Prescribed aspirin by consultant

[Zing6]

Hi all,

I had an appointment with a consultant for having a high BMI at booking appointment and anyway long story short I've lost over half a stone, maybe more as I was very sick from 6-12 weeks. I can still now only eat very small meals and still sick once a day - I don't eat junk food all day long, my diet is ok - I mean it could always be better but it's okay IMO! My BMI is now just 0.9 over their cut off for referring me to the consultant - but they don't care about my weight now, they always go by the booking in figures apparently ugh.

So, my consultant yesterday made me out to be about 80 stone and the unhealthiest person on the planet who's ever been pregnant and told me I was at risk of all sorts, blood clots, pre-eclampsia, a big baby, a small baby, infections, drugs not working as well as they should in labour etc etc (I'm a size 14/16 and physically pretty fit and active). She even told me that "the heartbeat will probably be hard to find today because of your high bmi and it's still early on but I will try my best" - I laughed in disbelief and said the sonographer found it easily 4 weeks ago... So she tried and found it first time clear as a bell, what a miracle rolls eyes. I felt like sh*t when I got to work and had a little emotional breakdown feeling like a giant elephant but then pulled myself together and decided she was just extremely rude in the way she gave me her advice and the way she spoke to me.

ANYWAY, she's prescribed me one aspirin daily 75mg and practically told me off saying I should have been taking it from the moment I found out I was pregnant.... I've seen plenty of midwives and doctors since then and no one else has ever mentioned it and I'm 17 weeks now!!? Which I said, she looked at me like I'd just spat in her face while she told me this is standard procedure!

Yes I am overweight for my height but I'm a shortie and my BMI has ever told a good story even when I was skinny!!! I don't currently and have never had high blood pressure and I've never suffered a miscarriage and my understanding is that if you have a history of either then that's why they prescribe you it? I'm seeing my community midwife for the first time in 5 days so I am going to speak to her about it all before I start taking it.

I've been booked in for 3 additional growth scans too - which I'm calling a win as I get to see baby 3 more times.

I'm not adverse to taking doctors advice and will take it happily if it's necessary and will do more good than harm. I suffer with headaches anyway and have also just read that you shouldn't take aspirin with a headache? She told me it won't harm the baby at all but I have read some contradictions since yesterday AND the pharmacist told me he will dispense them to me but he whole heartedly doesn't agree with the way they seem to dish them out to pregnant women, so any personal experiences and opinions are appreciated! It's my first baby and I feel like I'm being corralled into decisions and limited in terms of birth plans already as I'm now not allowed to birth in a midwife led unit because of my high BMI ughhh!

:-(

Bit rude of her to be making so many comments. I've got a BMI of 44 and am on the aspirin as well. My consultant mentioned some of the things as a heads up but said that she always went on a case by case basis to see what happened.

I think they have to give you the details just in case of something going wrong.

I agree with you that its annoying that you cannot have all the birth options - there is nothing more I would prefer to try than a waterbirth but that is likely off the table. Still at the end we will get a beautiful baby.

Aspirin in pain-killing doses (300ish mg) can be harmful, but in the low dose (75mg), it's fine.

As far as I understand, it is standard practice for women at higher risk of pre-eclampsia to be advised to take low-dose aspirin from 12 weeks.

Obviously no one can force you to take the aspirin (or anything else) if you don't want it, but I would seriously consider why you are taking a pharmacist's opinion over a consultant's and just double check with yourself that you aren't just angry/offended at the way the consultant spoke to you about your weight.

FWIW I was also recommended aspirin and am taking it.

Please take the aspirin. There is high quality evidence that you should be taking it. The consultant was rude but that doesn’t mean she doesn’t have you and your baby’s best interests at heart. After around 15 years of training vs a midwife’s 3 years, you need to listen to the consultant.

If something happened and you hadn’t been taking the aspirin as you’d been advised you’d never be able to forgive yourself.

I am amazed that as a 14/16 you have a high enough BMI to need consultant care. I am significantly larger than you and initially I was referred to consultant but then it transpired that the midwife wrote my height as 156 instead if 165 so when adjusted I was ok. Check the midwife has worked out your BMI correctly. It may just be because (as you say) "you are a shortie".

They advise aspirin based on risk factors for pre eclampsia, which are not all based on weight. I think they encourage most women to take it now due to the benefits. The dose is too low to have negative effects.

You also don't get referred to consultant just based on weight but again on other risk factors

Thanks for your replies. I’m not taking the pharmacists advice over the consultant but her attitude and the way she spoke to me wasn’t exactly understanding or nice. My bmi was 38.8 I think! and is now 35.9 which is still overweight I know. I’m not delusional lol!! Like I said I’m quite happy taking aspirin if there’s a need for it but I’m surprised this hadn’t been mentioned in previous appointments until now if it was really that necessary.

I was absolutely offended by her talking about my weight like I was absolutely huge but that’s not the reason for me questioning whether to take it or not. I don’t know what’s best and I was to get all of the information possible. If low doses can only do more good than harm then I will gladly take it :-D just the whole situation seems bizarre.

At booking in the midwife was borderline about referring me on weight alone, I’m 5’2 have huge boobs GG (no thanks to genes lol) but I also had some family history she thought I sounded worried about (I wasn’t really) and wanted me to have some reassurance from the consultant. The midwife said I’d likely see her once and be discharged back to midwife led care but this now isn’t the case so I’m a bit disheartened by that for sure... I have always been classed as overweight even when I was slim and much more athletic lol. I’m now a cuddly (lol) 14/16 on the bottom and 16 on top. If that means I have to take aspirin then absolutely fine but I don’t know why it’s taken all these appointments to be told at home 17 weeks.

