High BMI and consultant led care

[Daisyjay96]

Hello. I am currently 9 weeks pregnant and had my first midwife appointment last week. I was advised I would need consultant led care because of my bmi (37). During this conversation the midwife called me clinically obese and a risk to the baby. I explained this is highly triggering for me (past ed 5years ago, and weight focusing was a trigger for depression after last baby).
I understand the need for extra care, however my last pregnancy had no complications and I gave birth naturally (bmi 35) and nothing was ever mentioned about a consultant.
I eat healthy and exercise at least 30 mins a day plus see my P once a week.
I’m worried this negative focus on my weight which I was quite happy with, is going to trigger depression/ED behaviour.
Does anyone have any experience with consultant led care and how they found it?

I had this but nearly 15 years ago now, I think the only difference I had compared to a normal BMI pregnant woman was 1 or 2 consultant appointments, that was it, everything else was with the midwife.

I'm the same, currently 30 weeks pregnant with high bmi. I was referred to for consultant led care at my booking appointment (8weeks). So far I've had 1 phone call with the consultant & my weight has hardly been mentioned, definitely no pressure to lose weight from anyone. They were mostly concerned about gestational diabetes, which I did end up being diagnosed with at 26 weeks. Overall I've felt well looked after & reassured that's there's extra care available.

@OatcakeCravings

I had this but nearly 15 years ago now, I think the only difference I had compared to a normal BMI pregnant woman was 1 or 2 consultant appointments, that was it, everything else was with the midwife.

Do you mind me asking, how was your birth? Was there any impact on the way you wanted your birth to because of being consultant led? We're you offered induction ?

@JackJack84 thank you for that! That's my main concern, my weight being a negative focus

@Daisyjay96 I had a C section because DS was breech and at the time (maybe still now?) that was what they did with breech births there was no option of anything else.

I'm 20 weeks this Friday, bmi is 36. I also haven't had any pressure to lose weight. As far as I can tell, they're just keeping a slightly closer eye for pre eclampsia and gestational diabetes (not sure if the pre eclampsia risk is due to bmi or because it's been 10 years since I had my last pregnancy). I haven't seen a consultant yet but will be seeing one after all of my extra scans. Because I'm higher risk I have to have extra scans at 28,32,36 and 40 weeks and will see a consultant after the scans. I have my blood pressure checked and a urine test every time I see the midwife and I have to have the glucose test around 26/28 weeks. I asked the lady I saw last whether being under consultant care would affect whether I could give birth in a birthing unit rather than the hospital and she said as long as there's no concern then that would be fine. That is the extent of my knowledge about being under consultant care but I hope it's helpful 😊

Also they told me if my bmi was just one below (so 35 rather than 36) then I wouldn't have needed to be under a consultant so I presume that's why you weren't during your last pregnancy.

@hullaballoo19 thank you for replying with your experience, it's really helpful. I knew I was bigger this time round but didn't expect to be so triggered by the appointment. It helps a lot knowing what to expect

They hardly every mentioned my weight following the initial midwife appointment. I didn't gain much during my pregnancy, I think only a stone in total by the time DD was born.

I had a couple of extra scans and a couple of glucose tests but otherwise nothing major. I saw the consultant once but he didn't say anything more than the midwife.

I can't comment on normal birth as I had PPROM (unsure whether weight related) so it was a very medical event 😆

I'm sorry you were triggered, but the midwife and the consultant want what's best for you and your baby -try to keep that in mind, it might help reassure you. Nobody would/should bat an eye about the number on the scales and/or how you look, but when it comes to health, we have to go with the evidence. You have an increased risk of some conditions (note it's a RISK so yes, thousands of women with your BMI have had uncomplicated pregnancies and healthy babies) so they want to keep an eye on you. It can only be a good thing! 🙂 Congratulations on your pregnancy and good luck with everything! ❤️

@stackhead thank you for replying:) did they check your weight or is that something you monitored yourself?

Thank you @eloiseislost I'm trying to see it that way but it's a struggle because of my past issues, it's like a ride I can't get off. It's like I understand completely but my brain has gone off a million miles an hour

My last pregnancy was high BMI consult led (and other issues too) never mentioned my weight or weighed me.

The only difference to my other two babies was that they didn’t measure my bump but I had growth scans instead because bump measuring is even less accurate when you’re a higher BMI. I loved it because it was bonus chances to see baby

All my births were inductions but that wasn’t due to mh weight but other factors (placenta failure in birthday 2&3) but my consultant would have been perfectly happy for me to have baby spontaneously if I didn’t have other issues! Also no need for many medical
Interventions in any of my births

I had my first consultant appointment yesterday. Firstly they asked if I was ok being weighed (so I had the opportunity to opt out) and overall it was a positive experience.
My BMI is the only reason for consultant led care and they are happy with everything so I am choosing to see this as additional checks due to increased risk rather than anything more jugdy (I do however appreciate that different healthcare professionals can have different attitudes, so far I haven't encountered any negativity or judgement).
I have to have a scan at 28 weeks and also meet with the anaesthesiologist to check my spine to ensure they have a plan in place in case I need an epidural. I also have to have a glucose test as standard.

