Why is there a higher risk of intervention in overweight women?

[CathyandHeathcliff]

Just that really.
According to my BMI I’m classed as obese, I don’t see myself as such and I don’t think others would either. But it is what it is.
I’m 34 weeks today and I’ve been told I will most likely need intervention during labour which makes me want to just have an elective anyway as they keep insinuating I won’t progress properly anyway due to my weight.

My BMI was 35 at booking and I’m a size 18.

@jadeyloo Hi thanks for replying and interesting to hear from you.
I’ve actually been told I can have him at the Midwife led unit which is attached to the hospital, but separate. This is in part due to my overwhelming anxiety about hospitals and all things medical. The Midwife and my perinatal mental health team suggested the Midwife led unit.
About the monitoring, I’ve had the Midwife listen a few times and the heartbeat is very easily found with a Doppler. Plus the scans have all been really clear, even the 12 week one.
So I’m hoping despite my BMI, I’ll still be ok to have as little intervention as possible.

My BMI was 35 or 36 when I got pregnant. I was told that they wouldn’t want me to go past 39 weeks because of the risk of pre eclampsia and gestational diabetics.

I’ve done some work on this in a former life when I worked for a year with midwives developing new maternity programmes for obese mothers.

One trust I worked with were most interested in working with very obese mothers (BMIs high thirties and above), as they had had some very poor outcomes for mothers and babies in this category over the previous years- and more and more women were booking in at this BMI.

From what I saw in case studies/ anecdotally from midwives, part of the issue in the delivery suite is that bigger mothers generally have bigger babies, and in some cases, this is compounded when mothers are too large to physically move into positions that might help labour/ delivery progress naturally/ maneuveurs for emergencies such as shoulder dystocia etc.
Generally obese mothers have lower levels of fitness and may not cope as well with the physicality of labour, and may tire before delivery.

Plus all the reasons given by posters above.

Statistically many/most obese women are fine and cope well- but from my research I remember that complications and poor outcomes are significantly higher for mothers and babies in this cohort- hence targeted initiatives in a wide range of trusts across the country.

@TheSheepofWallSt Do you think they were genuine when they said I could have him on the Midwife led unit then?
The Midwife seemed convinced this wasn’t going to be an issue.

@Uncreative they haven’t said that to me yet

I’m still considering an elective c section as this option is open to me due to my mental health.

@cathy

Yes I do- all of the midwives I worked with were adamant that intervention free birth was possible and even likely for obese women, with adequate antenatal care, birth plans tailored accordingly, and an appreciation that if intervention was necessary, it should be decided sooner rather than later as a dire emergency.

FWIW my BMI was 19 when I fell pregnant. I had a textbook pregnancy, no issues, perfectly healthy baby, kept exercising until 40 weeks.... at 40+1 my blood pressure went sky high and I started to show some pre eclampsia markers (though it never did transpire). Because of this, I ended up having him on the labour ward (easy, lovely birth with no problems- except my BP was a bit terrifying - I was unconcerned, midwife very nervous) and although I didn’t need intervention, I didn’t get the midwife centre waterbirth I “planned”

My friend who was much bigger than me had an intervention free home birth a month later and was perfectly, totally, 110% not a concern to her midwife at all.

You never can tell. Try to relax

@CathyandHeathcliff - I forgot to mention that I am 40 stage may be a factor as well.

I gained a lot of weight in pregnancy and historically when I'm heavier my blood pressure goes up . Both times I got Pre eclampsia and had intervention because my life and the babies life was at risk so I guess the heavier you are the more likely this could happen . Plus I'm sure weight affects other stuff too .