C-Section because of BMI

[Yolocloud]

Has anyone else been 'forced' into a planned C-Section because of their BMI?
/Any woman around my size able to give their stories on their births? Were you able to do natural, were there more complications?

I'm currently 33 1/2 weeks pregnant and 23 stone, 5ft 9 (size 28). I have only gained 5lb throughout pregnancy after initially losing 20lb (so still 15lb less than initial pregnancy weight). Not once has it been mentioned to me that I would likely need a planned c-section. All my tests have been fine, good medical history and smooth pregnancy. I first had an appointment today with an anethetist who was happy I could have any pain relief in natural labour or c-section (only if required). I saw the consultant 5 minutes later who said that because of my BMI (bearing in mind I've seen her before and she NEVER mentioned this!) She said I should book in a planned c-section, also guilting me in case they have to wake up a the right staff in the middle of the night in case I need an emergency section. It's come as a very big shock as, like I say, this has never been mentioned before only the general 'Higher risk of c-section, that every 'high risk' woman gets.

I don't have personal experience of this although I have had a c section but for a breach baby

BUT I think it's because women with a higher BMI are more likely to have complications anyway and odds are you'd likely end up with an emergency c section so they are just pre empting this by saying to have a planned c section so they are more in control

I have a friend who is a similar size. She tried to have a natural birth with her first but couldn't and had an emergency c section. She had a planned one for her second.

I'm not sure what happened with her first but I know she was a big baby

Planned soooooo much better than emergency. I've had both and would jump at the offer as any sniff of not progressing in labour they'll do it anyway.

My BMI has just crept over 40 at 12 weeks this pregnancy (number 4) I'm still early on 17 weeks but I'm hoping to get it below 40 by 20 weeks. My last pregnancy I had a BMI of around 37 and had a huge lecture from the anaesthetist that an epidural would be really difficult but I've done all my labours with gas and air so it wasnt an issue for me.

Ultimately they cant force you to agree to a section however the bigger you are the more risks there are that there will be complications during pregnancy which will lead to an emergency section. If you are really against it I suggest you call your midwife and discuss your options

I am sorry that this matter wasn't treated more sensitively. I have had an EMCS followed by an ELCS. The first one was failure to progress and then a baby in distress where they jogged me to theatre, Dh literally just made it through the door of the theatre as they were about to cut me open. He was with me throughout the labour, but this was how rushed it was at the end. The ELCS made me see how rushed the EMCS was.

Due to your BMI you have a higher risk of a c section anyway, but also the complications of excessive bleeding etc following a c section are higher than a straight forward c section so this is the staff issue she was possibly talking about. There is an equipment issue too, they walk you to theatre for an ELCS but usually have to move you on a trolley for an EMCS and slide you across to the operating table which may require more people or equipment, side table extensions in the theatre to accommodate larger ladies, needle length, blood pressure cuffs etc. My old friend was a midwife and also had a high BMI and was asked in the school playground why she was booked in for a C section. She explained the above.

All these things can be planned out if it is an ELCS. I completely get the disappointment of how you imagined your delivery but you need to research the risks associated with a vaginal delivery.

Thank you for your comments everyone, I feel much better reading them. I think with everything going on, I have had so many appointments cancelled, so much info not passed on etc that this was just the tip of the iceberg. Unfortunately as many woman seem to be experiencing.

I've seen this consultant before and we've discussed labour etc, but again only said an 'increase risk' of C-Section. So bit out of the blue for me today. Definitely coming to terms with it now and as long my baby is here safe and healthy that is all that matters 😊

@Devlocopop

That was such a thorough and helpful reply! Really helped me understand the issue. Thanks.

I have have had 4 natural births with bmi ranging from 37 to 40 over the years. Never once was it discussed about a planned c section. Talk to them again about it, you and baby need to be safe, but talk through your options as you have a say in how you deliver your baby.

I would always go with the most up to date knowledge on what would give the best outcome for you/your baby’s health.

So I'm a larger lady.... I've had 3 babies so far all with gas and air no issues at all biggest baby 8.14.... I'm expecting a section this time due to placenta find out tomorrow however my bmi is 46 and nobody has mentioned me having to have a section because of weight.... I'd question it!!
Just to add also I've a family member who is much larger than me wearing 30+ clothes and she had a natural birth... Planned x

@MagpieWife thank you. I would hate to be in the medical profession making decisions about people's lives and knowing that a bad experience can affect someone for life. My sister had a traumatic birth, I won't go into details here, but it was incredibly scary for her and her Dh. It was devastating to here her talk about it not just the physical aspects but the mental aspects too. Both she and her now adult son are fine and she did go on to have another child.

@Yolocloud I know you are looking for other women who have been through a vaginal delivery. But your medical records have been looked at by the staff who will be over-seeing your delivery. They met you, they make those decisions based on you. It is not usual I don't believe to meet with anethetist before childbirth. You probably did this because of your BMI.

I chose an ELCS before I was even 20 weeks after discussing it at length with my midwife. I saw the consultant immediately after my 20 week scan to discuss my section. It was agreed there and then I could have one having demonstrated that I knew the risks. That is the one and only time I saw a consultant until I gave birth.

I have managed to find a hospital trust fact sheet for women with a BMI above 30. I think the most terrifying one is the

"still birth or neonatal death, 4 times more likely, 4 per thousand compared to 1 per thousand"

I have no idea about the hospital facilities of where you are, the likelihood of admittance to that hospital if their labour and delivery unit is full and where you would have to go instead. Only you can find out those things to make an informed decision. You need to think about this for a few days and research it.

www.royalberkshire.nhs.uk/patient-information-leaflets/Maternity/Maternity---complications-in-pregnancy-and-during-birth-if-mother-is-obese.htm

If you want to find full details I think you need to be looking at the risk assessment stuff. I heard a radio 4 Woman's Hour broadcast years ago, a midwife said they allocate money for a delivery and half of it is for the insurance for anything going wrong.