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??

No, it wasn’t @FluffyBear82 . Out of curiosity I put the same height/weight info into the online NHS BMI calculator, and got the exact same number. There was no where to select that I was pregnant.

In this case every pregnant woman will have to take blood thinners.

the midwife if very much confused. I would bring this up with someone else on ante natal, or even pals

The BMI thing is obviously nonsense. I know in lots of countries weigh-ins are routine at ante natal appointments but you still wouldn’t recalculate BMI at almost term, I would have thought everyone would end up overweight or obese if they routinely did that! If you get prescribed the blood thinners just ask why and then you can make your own decision as to whether or not you want them. It could be your age, if you have a section, or loose a lot of blood. I had them just for a section, no other risk factors. If this will cause problems for your birth plan like stopping you going to a midwife unit or having a water birth then I’d query it. Otherwise I wouldn’t bother.

I had a quick google and BMI should not be calculated on total weight including bump/baby BMI should be based on pre pregnant weight for preg records, if you have gained alot the Dr can provide a weight for baby/waters etc and that then is deducted from total weight to calculate an approx BMI (We all know what baby weighs varies as does waters). I would just tell her at your next session about what you find on decent sites (pref NHS) and have a discussion with her. The thinners is because when you are older more at risk of clots - last thing you need is some sort of episode because of blood clots while got a new born.

That seems bonkers!

This is from the NHS website - You'll be weighed at your booking appointment, but you will not be weighed regularly during your pregnancy. Your height and weight are used to calculate your body mass index (BMI).
If you are overweight you have an increased risk of problems during pregnancy.
Find out more about being overweight when you get pregnant.
You're likely to put on 10 to 12.5kg (22 to 28lb) in pregnancy after being 20 weeks pregnant. Much of the extra weight is because the baby is growing, but your body also stores fat for making breast milk after birth.

And this from NICE - Dieting during pregnancy is not recommended as it may harm the health of the unborn child.
Many pregnant women ask health professionals for advice on what constitutes appropriate weight gain during pregnancy. However, there are no evidence-based UK guidelines on recommended weight-gain ranges during pregnancy.
The amount of weight a woman may gain in pregnancy can vary a great deal. Only some of it is due to increased body fat – the unborn child, placenta, amniotic fluid and increases in maternal blood and fluid volume all contribute.
Measure weight and height at the first contact with the pregnant woman, being sensitive to any concerns she may have about her weight....Do not weigh women repeatedly during pregnancy as a matter of routine. Only weigh again if clinical management can be influenced or if nutrition is a concern.

Interestingly just gone back over my pregnancy notes and it clearly says lower than 3 risk factors is classed as low risk - ie no intervention needed. So even including the BMI thing I'm still low risk so don't know why she said that. But actually pleased I got some words of wisdom from you mumsnetters as I see now that despite that blood thinners are probably a good idea after birth!

This happened to me in my last pregnancy- I got weighed at 38 week appointment, nothing was said then once I delivered my baby ( who weighed 10lb2!!) they came round and said I needed the blood thinning injection due to bmi- The midwife on the ward questioned it as said I looked naturally slim and asked to weigh me again and said I'd lost 1.5 stone after delivery so was a normal BMI again so I didn't need it- seemed a bit crazy- I'd question it or ask to get weighed after delivery 🤷🏼‍♀️

BMI is bull. 😂Its outdated. I was once eating keto, doing gym 6 days a week, 3 types of martial arts and I was 'obese'. I was well fit not obese. You look fine. You can just say 'no thank you' to the blood thinners if you dont want them. How about you ask for a second opinion on it? I would also ask someone to remove it from your notes as it can affect where and how you birth as some places only 'allow' (hate that word 🙄) certain things (eg. waterbirth/homebirth) when your BMI is under a certain range.

I think we had a very similar thread recently, so it’s not an isolated case.

@bairnk that's exactly what I assume will happen with me, I will definitely ask to be weighed too!

