High BMI in pregnancy

[Eggcellent29]

Hi everyone,

I was hoping that some of you out there might be able to help me out!

My BMI is not ideal - I gained weight after my first pregnancy (which ended in missed miscarriage) and the fall out afterwards, pushing my BMI up to 33.

Anyway, I knew this would increase the risks in pregnancy but was rather upset to be referred to a consultant over it!

She rattled off lots of risks, even saying I may not be able to give birth naturally and that I will have a big baby. I have been booked in for extra scans, blood tests, etc.

All of my blood tests, blood pressure tests and urine tests have come back with no concerns.

I have gained 4 pounds at 17 weeks pregnant. I have no idea if this is too much?

I appreciate that this is all my own fault, but I am very distressed that it seems to be SUCH a big deal. I don’t know anyone else who has been given all this extra attention despite being heavier than I am!

Does anyone else have any experience of this? What did you do? Did it impact your pregnancy negatively in any way? Is this treatment standard? I feel like the fattest woman ever to be pregnant!

31 weeks pregnant with third child, aged 43 and BMI around 40 I think. My midwife is also pregnant and bigger than me.

I have not had any comments from professionals at all, it might help that I'm not defensive about it, but willing to do what's necessary to get through the pregnancy as safely as possible (baby aspirin, tinzaparin injections etc.)

Try not to stress, larger women have babies every day. Just smile and nod if people say anything.

Congratulations 😃

I had a bmi of 31 and was referred to a consultant last time. You get extra suppose and extra scans so nothing to be upset about. I put on 3 stone in my first pregnancy which was definitely over the recommended level for overweight mums. I too was annoyed at myself for not loosing weight first but it did not negatively impact my labour or pregnancy. I gave birth at a midwife led unit as I was 'signed off' as low risk by the consultant as there were no other markers of risk such as high blood pressure, gestational diabetes etc. In short, apart from additional support and scans, nothing changed for me having a high BMI.

My sister had a bmi of around 40 during her second birth and pushed back against advice (rightly or wrongly) to give birth at the Labour ward and had a text book water birth at home. It did take some frank discussions with midwives to "allow" her that though.

I don't mean that to sound like just because my sister was ok, everyone will be. In fact, I really worried for her and tbh, disagreed with her dogedness about having a homebirth against medical advice, but I use it to show that you are still able to make decisions for what you think are best for you and your child, even if the numbers on paper indicate that you'll be advised to do things in a certain way.

Don't beat yourself up

I lost all the extra weight and more in the first 6 months of being a mum (bfing and walking everywhere, plus carving out some 'me time' with help from family and doing yoga and pilates for a break from the baby).

My baby is 15 months now and I'm 7 months pregnant and my BMi was 27 for my next pregnancy and it's been text book so far.

Be kind to yourself. This is hard. Loosing weight is so hard, which is why bit everyone is 10 stone. It's a complicated issue. You are currently going through a very stressful time and i comfort eat when stressed. Try breathing, keep hydrated, make overnight oats for breakfast so you've always got something on hand, big pot of soup for the fridge to help yourself too and the odd takeaway is not going to hurt anyone, especially the baby.

@Eggcellent29

I think you're an IVF pregnancy too aren't you? In my area that automatically gets you referred to a consultant around 18 weeks

They have this calculator thing which awards points which determines your risk and if you get referred but my midwife said the ivf alone would get me seen. When I had the appointment I was
Told I would be shared care and could choose
Midwife or consultant led at that stage (but things got more complicated when my baby measured small so now I'm consultant led)

Thank you all so much for your replies!

I will, of course, take all the medical advice given and I don’t plan to fight back against any of it.

Yes, I am IVF pregnancy. I did think that could be a factor, as well as previous loss. So perhaps it’s the whole thing together.

I’m not sure which one I’m led by - I have normal midwife appointments plus consultant appointments as well.

I suppose I should be grateful for the extra chances to see baby! :)

Hi!
I'm pregnant with my 3rd baby and my BMI is 35.

