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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

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Original poster

Pregnant and overweight. Consultant led care. Any advice?

22 replies

Charliewasagoodhamster · 04/07/2013 11:45

I have just been to register my pregnancy with my Dr and went in so happy and come away in tears. The bit of weight I have been meaning to loose is far more than I thought it was and it has put me just under a BMI of 30 so the Dr wants consultant led care.

I have been in denial about the extra weight and this has really knocked me. Obviously I will do something about it sensibly now but I'm feeling crushed.

My first pregnancy was midwife led and straightforward. What is different with consultant led?

And what is the best way to reduce BMI safely when pregnant?

Thanks for any advice. It would be welcome.

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TinkyPeet · 04/07/2013 11:50

You don't need to reduce your bmi and I am suprised you have been referred for a 30!! My bmi on booking in was 37, so I am under 'shared care' as they call it, but initially I saw the consultant once after my dating scan and she asked why I had been referred, I said bmi. And she was like, oh, ok but you're okay? And that was it, they will send you for a GTT at 26 weeks but you won't be put on any dietary plan or anything and I would be shocked if anyone actually brings it up to you tbh!
As long as you feel okay and keep a good balance of everything don't let it get to you. Honestly :) chin up xx

BurbGirl2013 · 04/07/2013 11:51

I'm sorry I cant offer exact advice on consultant led etc but what are your main (bad) food/habit weaknesses that you can obviously identify?

meditrina · 04/07/2013 11:56

I'm a bit surprised that they have recommended this when your BMI is under 30.

There isn't that much you can do, as dietingisn't recommended in pg. But if you eat healthily and minimise/cut out alcohol (as you'd probably be doing anyhow) then it might edge things downwards a bit.

Consultant led care in pg isn't a biggie. It means that your appointments will be with the hospital team of midwives (who may have clinics in community outreach locations anyhow) and you'll probably have at least one appointment with a hospital based doctor (not necessarily the consultant herself). It means that if anything is picked up in monitoring (which is essentially the same whether hospital or community based) you are already in the system, which can be handy.

It doesn't commit you to any particular delivery options. If there are no complications in your pg (and there may well not be - being in a higher risk group means only that: higher risk, not inevitability) then there is no reason for a highly medicalised labour/birth. Indeed a consultant team annotation on your notes saying you are suitable for MW delivery can be useful as it is much clearer to point at that on the day, than have admissions bod try to make sense of your notes at what is bound to be exactly the wrong moment.

Original poster

Charliewasagoodhamster · 04/07/2013 11:57

Thanks TinkyPete. That is a bit reassuring.

BurbGirl, I know all my bad habits. Stress eating. Sweet tooth, work near a Greg's and no willpower. I started going to a gym about 2 months ago and an getting fitter but still snack at work so no weight loss. I've got fit and healthy many times and then something drops and I let go again.

OP posts:

meditrina · 04/07/2013 11:59

PS: I was BMI of 30 ish for my second - no weight related issues in pg whatsoever, though I had consultant led care anyhow for other reasons. And a delivery in the 'home from home' MW-led low-risk unit, though that was one sited in a hospital not out in the community.

Original poster

Charliewasagoodhamster · 04/07/2013 12:00

Thank you Meditrina. That helps explain it and doesn't sound too bad. I want what is best for the baby and extra monitoring can't be bad.

I need to get over feeling so ashamed.

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Original poster

Charliewasagoodhamster · 04/07/2013 12:00

I had a water birth for my first and was hoping for the same again.

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Alibabaandthe40nappies · 04/07/2013 12:01

Don't stress, honestly. They will see you once and then depending on how you/baby are will decide how much 'extra' care you get. It might be none at all.
They will probably want you to have a glucose test to check for gestational diabetes, and you may get an extra scan or two.

Runswithsquirrels · 04/07/2013 12:04

Booking in BMI of 31, normal midwife led care. Only extra I had to have was the GTT which came back fine. Preg has been good and no problems. Maybe check what is your trust's policy?

meditrina · 04/07/2013 12:07

Ask about water birth a bit further along. If everything is going well, then it should be a possibility.

Oneforthemummy · 04/07/2013 12:08

I was categorised as 'high risk' for my pregnancy because it was IVF, I am over 35 and overweight. This meant I was consultant led too, but in reality it made very little difference - I had appointments with a consultant at the hospital but also with the midwife, and it seemed more to be about extra monitoring than anything else and IMO was a good thing (it was my first pregnancy!) The consultant didn't restrict anything labour-wise - he would have been happy for me to have a water birth, but as it turned out, baby had other plans!

