High BMI and Waterbirth

[VeeAye]

Hi all,
I have seen that many areas don't allow waterbirths with women with a high BMI and I was wondering if anyone has any experience with getting a waterbirth despite what policy says.
I am going to ask my Midwife about it when I see them in a couple of weeks but wanted some back up, if they try and say it wont be possible.
Any specific experience with Manchester Hospitals would be great.

I wanted a water birth but wasn’t allowed one due to my BMI, it was to do with the weight limit for the pool itself not to do with my health.

I have a seriously high bmi and was told basically it’s a case of, if you’re unconscious can your birthing partner pull you out and get you to the bed. Our place is weight rather than bmi though and it was capped at 15 stone I believe. No way in hell hubby could pull me out so it was a no go.

How high is high? If you're close to their cut off you might have a small chance. The problem is that should you need help out of the pool for any reason whilst in active labour the midwives, whoever you have as a birth partner, and you are going to struggle, putting you and them at risk of injury. And that's if you're conscious. If you're not, well...

Rules like this have history in serious complications for someone once upon a time. Even if it's not likely to happen it has happened before. Easier to say no in the first place, than to risk it.

Ask their reasons. If it's to do with staff not being able to lift you, surely it should be based on weight rather than BMI. A 5ft woman with a BMI of 30 will weigh a lot less than a woman who is 5ft10 with BMI 29. On that basis I might bring that up if you are shorter than the average height (5ft4).

A lot is to do with whether it’s possible to monitor the baby, it can be impossible to listen in to the FHR as frequently as is needed to be safe in the pool while you’re labouring with a very raised BMI. Not always but it’s a major consideration.

Do you mind if ask what it is?

Plus size midwife on Instagram (did a AMA on here actually) has some good discussion about this. So in theory you should be allowed one as the hospital should accommodate you, and they should have a hoist etc if the worry over getting you out of water is so big blah blah blah. The reality is, or at least is was for me, that arguing against the Trust for something they are determined to say no to was too stressful for me in pregnancy especially as there's a chance you might never use the pool even if they did say yes. You could have a c section or whatever. I also just didn't want to repeatedly have the conversation of "you're too fat"? It didn't help my headspace during pregnancy. But do check out her Instagram, it's helpful.

As PP said, it could be to do with safety and whether it would be safe and possible to get you out of the pool quickly in an emergency where you were unable to climb out yourself. In reality trying to hoist someone out of the water is not practical in an emergency with a slippery patient, hoist slings to try and safely place under a wet, slippery unconscious patient all whilst using equipment that is electrical and not designed to get wet.

It could also be that your BMI takes you out of the 'low risk' category and that they want baby to have continuous monitoring throughout active labour. A few trusts have portable waterproof CTG machines but most do not and this could be a factor in why they don't want you to use the pool.

If it is the monitoring that is their reasoning then you could sign something that will be called something along the lines of 'birthing outside guidelines' saying you are happy to go against their recommendations but only you know how you feel and what is reasonable for you. I am by no means advising you to go against medical advice but for a healthy woman with a BMI of 30 who has had a straightforward pregnancy with no issues, then they are right on the borderline (in my trust) of who would be allowed in the pool, yet a woman in the same circumstances with a BMI of 29 would be allowed no question and they would be happy with intermittent monitoring for baby. Depends on your individual circumstances.

Do your research, and use your common sense - hospitals can't use common sense, they just have policy.

But basically, they can't 'not allow' you to do anything. If you want a water birth you can have one. They can advise you not to, they can say it's against hospital policy, and you can say 'ok, well that's my choice so that's what I'd like to do thanks very much'.

If once you've done some research and discussed with your midwives, you think it's not sensible based on your specific circumstances, then that's a good reason not to have a water birth.

Thanks all. I understand the potential risks I just wondered what people's personal experience was. I do have a high BMI but I think thats such a stupid calculation. Interesting to see some of yu say that their hospital did it on weight which is a lot more sensible and the reasoning more understandable.
I also have a chronic pain condition which I know is better warm and in water hence why I think a water birth would be beneficial.

This is incorrect. Of course a lot of giving birth is down to your choices and you can make your own decisions, but a water birth is not one of them. Much of it is to do with the safety of the midwives. The sides on a birthing pool are high and the midwives must be able to get you out in an emergency. If your weight is deemed too high to be safely moved out of the pool in an emergency then they can refuse you. They just won’t fill the pool. They won’t risk the safety of their staff, and potentially causing further complications during labour.

The best thing to do would be to talk to your midwife and find out what the limit is.
If they say it’s not possible then ask what other options you have.

Ooh please let us know what they say! I’ll be giving birth at Oldham later in the year and have always wanted a water birth but wasn’t even going to ask them about it because of my BMI!

You're right, that is true to an extent - but I truly hope that wouldn't happen.

There is likely to be a consultant midwife etc who will sign you off to use the pool, just put you down as 'birthing out of guidelines' obviously that needs to be discussed before hand.

However, if it really came to it, you can fight for it because you do have rights about your birth place. I just would really hope it wouldn't come to that as you'd either come to the conclusion yourself that it wasn't a good choice, or someone with some sense would sign it off at the hospital.

Emma Ashworth runs workshops on this specific subject.

If you're leaving it to the day then yes of course they're not going to fill the pool.

I was literally about to post as PP has - look up Emma Ashworth on Instagram - she has lots of info on there about what your rights are and how to go about arguing it with the trust if you choose to.

I think it depends on how much you weigh and if they could safely get you out.

Are you being weighed during checkups? I wasn't so I don't know how they would know BMI...

At my hospital (not Manchester), the cutoff was a BMI of 40.

I had 2 water births ,a year apart ,bmi was very high 50 with both
nothing was mentioned,,not by midwife or consultant,there was no problems..
however ,this was approx 23 years ago
I then requested a water birth approx 13 years ago ,same bmi ,and was told no ,I was to heavy ..even though it was same hospital,and same place I was requesting water birth ..
was disappointed,but the bath was very fast ,so probably wouldn’t of had much time in the water anyway.

Birth ,not bath 😀

@PickledScrump true but shouldn't it be the woman's choice to take that risk? What about woman married to firefighters or weights lifters that could pick her up in a second? Also what about the risk that she then buys a birthing pool for a home birth that would be more risky than an in hospital water birth. We can advocate all we like for the babies safety but mum also needs to be happy.

If you're on Instagram there's a lady on there called the heavyweight midwife - she is or was a mumsnetter, her info/knowledge is great.

@sleepyscientist of course it should be the mothers choice within reasonable measures. But it is also up to the hospital to protect their staffs safety which is why these policies are in place. Firefighters aren’t automatically incredibly strong and how many women have weight lifters as a birthing partner. If you pass out you are basically a dead weight, plus slippery as you’re wet. It’s not as easy as people think to just get out. Birthing pools used for home births are actually much easier as they are inflatable so a lot easier to get in and out of.

Many hospitals actually review each case individually before making a decision, but their decision is for the safety of mother, baby AND staff.

Have you thought about a shower instead? I was in the same position as you although didn't mind WB or not. When I went into labour I asked if I could have a shower as I felt sweaty and gross. I was able to stay in the shower for quite a while as things progressed. The water on the small of my back was really helpful.