My 1st booking appointment I mentioned my weight and said that I didn't want to gain too much weight- so the midwife said that she would refer me to a consultant because I had mentioned my weight.
I thought okay all is good.

I then had my 1st scan at 8 weeks- no problems saw the baby and heat bear straight away- this was a private scan that I had booked myself.

My 2nd scan was an NHS one, which I thought would be the same.
I laid on the bed and she saw the baby straight away. She mentioned that the baby was in the wrong position to check for certain things.. told me to cough and drink more water etc. She complained about the baby was in the wrong position and also that I hadn't drank enough water..
She then said "well you're bigger so it's hard, you may have to just come back when the baby is bigger"
I was sent for a walk to make the baby move... I came back and the baby had so the checks could be done.

I then read on the paper work "not clear image of baby as raised bmi " !?? Which, wasn't right as she had told me she could see the baby fine it was just in an awkward position and blamed it on me not drinking enough water then when baby moved was able to do the checks.

It made me so upset and made me feel like crap. My friend is 3 stone heavier and didn't have any of this when pregnant.

I then rang the hosp the following day and cancelled the consultant app and I explained how awful the scan experience was and how I'm dreading going back for any other app now!!

It doesn't sound that bad while writing it out but she was misrable and made me feel like crap about myself.

I have a midwife app at my docs next month where I will explain if asked why the consultant app was booked.
I'm trying to keep my weight down as much as possible this pregnancy but honestly just feel like crap now. Like I'm the fattest pregnant woman. Just feel rubbish.

Sorry for the rant. I can just relate.

The consultant or midwife led bit is only relevant to birth.... whether you can be in a midwife led unit or if you have to be in a labour ward

I'm now consultant led but still regularly see my midwife

My BMI was 35 when I got pregnant I was careful with my diet and exercised throughout pregnancy and still got gestational diabetes and pre eclampsia

They need to keep a close eye on you because a large baby through gestational diabetes is the best case risk for a high BMI. In reality, according to my consultant, only pregnant women of a normal BMI get a large baby with gestational diabetes. The babies of Obese women with GD tend to develop other complications that result in small / IUGR babies and are more likely to have stillbirths as a result (which is why heparin / aspirin is provided).

Four pounds gain may not be a real gain but just water / poo weight, however in your case I would try and stick to a calorie controlled diet. My BMI at booking in was 26 but I have PCOS and thyroid problems so this is equivalent to a higher BMI in normal women and weight gain was not advised - I have been eating 2000 calories per day and ensuring I have at least 30 mins moderate exercise per day. MW did say they would normally advise women with BMIs over 30 to lose weight during pregnant and may consider this approach if I gain too much in the 3rd trimester.

Hello, please don’t panic - I certainly did at first too! I’m 40 weeks& 5 days at the moment waiting on the birth of my little boy. My bmi was was High at booking appointment at 42. I feel so sad for the women that have high BMI and been spoken down to or made to feel awful - but me personally and a lot of other women I know have been supported 100%. I was told I would have extra scans and may need to see a consultant at the end of my pregnancy if I had put more weight on and had more chance of having a c-section. I don’t know how I managed it but I managed to lose a stone in pregnancy I think by just generally feeling happy. I had a missed miscarriage before this pregnancy and put on weight because I was so unhappy. I was also refered to a healthy eating and advice midwife and she was fantastic and supported me the whole way through. The NHS have treated me with dignity and have been nothing short of amazing. I look forward to continuing after he’s born with healthy eating & lots of walking! Good luck you will be amazing. Xx

@Roozy123 I am so sorry to hear that you have had such a negative experience! It’s horrible when people who are there to support you make you feel awful about yourself. You are most deffo not the fattest pregnant woman alive and I am sure you are doing everything you can to provide the best for you and baby. we are only human at the end of the day!

@sittingonacornflake oh no! Do you mind if I ask how far along you were when these problems came up?

TeddyBear45 GD sounds like a real risk, but I wonder how many women actually develop it? My diet is generally quite controlled, I’m a sucker for routine 😂 But, having said that, pregnancy has deffo made me feel hungrier so I have to keep an eye on things for sure! I have been known to sneak in extra treats recently, but show me a pregnant woman who hasn’t given in to a craving!