I was weighed at my scan appointments as well as having to pee in a cup everytime BUT they never ever told me my weight when I was weighed and it was never commented on.

I weighed myself at home because I was conscious of not gaining too much.

Hello lovely.
Just to add my two pence.
I had DD in November 2020 and was consultant led. BMI 40, previous section.
They told me I was consultant led from the start, I think I spoke to a doc on the phone (covid restrictions at the time) mid way through and then around 35 weeks? They signed me back over to the midwives at this point.
After my booking in apt the only other time I was was weighed was at one of the scans, maybe the 12 week scan where they take the bloods as part of the screening tests.
My weight was mentioned purely in a ‘your weigh can add a small risk of XYZ’ and I was given a couple of extra scans towards the end of pregnancy as having a higher weight can increase the risk of placental blood flow reduction.
Tell your midwife how you feel, they’ve got to let you know the risks but need to make sure your mental health is protected x

Thank you @Blitzes and @PeaceLily2000 I'm more than happy to have the checks especially if I get more scans, it is deffo just the weight/ weighing and then any comments made that are playing on my mind, as well as worrying about birth!
Thank you so much for sharing you experiences with me. It's really helping ease some anxiety

Thank you @MonkeyPuddle I did share my concerns with the midwife, but it was sort of brushed off, I will deffo bring it up next time though and be a bit more upfront about it

Ah love no worries.
It’s gotta be hard for you balancing things, you’ve got this.
Congratulations on the pregnancy!

[quote Daisyjay96]@JackJack84 thank you for that! That's my main concern, my weight being a negative focus [/quote]
I think high bmi is such a common thing now most hcp's don't bat an eyelid. In a way the consultant led care has worked out for my benefit as I've been getting extra scans. He did ask my midwife to weigh me at my 26 week appointment only because of my bmi was over a certain number then I'd have even more scans. Midwife has never made an issue of my weight & most of the women I see at my appointments are of similar size to me so definitely not unusual.

I had a consultant led pregnancy (before covid) - basically was weighed on my initial meeting with midwife who referred me to consultant due to bmi.
I was never weighed again (I did infact lose quite a bit of weight due to sickness) so I don't really see why they made a big deal of the weight but never mentioned it again!

I had to see the consultant every 2 weeks and each time he asked why I was there 🤷🏻‍♀️

Hello 😁

I'm 37+3 and have been consultant led in this and my previous pregnancy due to high bmi. I think I was 30 odd last time and 35 this time.

Both have been really positive experiences, extra scans to check growth, but thats lovely because I've got to see my little girl three extra times.
Haven't had any 'extra' this time in ways of gtt testing or aspirin. But I did take higher dose folic acid after booking appointment.

My weight has never been mentioned since my booking appointment, neither have I been weighed by anybody medical. I have weighed myself though just to keep an eye for peace of mind.

I had a random blood test which covered/ looked at my diabetes markers, nothing further has come of that so they must feel that everything is as it should be.

Labour 1 was pretty straight forward, I went spontaneously at 38 weeks, delivered at 7lb13 little boy with epidural. Although I wasn't given the option for a water birth it's not something id have been interested in anyway.

This time, I'm obviously still pregnant but was asked if I wanted a home birth, so obviously means I'm not in the 'high risk' category. I also declined that as I loved the epidural, I'd like one this time too 😂

I hope my info helps you, you can have a positive high bmi consultant led pregnancy

Oh I'd forgotten that they also got me taking a higher dose of folic acid until 12 weeks and I'm taking an aspirin a day (I believe the aspirin is to lower risk of preeclampsia). I'm not sure if it would be helpful for you but they've also referred me to a scheme, I think it's called glowing potential (really not sure if that's right!) which was specifically for women who have concerns about gaining weight and weight during pregnancy as I have a diagnosis of non purging bulimia (not been an issue for a while but I still have lots of problems around my weight and self-esteem). Might not be available in your area but possibly something similar. Your posts seem like you'd prefer not to think about weight as you're concerned about it being triggering but thought I'd mention in case it was something you'd find helpful. Good luck in your pregnancy 😊

I'm 20 weeks with a bmi of 37. No one's mentioned consultant led care. Been told ill get extra scans at 32 and 36 weeks and that's it

I was consultant led last pregnancy (5 years ago) for a variety of reasons. One was BMI, weight was not mentioned at all except to send me for gestational diabetes test (I was) and I was told I would be able to have a water birth because of my BMI. I guess that's health and safety for the midwives if they needed to get me out of the pool, basically that was it.