BMI measured during pregnancy

[Browniee]

So I had my BMI calculated at my booking in appointment (10 weeks) after 5 weeks of eating not my normal diet —rubbish— because of horrible nausea and it was slightly over into the overweight category. I wasn’t worried even though midwife was a bit snotty about it.

During my pregnancy I haven’t been weighing myself but I have been in the same size 14 maternity jeans and tops throughout, have eaten as normal (vegetarian, quite a fresh healthy diet) and until 31 weeks I was walking 3 miles a day. I also haven’t really suffered from swelling or much weight gain - just a huge pregnancy belly!

Today at 35+4 the midwife has done my BMI again and obviously it’s shot up (I’m full of a baby/waters/placenta etc) and has threatened me with consultant lead care as I’m tipping into the obese category! It’s made me feel utter shit as I’ve been planning on going to the midwife lead unit and feel like I’m having options taken away from me.

Just wanting advice of anyone else whose experienced this? I was feeling super positive and excited about birth after a really wonderful antenatal class at the weekend and feel like the midwife has put a massive downer on that.

No, that doesn't sound right to me. You're not obese, you're pregnant! I was overweight when I got pregnant and I expect pregnancy tipped me into obese (I didn't actually calculate my BMI while pregnant). No one mentioned consultant led care and I had three straightforward births.

With DS1 I didn't know (or want to know) my weight or BMI throughout the whole pregnancy. If I wasnt obese at booking in then I was definitely very overweight and no question was I obese in the latter stages. I never once got told about consultant care and as far as I'm aware I could have gone to a midwifery unit, although I chose the hospital. I just couldn't have had a water birth.

I'm significantly slimmer this pregnancy and was 68kg at booking in which sat me right on the normal/overweight line (apparently I'm now an inch shorter?! Think they have mis-measured my height tbh) and my mw didn't say anything other than she thinks that's crazy and sees no problem at all.

Think your mw sounds harsh tbh. Do you know in total how much weight you have gained? Surely after your initial weight in, BMI shouldn't be thought about but the overall gain? After all, it's not like you've only been gaining fat - theres a baby and all sorts in there!

Wut? Is this even a thing? I wasn’t weighed once during pregnancy! If you’re wearing size 14, unless you’re rather short, how can you be obese? I wouldn’t give it another thought.

@Sculpin - thanks for replying. That’s really reassuring and I’m glad all three of yours were straightforward! I’m hoping that if my labour starts naturally I can just turn up and no one is going to be worrying thinking about my BMI at that stage.

well, it's good practice to monitor weight gain in pregnant women.
too much or too little can indicate issuesthat might need treatment (gestational diabetes for example).

that doesn't excuse the midwife's insensitive manner.

@amehh I haven’t been weighing myself throughout no, just using how I fit into clothes as a judgement. Was in pre-pregnancy dresses until about 31-32 weeks and only stopped because bump was making everything a bit short at the front. The only thing I’ve noticed is a little bit of extra chub on my cheeks!

I’m hoping it is just that she’s a bit harsh...there are other things I’ve picked up on throughout too so maybe she is just a funny one. I had another midwife when she was off sick once and asked about BMI for using the birth pool during labour (which I’d like if possible) and she said I’d be absolutely fine to use it.

I was shocked she even measured my BMI and didn’t take any weight off to account for baby etc. just purely based on what the scales said versus my height. I’m glad other people think it’s weird!!

@Browniee if you have been in size 14 pre-preg clothes up until 31 weeks there is no way you can be obese! Sounds like she is just unfortunately a grumpy midwife, ignore her. If she keeps on or tries to force you to be consultant led over BMI you might be able to ask to change midwives.

Mine was recalculated but they said it was only to identify people who might be an anaesthetic risk in advance rather than not discovering until an emergency?

Jesus, when did checking the BMI of pregnant women become a thing? Weighing fine, if they must, (but you're entitled to refuse, like you're entitled to refuse any ante-natal care) but somebody please explain the sense behind measuring BMI?!

It’s standard practice to recalculate BMI at 32-34 weeks as evidence shows that gaining a significant amount of weight during pregnancy can increase risk of disorders such as gestational diabetes, pre-eclampsia and venous thromboembolism. Your midwife is going the right thing although the way she has communicated this may have been less than sensitive.

I believe NICE guidelines don’t recommend doing a BMI at 36weeks as it’s inaccurate for obvious reasons. Only people that are weighed regularly are those with bMI over 40 at my unit.