I can’t imagine many women don’t gain any weight at all by 17 weeks pregnant? Seems strange that we have been advised different things in regards to losing weight. I suppose they advise on a case by case basis?

@Babycakes1989 That is so good to hear!! I am so pleased you’ve had a positive experience, fingers crossed I have the same!

@Eggcellent29 diagnosed with GD at 38 weeks and then went in to be induced at 40 weeks which is when they diagnosed pre eclampsia. And I really really looked after myself through pregnancy with weekly fitness classes, swimming twice a week lots of walking eating well but I apparently couldn't undo the damage. I'm a year and a half post partum and got my BMI down to 27 (and still working on it) because it really scares me how poorly being obese can make you.

I had a similar BMI at booking and gained almost 4 stone in pregnancy. I didn’t have any extra scans or anything and was still considered low risk as I didn’t have any other risk factors.

I had a very very straightforward pregnancy and an even more straightforward labour and delivery so it is possible!

I did see the consultant once for other reasons and he was a total arse. They all are I think!

Try not to worry too much and good luck

I was told I shouldn’t gain any weight at all - so effectively I am losing weight and baby (and all the materials surrounding it) is plugging the difference. But usually for normal who are at my BMI (26 so just in the overweight range) the advise is to gain up to 4kg. The advice for a BMI over 30 is not to gain but if you do calorie restriction can be recommended. For BMI over 40 they offer Referrals to special Diet classes for pregnancy weight loss.

As for GD - I was given links to research articles by my consultant that said over 70% of the women identified globally as having GD (across 20 population studies in the US) have a BMI above 25. With the percentages increasing as BMI increases, so BMI by itself definitely does increase the risk. The women who develop it at a normal / underweight BMI tend to either already have diabetes / PCOS or are of specific ethnicities where GD is more common. If like me you have PCOS and a history of autoimmune disease, are Indian (one of the ethnicities where it can happen anyway) and have a BMI over 25 then you’re screwed!

@sittingonacornflake it sounds like you have been through a lot! But you got through it 💪 well done for pushing for the goal you want :)

@PhyllisVance That’s interesting, maybe it is the other risk factors then. I suppose I’d rather they were over cautious than didn’t care!

@teddybear45 Those are some scary facts! It’s interesting that the vast majority of women with GD have a high BMI, but I meant more how many women with a high BMI develop GD. In theory, 70% of women with GD could have a high BMI, but only 20% of women with a high BMI develop GD if you see what I mean (totally made those numbers up btw 😂).

It sounds like pretty much every pregnancy has its own risk factors. We could all worry ourselves senseless given half the chance 😩

@Eggcellent29 thank you and good luck to you! No point in worrying about something you now can't control. Worrying is a bit like sitting on a rocking chair - it gives you something to do but won't get you anywhere.

Predicting GD in obese women is something that’s being trialled in London by the NHS But to be honest just wouldn’t be accurate unless trials were completed in Asia too. Right now they say approx 30% of pregnant women in the UK with a high BMI get Identified and diagnosed with GD. However it’s still possible to get GD and suffer throughout pregnancy and not realise you have it unless something goes wrong. There are horror stories of overweight women (In the UK!) not flagged for screening or as high risk but then finding out after a miscarriage / stillbirth.

Hi guys! So happy I found this thread! This is my second pregnancy by BMI is around 42/43 I think may be a bit more! I'm dreading my first midwife appointment! XX

Hi all. I am sorry to hear such bad experiences. I appreciate there is a higher risk but there's no need for mw or Dr's to make us feel like crap. We know we are overweight overall.

My bmi is 31 after mot losing weight with baby number 1. So far at 25 weeks I haven't experienced any additional appointments related to weight or rudeness.

I am however, concerned about birthing options. I would love to consider a mw led unit with birthing pool. Does anyone know the likelihood of this? It may be I need a c section but I would like to consider it.