I agree @Quinnie1 that happens a lot with sports people, ridiculous!

Yes it's clearly not an isolated incident, I'm having a hospital birth so won't affect my choices but don't know if it will affect medics decisions at the actual birth so will definitely bring it up!

www.nhs.uk/live-well/healthy-weight/bmi-calculator/

NHS advice is to go with a womans pre pregnancy weight (long way down under the 'limitations

Sorry posted too soon

....under the limitations of BMI section

I agree this is madness! I wasn't weighed after my booking in appointment and actually put on more weight than the 'advised limits'. I doubt you will have a problem at the hospital, they should be able to see that you are clearly not obese and it wouldn't be a midwife prescribing blood thinners, it would be a consultant.

Lots and lots of women have blood thinning injections after birth, I had them after both my boys it’s nothing to worry about, I wasn’t overweight or over 40, did she mention them for a different reason but baby brain has you a little confused.

I would be wary of going along with everything they say. So many things that are routine or protocol are unnecessary. That includes weighing during pregnancy, automatic inductions for being over due dates, internal exams, foetal monitoring during labour etc etc. Each trust has their own rules so it’s clearly not always evidence based. You need to do your homework and be Prepared to challenge things.

That is totally ridiculous! The BMI calculation cannot be used when you are heavily pregnant.

Absolute nonsense, no evidence base for it whatsoever. And if you accept blood thinners you increase your risk of PPH by 30% please do question this policy. It's batshit

Good job. You ate too many pies. You were nearly 40BMI what has that got to do with anything. Most women will have an overweight or just in obese BMI near or at full term just as most non pregnant women who are weighed whilst holding someone's else's full term baby will also weigh as overweight or obese. The whole point of (outdated) BMI is to check if someone is carrying too much body fat. If someone is very muscly they often fall into the overweight or obese BMI just as someone carrying an extra little person. This has nothing to do with body fat and is therefore not a health risk. Rugby players are notorious for having very high BMIs. They aren't at risk due to their weight. You were just fat and pregnant. Totally different scenario

Re: blood thinners, I was weighed after my baby was born and my BMI was below 30 but I had blood thinners anyway following surgery to repair a perineal tear. This was like 2 weeks ago so not outdated! Better to see what happens and be cautious rather than outright refuse I think. Best of luck with your upcoming arrival!

Sounds bonkers to me but one of mine was 11lb 2 and by the time I got out of hospital 5 days later I d lost over 2 stone

Your midwife is wrong. I would want this corrected on the notes personally.

And did you ask what the risks were of the clexane?

This midwife is clearly confused... of course a BMI will be high at 36 weeks pregnant! Should not be calculated after booking, the BMI to calculate risk factors should be the one used at booking. They can weigh you to look at risk for gestational diabetes (although a bit pointless as late as 36 weeks) as excessive pregnancy weight gain can be a risk factor but BMI will be totally inaccurate.
I think depending on mode delivery of baby they will advise you regarding risk for blood thinners but just point out to hospital staff (presuming that's where you are giving birth) that the midwife calculated your BMI at 36 weeks pregnant so it is not accurate as a risk factor. Hopefully it will all go smoothly, with no restricted mobility afterwards and there will be little need for blood thinners.

All the best with baby, and sorry you've had to put up with lots of shitty comments that clearly don't make sense 🤦‍♀️

It may well affect how they treat you during the birth. You don't want to be rushed through into an unnecessary caesarean, for example, because of this. Please be very firm in clearing this issue up in advance. Doctors and midwives can be very arrogant and condescending towards women in labour and pregnant women so I hope you can advocate for yourself. Good luck.

Thank you @Nursemumma92 it is frustrating when people don't seem to understand what your saying!!

@Lilgamesh2 oh yes I have no problem advocating for myself! I'm going to speak to them at my next appointment and clear things up.

Thanks everyone for your advice! 37 weeks now, getting impatient to meet my little boy!! 😍😃