Midwife told me BMI over 30 at 36 weeks?!

[FluffyBear82]

Hi, I'm so annoyed about this. Midwife weighed me last week at my 36 wk appt. and told me I was ever so slightly over 30 BMI, she put it on my hospital notes so that I now have 2 risk factors (the other being I'm 40) and told me I might need blood thinner injections after birth!! Let's put this into perspective - I wear a size 12 in clothes and gained 1st 10lbs overall. I've been wearing the same clothes since 1st trimester. Why isn't she taking into account baby weight gain?! As soon as I give birth my BMI will go right down so I'm curious she is basically saying my weight is a risk and I'm obese!!!!! Just to say she is a lovely midwife and certainly wasn't rude or mean about it, just factual but I think she's completely wrong!! Anyone else experience this?? Am I right in thinking she is wrong??

I'm not a medical professional so I don't know the ins and out. But even if most of the weight gain is the baby the Op is still physically carrying around that much weight for the next few weeks, she's still pumping enough blood to sustain that much weight etc. Whilst after delivery it sounds like the Op will be back to a normal weight it just sounds like the midwife was letting her know that because her BMI has tripped into the next box (at the moment) and because she also has other risk factors (age) that she may require a particular medication.

Recalculating BMI at this stage certainly doesn't seem sensible. If you're prescribed blood thinners then I think a doctor will be the one to do it. I would have a frank discussion with the doctor about your concerns on how this was calculated and whether or not there is a clear case to take them. It's most likely borderline if you only have two risk factors, one of which was calculated wrongly. Hopefully an honest conversation with the doctor will help you think about the pros and cons and whether you want to refuse them. Having said all this, I'm taking them from 28 weeks but had a higher BMI at booking and a family history to consider so for me I saw the benefit - it's such a personal decision.

Interesting - seems that research is being undertaken in this area .... looks current as far as I can tell.
www.sheffield.ac.uk/scharr/research/themes/economic-evaluation/blood-thinners-during-pregnancy-or-after-birth

Assuming you're referring to Clexane, just don't take it.

Whatever your BMI is and whether it’s correct or not, you look fab, such a lovely baby bump!

Based on NICE guidance they aren't supposed to do a BMI after first trimester as it isn't accurate when pregnant! They can do weight during pregnancy to track your weight gain and provide advice.

I think the midwife must be confused.

If anyone tries to prescribe anything I would point out your weight and BMI at booking and state that you aren't comfortable with bmi being done again at 36 weeks.

It does seem odd to calculate BMI at 36 weeks pregnant, unless they use a calculator that allows half a stone's baby weight.

However, I'd stop worrying about it and just be pleased you'll have the blood thinning injections as I'm pretty sure they're quite harmless but will lower your risk of clots at a time you're more predisposed to them.

@ReeseWitherfork thank you!! 😄

To be honest I havent even googled blood thinners because it's the first time it's ever been mentioned and specifically because of my weight, which I thought was madness! But your comments on my age as well I see that maybe it's not necessarily a bad thing. I will definitely discuss it with the doctor after but I'm sure I wont need them!

I'm a little bit mind boggled with the recalculation of BMI with an almost full term baby - it does seem bonkers. However, as someone who had postpartum DVT and pulmonary embolism with no risk factors (healthy, young, normal BMI) please do take the blood thinners if they are offered. You are at higher risk of blood clots during pregnancy and post birth than you are normally, and I wouldn't wish my experience on anyone. I wish I had been offered blood thinners at the time.

I sometimes wonder where some comments come from. I was told during late pregnancy that I had to go to the GP to sort out my high blood pressure. It was 130/75..... the GP said that that's not too high and she certainly wasn't going to medicate a perfectly fine blood pressure in a pregnant woman.

Can't believe all the people missing the point here.

OP, you're right. There's some guidance here (could only find US) on what constitutes healthy weight gain in pregnancy based on preceding BMI- from what you've said it sounds like you're well within the limit. www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-weight-gain/art-20044360

I'd raise it next time you speak to someone other than that MW as you don't want high BMI on your notes, as it may influence advice down the line.

You look fine to me. I'd ask a second opinion on the blood thinners, if they're necessary die to your age then fine, but bmi is just stupid in your case.

Quite clearly you’ve oversensitive and defensive about your weight.

Being a size 12 is irrelevant if your BMI is already so high that being pregnant pushes it over 30. Mine has never got anywhere near that even at 9 months pregnant.

I don’t think the blood thinners are because of your weight moreso age ? . I had a BMI under 30 and had to have injections for 10 days after the birth because I am 35

I'd ask some more questions.

I'm wondering if booking in weigh in or later one been missed and MW had a moment and didn't think though that can't do it so late.

My pfb surprised everyone as she was over 9lb, placenta and after birth was according to MW on the impressive side - so when I did get home day later I weighed just under stone less than booking in weight - healthy eating and move to very hill location I had to walk up for work. So I don't think you could accurately account for baby weight - as no-one was expecting DD1 weight.

@travelmad I'm so sorry to hear that and it's certainly given me food for thought.

Some of you comments have made me rethink blood thinners if they are suggested as they can only be of benefit I guess. But I'm still not happy about having my weight marked as a risk factor on my notes and will definitely query this with someone other than my midwife as I don't want to offend her!

Midwife is wrong

You should calculate bmi at start of pregnancy and then look at weight gained. And even then I think its fairly bollocks.

I was 7'11 and went up to about 12'.

I was back down to 8' within a couple of weeks of having DS.

He was a normal weight.

One of the problems is if you are a smaller frame, there isn't anywhere for baby to go but out and i think that complicates things.

I believe that if you are particularly tall/small you are more likely to be an outlier who isn't a particular issue in terms of weight gain and are on the edges of normal.

I'd argue there's a fair point that you may well be more at risk because you have changed shape so much, but i dont think you are doing anything wrong nor could you do anything differently as that would come with its own risks.

Certainly this isn't standard practice and isn't back up in scientific evidence.

Thats where I'd be questioning what bollocks she's spouting.

@YellowTreeHouse 😂😂 my BMI was 25 at booking which is healthy and I'm still wearing the same maternity jeans I bought in 1st trimester - go figure!! 🤣🤣

Yes true in regards to size, I'm only 5ft and been over 100th percentile since being measured! Big bump but probably cause I have a tiny torso and nowhere for baby to go but out! Or I may well be having a whopper of a baby! But take away baby weight I know I would only a couple of pounds over weight!

I don't know why pp aren't getting this either op. Do they not understand 1) pregnancy and 2) BMI? I assume not.

Also while I'm here, BMI is a very flawed measure of health and being overweight.

@knittingaddict thank you, exactly! And I agree, muscle weighs more than fat and I've read about sports people who are classed as obese on BMI 🤔

My midwife reweighed me at 28 weeks, and recorded my BMI. I thought it was a bit odd too, but maybe it’s standard practice in some trusts?

BMI is irrelevant in later pregnancy. Your midwife should have recorded weight but not BMI. You can asked to have that note removed from your records I believe? I'd be fuming as some midwife led units only accept mothers up to a certain BMI (as at booking in appt) and thus this could affect your options.

@LivingNextDoorToNorma do you know if anything was deducted for baby/placenta/amniotic fluid etc or if your whole weight was recorded as BMI??

I had this at nearly full term. I was 42. I wasn't offered any intervention. I was very fit and healthy and a daily gym goer right up until the day before birth so wasn't worried. It came right down when I had my 9.5lb baby and I was pretty much back into normal clothes a month or so later.

I'd speak to her and ask her to clarify.