ReikiMummy · 04/07/2013 13:05

Hi OP,

As others have said, it means a bit of extra monitoring, and going for the GTT test at 26 weeks... however just wanted to say that my BMI was 39, however because I listened to my body all throughout the pg so far - I actually lost weight in the first trimester.

Not through starving myself, and I was also lucky in that I didn't get morning sickness, I just ate (making sensible choices... apple over a bag of crisps for example) and listened to my body, snacking / grazing rather than big lumpy meals.

Up unto week 36 - I'd only put on in total 6kg from the start of the pg, so I know my weight dipped and then picked up again.

I'm now 38w 6d and have the birth pool set up at home (nearly) all prepared for the LO's arrival hopefully in the next week or so!

HTH. :)

Original poster

Charliewasagoodhamster · 04/07/2013 13:08

Thank you all for your response. I've calmed down a bit and feeling more positive. Thanks.

ReikiMummy, I am really happy to hear you have a home water birth planned. Good luck for it.

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BurbGirl2013 · 04/07/2013 13:15

Charliewasagoodhamster - sounds pretty typical then! Also doesn?t sound like you are really overweight?
I am a size 10/12 but for me food is a constant temptation and always on my mind & I have to struggle to control my urges constantly...know its such typical advice but as I?m now eating far more carb heavy foods as its the only thing with my PG (am 18 wks) I can literally stomach, I?m forcing myself to get off a stop earlier to and from work (if weather permits) and brisk walk it. Even though its only 15 mins each way I think that?s making a difference stopping me from ballooning. Im going to gym once or twice a week and still doing weight machines on legs/bum and going at much slower rate on treadmill (jog v slowly for 2k and walk up incline for 25 mins) but this helps too and makes me feel so much better inside too. Good luck! X

Beckmum4 · 04/07/2013 15:59

I can so relate iv have 3kids and all perfect midwife led pregnancies but this time my midwife took one look at me and referred me to the consultant. At the apt at 16 weeks the consultant said why are you here?? I guessed dont know think its because im fat And midwife piped up "I wouldn't refer for no reason "!!
I'm gutted to its made me feel so fat and overweight and now at 28 weeks iv put on 8lb and midwife still feels the need o tell me I'm fat :(

FoofFighter · 04/07/2013 16:20

You can turn down their recommendation for consultant led care, I am surprised you were referred for 30BMI, I thought the NICE guidleines were 35BMI?

I was put on CLC without my knowledge or discussion and queried it, with a BMI of 32, I was more concerned at what it would mean re birth choices for me as I know sometimes it affects them such as water births, but was assured in my case at least it wasn't going to hinder any birth choices and was simply a case of a two of my mw appts being with the C instead. And that I may get an extra scan at 34w.

I'm having my second appt with the C on Monday, at the first he was a bit that I'd been referred at all. I got no advice on weight gain in pregnancy/diet/exercise from him anyway!

Original poster

Charliewasagoodhamster · 04/07/2013 19:10

That's awful how rude your midwife sounds Beckmum. How do you manage to not tell her where to go. 8lbs in nothing in pregnancy for 28 weeks. Well done.

Fooffighter, I am very glad to hear it won't effect your birth choices. And surprised that no advice comes with the referral.

Thanks Burbgirl I need to do those things. I could go walking at lunch time. I just don't use the opportunity. I shall have to push myself more.

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PickleSarnie · 04/07/2013 19:23

I'm really surprised that you've been advised consultant care based purely on your bmi especially since your last pregnancy was straight forward. Are there any other medical issues you have that may be contributing to their decision?

My BMI was 31 on booking. It was never mentioned again. I didn't have the GTT and I was actively encouraged to have a homebirth which I did.

Original poster

Charliewasagoodhamster · 04/07/2013 19:39

Hi PickleSarnie, the dr explicitly explained it was about my weight. There are no other health issues.

I am beginning to think the consultant will see me as a waste of time.

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PickleSarnie · 04/07/2013 21:01

Id kick up a stink if I was you then. Have you seen your midwife yet? She's the one who can make those decisions and I'm sure she won't care about your bmi.

Xmasbaby11 · 04/07/2013 21:18

I was consultant led due to being overweight. It didn't really mean anything. I was given a bit of a talk at 12 weeks about not putting too much weight on, had glucose tolerance test at 20 weeks, other than that, absolutely no different. Had no bearing on the birth.

3boys3dogshelp · 04/07/2013 21:39

I have had consultant led care for all 3 of my pregnancies for different reasons (not bmi). At my booking appt this time the midwife said I had to go clc again as I have 'awkward babies!'. I'm 26 weeks now and haven't seen a dr at all. It made no difference to birth choices apart from being advised not to have a home birth. I was all set for water birth this time but labour was so quick he was born before the pool had finished filling!

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