Thanks ladies xx

I think she could have been kinder but she has to share the risks. I'm 5ft 9 and currently a 16. I am very overweight. My BMI on booking in was 29 which is borderline obese.

In the kindest way, if you are a 16 but only 5ft 2 then she really does have to make you aware of the worst case scenario. I am glad your pregnancy is going well and hope it continues to do so! I'm sorry you felt upset but I. Think they must become frustrated at the obesity crisis in this country and with people saying I'm not that big but the numbers say different - and I say that as an overweight person myself!

Sorry at gone** 17 weeks

Bloody phone lol

Yeah for sure easternedge thank you. I guess if taking at such low doses then I have nothing to worry about. She prescribed me some which I assumed would be for the rest of the pregnancy but actually it’s only 4 weeks lol!! How long are you supposed to take it for, what week? Or until the end? I thought she told me until the end but I may be wrong!?

My BMI was 39 when I was pregnant and they had no trouble finding heartbeats or doing scans. I have a lovely healthy daughter. To be fair my midwife did tell me I needed to take children's aspirin from 12 weeks but no one was ever horrible about my weight when I was pregnant.

It will be until the end but you'll have to renew the prescription as they only give you 4 weeks at a time I think

Thanks moonlight. I’m hoping I’ll see a different consultant next time haha. Yes I don’t think I can have a waterbirth either which is a shame as I’d have loved to try that. Maybe next time x

Ok thank you user1287.... I’d read other posts from here saying they were stopped at 35 ish weeks so was just wondering if I had it wrong! Thanks everyone you’re making me feel more at ease about it. I’d read that it could have side effects with the baby but I think I may have been reading about higher doses than what I’ve been told to take!

She sounds horrible but take the aspirin.

I'm twenty weeks and put myself on it, the midwife never mentioned it. This is after hypertension in my last pregnancy. Saw the consultant yesterday and she asked if I was taking it and I sheepishly admitted I had basically put myself on it after doing the research and she was really pleased as I should have been told to start at booking in. Sometimes it's easy to slip through the net with the midwives but from everything I have read it's fine in the right dose (what are the contradictions you saw?)

Oh and some people say stop at 36 weeks and some say take to the end, my consultant said it didn't really matter but stop if you have a bleed and seek advice.

Raised BMI at booking increases risk of PET hence the aspirin prescription. A midwife wouldn’t have given you a prescription because that is out of their remit.

Mummyme yes I know they wouldn’t have given me one but I could’ve started on it over 9 weeks ago 🙈 never mind it looks like it’s good I’ve been told to start it now rather than further down the line so I will take it. I read it’s best to take in the evening because it absorbs better.

Sorry to hear the consultant was rude to you!!! My BMI was 34 at booking and probably about 40 now at 38 weeks. I am under consultant-led care but my weight has barely been mentioned (I laughed at the registrar who mentioned my "slightly raised BMI", not sure who he was kidding). I have other risk factors too though, mainly bad anxiety for which I take medication. No one has ever mentioned aspirin or a higher dose of folic acid to me I found the RCOG leaflet they gave me about obesity and pregnancy (only "intervention"/ support related to my weight ) really unhelpful and quite upsettiny

Oops! Also not very impressed when the midwife said "oh, you have gained weight" when she weighed me at 28 weeks - what did she expect? I've felt sick throughout so constantly eating and no one gave me any dietary advice. Sorry, I'm on a bit of a rant! I find the doctors are very factual and I've cried every time they've reeled off a list of potential risks, even though every birth has risks and they're just doing their job! You need the midwives and nurses for emotional support! Good luck!

I thought that leaflet wAs quite thorough! And it mentions both aspirin and folic acid if I recall correctly.

I'm going to be honest and say I think more needs to be done to reduce obesity in pregnancy. Being very very overweight has become too acceptable. Again I'm totally overweight myself.

NCPuffin that’s not good you’ve been upset frequently. I was upset yesterday but more that she was making me out to be morbidly and dangerously obese when I think it needs to be taken case by case not just on bmi. We are all different body shapes and I’m sure if I didn’t have my boobs I would be a much healthier bmi. It’s proven to be an outdated tool but should be used as a guide. I’m not offended she thought my bmi is high, it is high! I think she needed to reassess her people skills though which is what upset me along with her disgusted facial expressions lol. She wasn’t exactly slight herself 😂

I don’t I’ve seen that leaflet? I wasn’t given anything yesterday... other than prescription and told to book in for growth scans.

I will add a different opinion here - I had my first pregnancy in Canada, and the midwives there I thought were much better at explaining risks and letting me make decisions for myself regarding my care and treatment.

In the UK, it was very much according to the tick-sheet, with no accounting taken for individual circumstances.

I, too, was proscribed aspirin (BMI 42) but didn't take it after reading the reasons for it, what it was given to try to reduce the risk of, and what the other risks were around it. Which my consultant was unwilling to discuss with me, preferring instead to just tell me to take it because of high BMI and not waste her time asking questions.

I didn't take it because in every other risk category for pre-eclampsia, I was low risk (no diabetes, no migraines, never had high blood pressure, no preeclampsia in previous pregnancy, and none among my family members). That it lengthened the pregnancy was an issue for me - having gone 10 days over before induction in my previous, and with all my family members similarly going past due dates by significant amounts.

You can download the leaflet as a pdf - I think it's really helpful and reassuring. Not sure how to attach a link.

Your BMI at booking in was only one point off morbidly obese and that's why she was behaving like that. It absolutely doesn't make it acceptable and we all agree she was out of order but imagine if she didn't do her job properly and heaven forbid something happened to you. You and baby health are the most important thing not hurt feelings although I know how bad it feels