If you’re referred to consultant or refused use of birth centre, ask how they account for baby/placenta/blood volume/fluid and ask what NICE recommend

I was never weighed, they asked my weight and calculated my BMI. It was never checked again.
BMI is not accurate for pregnant women apart from really early)
www.nhs.uk/conditions/pregnancy-and-baby/overweight-pregnant/

I think she is wrong and I would refuse the scales if she is going to use them to send you to consultant without proper reasons

I was re-weighed at the end of my last pregnancy but I was told it was just so that they have a reasonably recent record of your weight in order for them to be able to safely work out anaesthetic doses etc in an emergency. No one wants to be stuck on a set of scales if there’s some rush to theatre happening! I had my BMI calculated at booking this time as per usual and then had to have a consultant appointment because I’m a bit too fat, but he just looked at me and said there was no need for me to see him again unless I get sent for a GTT and it comes back positive. I’m 23 weeks now and I’ve only put on about 5-7lbs so far so hoping that I can stay well under half what I gained last time! I’ve not been told anyone has any concerns yet. If they do I imagine they will refer me back to the consultant, but I don’t anticipate that happening. Got midwife sounds a bit rude and would probably do well to remember that haranguing a hormonal woman about her weight is unlikely to end well since a) she can’t go on a sodding diet because she’s PREGNANT and you’d only shout at her anyway and b) of course she’s got heavier, there’s a whole extra person plus placenta and fluid inside her!

@MadameJosephine it is not standard practice in England
For all women? It is not.

It’s standard practice to recalculate BMI at 32-34 weeks as evidence shows that gaining a significant amount of weight during pregnancy can increase risk of disorders such as gestational diabetes, pre-eclampsia and venous thromboembolism.

But it sounds like the OP is being reprimanded for being over her BMI at 34 weeks, not for putting on a disproportionate amount of weight.

The latter would be grounds for concern.

The former is surely an inevitability in, what, 95%? 98% of virtually full-term women...:?

In all my pregnancies I’ve never been weighed, nor have a weighed myself. I know my weight was healthy before them, and from about 4-6 months after them.

It is where I work windysowindy

@YemenRoadYemen

Thank you - You’ve put into words exactly what I meant! I don’t mind being weighed at all if it’s needed for notes as other posters have mentioned (anaesthetic for example) but it was more than she was commenting on my BMI being in a certain category.

@Mummyme87 interesting about NICE guidelines, I’m going to look into those. Thank you! Just want to be informed in case it comes up again!

@Babyhumps exactly - taking my weight is fine, it just seemed like a bit of a pointless exercise with no other calculations alongside it (like taking off average weight of baby/fluids/placenta etc !)

That's ridiculous. Fair enough keeping an eye on weight gain and advising you based on that but calculating BMI at 35 weeks pregnant and comparing to normal thresholds is completely meaningless. I would hope a consultant would bat you straight back to midwife-led if this was the only reason for a referral. Personally I would refuse any consultant referral and ask for a new midwife who was going to support me in the few weeks left rather than cause me anxiety!

Also surely everyone bar those with a low BMI at booking would be classed as obese by 36 weeks if this were standard practice!!

I had this. They tried to force me to be consultant led and a hospital birth and then tried to say I needed an induction by 39-40 weeks due to being obese due to BMI through weight gain. My lovely community midwives agreed with me it was ridiculous so I changed late on to a homebirth. Went into labour naturally at 40+10 and while I ended up having to go in due to my BP reading higher (was fine once I got rechecked at the unit) I was allowed to have a none consultant led normal delivery. Next time I’ll refuse to be weighed. I stayed a size 14 at 5”11 and was back to pre pregnancy weight in a couple weeks. Seemed to all be water weight. Try not to let it spoil it for you-it ruined the last month or so of my pregnancy and made it very stressful. Next time I will be ensuring I’m at the bottom end of an acceptable BMI so I can’t pissibly be overweight at the end to save the dramas. FWIW I’m still “overweight” according to BMI now (by a few lb so only just), a size 10 and can apparently loose like 3.5 stone and still be a normal weight which I’m sure will look ridiculous as I’m already fairly slender now and exercise a lot. It’s an outdated system that imo has no place in preganancy

What?! As far as I was aware, your BMI at booking in is the only measurement that counts. For what it's worth, I was obese at booking in and nobody ever made me feel bad about it, nor did I have to go under consultant care (until there were non-related concerns with my baby). They would have been happy for me to be in the MLU and my pregnancy was healthy and complication-free (besides her having a giant head which got stuck in my pelvis!)