but not by loads. I am 6 feet tall, broad and wear size 18 clothes. BMI is 33 (although I think BMI is a big pile of twaddle as far as evaluating health)

So am I really so fat that its dangerous for me to give birth without medical supervision over and above a midwife!? I'm only 22, second child and pretty darn healthy I think.

Please tell me there surely can't be a law like this????

BMI is not 'a big pile of twaddle as far as evaluating health'. I must have missed your medical degree

Bizarrely, pregnancy itself, whilst regarded as a physiological normal event, is a risk to your health. Couple in other risk factors such as obesity and your risk increases; not just beacuse of the likelihood of complications such as gestational dibaetes or hypertension, but scanning your baby and your placenta becomes difficult - making it difficult to spot other complications that have arisen independently from obesity. Siting epidurals is very difficult, and you are an anaesthetic risk.

That does not mean obstetric staff have a carte blanche to be rude or disresectful to you; I would certainly raise this with your midwife.

As other MNers have pointed out, your obesity is not a prescription for a complicate pregnancy and birth - as your first experience has demonstrated. But I do think you have to get your head around the fact that you are more likely to have complications.

Why don't you keep an open mind until 36-37 weeks?

Hm, Highlander....I agree with you that being overweight increases risks, in pg aswell as normally, I suppose...however...tbh., I can not grasp (possibly stupid, I know) how BMI really can give you guidelines on anything....because, it misses so many imporant factors...forinstance men, naturally have a higher muscle ration, and of course each individual will have different muscle fat ratio...it also does not take into account where a person carries most of their fat, which is, surely you will agree, fAR MORE TELLING IF YOU WANT TO WORK OUT RISKFACTORS... ooops caps, sorry....
For those reason I really , personally, think that BMI is quite a rubbish tool....

Also, a 6ft size 18 woman, personally would not strike me as that severely overweight,as in risk factors increasing that much

FWIW, a friend of mine, she must have been 5.3 who was a size 16-18 had no problems to get a HOmebirth dispite the fact that her previous 2 Baby's were on the larger size....

In the end, OP, it is your decision and aslong as you are aware of all the possible risks than really it is your decision....of course you have to consider all possible consequences, etc...but it is your right to have a HB, and by your OP (have not read anything bar OP and last post by Highlander) you don't seem to be unreasonbable or anything in wanting a HB....unless there are other riskfactorss, etc...

Highlander - have you looked at the photo of the OP? She does not appear to be overweight and she says herself she is "6 feet tall, broad and wear size 18 clothes"

Surely build must be taken into account when assessing whether someone is actually obese? Prior to pregnancy I was ALWAYS underweight based on simplistic BMI due to a naturally slight build.

Have just looked at your picture on your profile and can't believe your midwife told you that

After my 2nd scan with dd1, I read what the sonographer had written and was a bit surprised at "difficult scan due to high BMI"
I'm 5'8'' and probably weighed about 12 stones at the time, was 22 weeks pregnant too.

Good luck in trying to get your home birth.

cali, that is shocking and disgusting....
AND PEOPLE WONDER WHY SO MANY WOMEN HAVE BODY IMAGE PROBLEMS...GRRRR.......sorry, blardy caps lock again....

ruthmollymummy.

well i am 5ft 3, size 22, and BMI of 34

i have just had a home birth, midwife did state my high BMI was a risk factor but as i was otherwise low-risk all should be fine. and it was.

i had check for diabetes (had it in previous pregnancies), which came back cdompeltely clear, normal BP throughout, no swelling, protein etc etc. if at any stage i was unsure about proceeding with homebirth, then would have gone to hospital. but all was ok. and one of the most relaxed births i have had, with minimal intervention, and a hands-off midwife who let my body do what it needed.

cali, it says that on my scan notes as well.

was just another black mark against that particular hospital,

With dd2 I had lots of scans and was a similar size, BMI is 25 and nobody else seemed to have difficulties in scanning me.
Had moved back home so different hospital luckily.

misdee, it just makes you feel awful doesn't it. sounds like your home birth went really well.

You may find that it's because you outside of the range they use for automatic booking of a HB. I was "refused" for DD because DS1 was 10lb 1oz (and outside their range) but went to talk to the hospital consultant and he was fine about it.

Highlander, some of the points you make are true but where I take issue is that risk factor is determined by a number alone without actually looking at the lady as an individual and holistically.

Yes, women who are overweight are at increased risk of high blood pressure and diabetes, amongst other things, but these things are screened for in ALL pregnant women so why do we treat them as high risk before there is even a problem?!?

For crying out loud, raised BMI is being treated as if fat women are walking time bombs! The lucky wee smokers are getting away almost scot free here on the back of us all getting nervous about fat birds having babies!

I fall into the morbidly obese category and had a BMI of 45 when I had my last homebirth. Even though I had had two previous normal births, my midwife tried to tell me I was being foolish for not having anaesthetic review and certain screening and she knew I was a midwife and therefore making an informed decision.

BMI is only ONE factor in assessing someone's health status (and not a very reliable one at that). Look at the individual, Does she have existing health problems? does she have mobility issues? Does she smoke? Has she had previous normal births?

Also a point about shoulder dystocia - this is not an issue primarily related to obese women. It is not even an issue related primarily with large babies. It is an issue about the size of the baby being dis-proportionate to the size of the mother's pelvis. IF the mother has diabetes (which obese women are at increased risk of developing) then she is at increased risk of growing a large baby which could potentially become stuck during birth. However, around 50% of shoulder dystocia cases are with babies of average size so it is inaccurate to say that this is a major risk factor with maternal obesity.

aren't many shoulder dystoxias also more down to more intervention in the first place...
I am sure I read that somewhere but can not remember where or when....it's been a few years since I looked at Birth etc...closer

What a load of bollocks.
I had some hiccups getting my home birth with DS1 (I was 33, BMI of 21, very healthy etc etc) so I wrote to the head of midwifery at local hospital using suggested wording in my letter from the AIMS website. It clearly worked and I got my HB for DS1 and then again for DS2, both great.
Dont take no for an answer and be persistant.
You look really healthy and happy in your pics.
Good luck, home births are fantastic.

They can be FLRAL. Often a shoulder dystocia can actually be caused by what is referred to as "bed dystocia", ie the woman is flat on her back on the bed and therefore the dimensions of her pelvis are reduced. Often in cases like this, the dystocia is resolved simply by moving the woman. Instrumental deliveries are also a higher risk factor for a shoulder dystocia as your baby is being pulled out and is potentially at risk of having it's shoulder impacted against your pubic bone before it's had a chance to rotate properly.

sorry, I know this is a bot off-topic about SD, but am doing a lot of thinking about it atm as had one last delivery

'they' say true SD isn't down to position or whatever, but - as Howdie says - is physiological. I'm trying to weigh up my risks for another one (impossible) - I'm a slim build but ds was a bit of a hulk, lol

anyway, RMM, this site may be useful for all sorts of research, if you haven't seen it already homenirth, which I'm sure you have!

and fwiw, I had a drug-free labour, standing up and then kneeling and leaning for 2nd stage - makes me think mine could reoccur