Consultant Led due to midwife calculating BMI wrong.

[blackpony]

Hi all,

I was hoping to get some advice on my situation. I'll try to keep it short and not ramble!

This is my first pregnancy, I am now 15 weeks. I've always known home birth was going to be my choice providing no serious issues prevented it.

Anyway, at my booking appointment I told the midwife of my intention to birth at home providing there were no serious worries later, straight away she was dismissive and suggested I go to the local birth centre as it was, "like home anyway!", and then said we wouldn't be discussing where I would give birth properly until 36 weeks anyway so there was no need to worry about it now. She told me I would be under the care of the community midwives.

Fast forward a few weeks and I find out at my antenatal appointment I am under Consultant Led care as a result of my BMI being over 35 and not "eligable" for home birth. No one had discussed this with me at all and I was a little shocked as I was sure it was under 35. I questioned it with the nurse at the appointment who was rather rude and weighed me again and said as I had put on weight it would be over 35 now anyway. I asked if a recalculated BMI at 15 weeks would be accurate and she said, "Oh, well the baby doesn't weigh anything at this stage!".

I looked over my notes when I got home and realised the midwife at my 12 week booking appointment had made a mistake while converting my height from imperial to metric, put me at shorter than I am and worked my BMI out at 36 when in fact it was 33. It is only now 35 at 15 weeks.

I am very upset about this as I don't want consultant led care, I find hospitals very stressful and don't want to be there any more than necessary. I definitely don't want to be cheated out of my home birth option because of a clerical error!

Do you think I should call the midwives now and ask them to sort this out and take me off consultant led care as I should not have been on it in the first place, or would it be better to wait until my appointment with the consultant in two weeks and discuss the issue with them? I am worried that now they have they have me in the system as high risk it might be difficult to get off it even though if the midwife had not made that mistake I would not have been on it in the first place, so I don't know whether to kick up a stink about it now and not even go to the consultant at all. I don't have a lot of faith in the NHS staff due to several bad experiences, so this is really stressing me out.

Thanks to anyone who managed to stick with that essay, and thanks to anyone who has any advice to share.

As it causing you some stress why not just phone the midwives unit you're under and ask if it can be changed, whether you can opt out of consultant led care and whether its still a practical option for you to home birth.

If you get all your questions written down on a pad by the phone you can make sure you get answers.

I've had three DC in three counties and all have been by consultant led care for varying reasons. Te criteria appear to have been quite different though and whats been written in my notes has been different.

You are not in prison - you cannot be 'told' that you can't have a home birth. that said, I wouldn't go against medical opinion for the sake of it and you are 35 now anyway so the risk is there

You can give birth wherever you want - just tell them you want a homebirth. They can't say no!

I'd ask for a different midwife as the original one is clearly incompetent and decline consultant care. Have a lovely home birth x

I would wait until your consultant appointment and discuss with them your concerns. It is no bad thing that you have been referred, all being well they are likely to discharge you back to midwife led care.

Regardless you have to realised that with a bmi of 35 you are at a higher risk, but like others have said nobody can tell you where to give birth.

Good luck

Ok well the op is upset and said the midwife was dismissive, regardless of whether she can do basic calculations it sounds like op would maybe be more comfortable with a different mw. A better personality fit?

Seems like a waste of the op and consultants time if it's just a clerical error sending her there. If op was in Europe and had to pay £200 for the appt I'm sure you wouldn't all be saying go anyway. Seems a bit silly to me.

I don't think it's a bad thing they want to take care over you and your baby - in fact it's an excellent thing. Even with a BMI of 33 you were obese and that brings extra risks. It may be the consultant will have a different opinion to your original midwife but that's why you were referred to a specialist - because they have greater training and experience in higher risk pregnancies.

How you have the baby is far less important than having a happy healthy baby.

Good luck op

I think the consultant will just refer you straight back to mw led care, esp if you help them notice the clerical error. My friend found herself in consultant-led care two weeks ago cos she had opposite BMI prob - 18. She was referred back (with her agreement) despite that not actually being what the consultant should have done... (she actually was BMI 18) so I'm sure they'll do it here when it's probably fairly clear there was a mistake. Good luck getting what you'd like.

A BMI of anything over 30 is considered obese. I don't know what the risk differences are for a BMI of 33 and a BMI of 35 but I would imagine that anybody with a BMI of 30+ is considered to be at higher risk off complications during childbirth (I'm sure many many people of this BMI also have uncomplicated births).
I think you need to discuss the whole situation with the consultant and then heed whatever advice he provides.

Ask to speak to a Supervisor of Midwives. Many hospitals are now actively trying to find ways for women to have the birth they want and are happy to discuss options, part of which is a full discussion of risks.

My BMI undressed is 17.6 but clothed is 18.1. The referral criteria to the consultant is a BMI under 18.

Husband decided to fill in my form and be helpful by asking me my morning weight and calculating my BMI, which was the lower one so I am now under the consultant.

My midwife said I would have additional growth scans due to my weight. TBH I am actually quite pleased to have additional scans. It's my first baby so the more support I have the better