I have a BMI of 40, have had extra scans and had to see the midwife and dietitian after every scan. They also warned me of the extra risks but so far the midwifes I have encountered have been encouraging thankfully. I was tested for GD but all fine, baby is measuring average size so far and my blood pressure has been great so far, I know that could always change but being bigger really doesn't have to mean big babies etc. I understand the risks for higher bmi's but I hate the scaremongering that some midwifes and doctors put on people, I wish everyone would be treated individually.

Hi - can I join? I'm 30+6 and only had my first consultant app today. Not had any complications as yet - GD test came back negative and BP has been a little low throughout, low iron but that's it really. However the consultant said I should have been referred earlier and have three extra scans (one at 28 weeks that I've missed now sadly) and it's scared me a little.

Up until now, my MW has been really good and kept me calm, even when I've been freaking out about Spina Bifida etc (I didn't take a higher dose of folic acid and no aspirin - it wasn't even mentioned until today) I'm measuring in normal range but all the talk of extra scans (I thought there would be one, not three!) just worries me so much about what could be wrong. I know it's completely illogical as I should be happy to see baby more and it means they can act if something becomes a concern and they will know about it, so I can't explain why I feel this way. Has anyone else had any reactions like this?

And has anyone had anything discovered at the growth scans that was missed on an anomaly scan?

I'll join too please! I'm 12+5 and at my booking appt my BMI was 30.1... 🙄
So a few days after my booking appointment I get a letter asking me to attend a "Health in Pregnancy" clinic - didn't know what it was until I read the booklet that came with it. Total scaremongering in my opinion (Stillbirth risks, miscarriage etc) and I hadn't been told I'd be receiving this appt so lost my head a little bit!

Went to the clinic, all the other women were asked by their midwife if they wanted to attend and consented to the referral being made whereas I had had no idea. Also, all the other women were taking a higher prescription dose of folic acid (again, I knew nothing about this either!)

I felt like an absolute idiot. Not to mention was pretty peeved about the whole thing (especially not having consented to the referral to the HIP clinic!)

I have a consultant appt in a few weeks time but assumed this was due to a genetic condition I have (they're not sure how it will affect pregnancy, if at all) and now I'm wondering if it's actually to do with my weight.

The icing on the cake is, like the OP, I gained weight following a miscarriage earlier this year. My BMI was well under 30 when I miscarried. I feel like this whole thing is a kick in the teeth when I should be over the moon right now 😞

Thanks for reading.

Mine was 35 for my first and 30.2 for my second. No issues, no gd, no blood pressure issues. It meant extra scans for my first baby (though I didn't realise it was because I was fat, i thought they were doing them for everyone lol) but it wasn't really mentioned bar needing the gtt. For my second even though I weighed 10kg less the diet woman spotted me and invited me to talk, but I politely but firmly sent her on her way. I'd just lost 10kg in the previous 3 months - it wasn't lack of knowledge about the evils of cake that made me fat, it was liking cake too much.

You'll be fine. Try not to worry too much and whilst you can try not to go overboard with the weight gain, it's not worth making yourself miserable over. Pregnancy is hard enough without watching every calorie.

BMI of 40 at booking in here. I've had a high dose of folic acid and I've been taking 75mg aspirin since 12 weeks. I'm 31 weeks now and everything is going fine apart from the fact my baby appears to be quite big. I had a glucose tolerance test at 28 weeks, came back fine but the sonographer at my last growth scan has referred me for another as baby is above the 95th percentile. The extra scans are a bonus, I love the reassurance. Most people wouldn't get that. The rest is mildly annoying but I know it's best so I don't grumble. There are increased risks with being overweight but you'll be well monitored. However that doesn't mean you should put up with being spoken down to or made to feel like a bad mum because of your weight. Only one midwife did that to me so far and I called her out on it. In a nice way but she did apologise.

I had a higher BMI than this and was not consultant lead.
In fact no one really said anything, of course they mentioned the risks. Had extra growth scans.
I gained about 2 pounds in pregnancy as I have myself the kick up the arse I needed. Actually ended up loosing a stone once baby was out, result!
Doesn't mean you'll have a big baby at all.
My DS was born at 38 weeks signing 7lbs 2oz