BMI Mistake maternity notes

[Bunny44]

I've recently transferred hospitals due to relocation at 36 weeks pregnant. Pregnancy has been uncomplicated, I was 34 when I got pregnant, size 8-10/BMI 22 before pregnancy and very active. I have gained slightly more than average weight but I was previously told this was fine especially as I've remained active throughout pregnancy and no health issues I.e. Good blood pressure etc.

The midwife I saw at the new unit seemed to be a trainee as she was supervised. She was copying over information in my booking appointment but seems to have put my starting weight as my weight at 37 weeks which has given me a booking BMI of 30.1. When I saw the consultant at the hospital a week later in her notes I saw she has written everywhere that I'm a high risk birth due to my age (now 35) and BMI above 30. I understand that the BMI above 30 risk should have related to booking BMI, not my BMI now?

I'm concerned and irritated as I believe this had implications for medical decisions during the birth. I look fairly slim apart from my massive belly now (which I've been told is measuring small) so I'm irritated the consultant didn't look at me and question this before writing it all over my notes.

Should I seek to clarify this ASAP or will it be ok? Can I get it corrected? The current hospital only seem to use written notes and nothing digital.

Yes I would definitely query this asap and don’t let it go.

I am also 35, having extra growth scans with a consultant, and only my booking bmi is ever recorded in my scan notes each time. I’ve never been weighed since.

Bizarrely I used to work as a midwife at a hospital which reweighed at 36 weeks and recalculated bmi and used this new “bmi” to tell people if they could use the pool, etc. I did keep raising it saying I’m not sure this was very accurate but it didn’t change……not sure if it has since I left.

Ok I'm seeing my midwife today so will bring it up.

It is normal to weigh you again at 36 weeks or so but I think the issue is they class your weight risk based on your booking BMI and mine has been recorded incorrectly in the new notes. Technically it is my booking BMI for the new unit, but I believe they mean your initial BMI at 12 weeks.

Surely most women would then be classed as overweight?

I was only ever weighed at booking in with both children. My midwife said it was pointless weighing after that due to bump.
I would be extremely unhappy if I was made high risk due to my weight at 36 weeks.

I corrected minw myself as I got weighed at the GP pre pregnancy literally 5 days before conception and added that my BMI was healthy.
At my booking at 8 weeks I already put on weight and had stretch marks and I was over by 0.5 and I was like NOPE. So changed that.
I also refused Consultant intervention. It is your body your can say no to anything you want. I did and I had a natural birth at a midwife community led centre. Bo complications. I lost 30kg within 10months postpartum.

I did actually correct the consultant when I was there and said my booking BMI was 24 not 30.1 but I think even she got confused at that point and so just left it but I'm worried this has implications for my birth plan, which haven't been properly discussed with me. I'm now 38.5 weeks pregnant so could be any day now.

Also for added stress factors, my mum is my birth partner and has an eating disorder which she projects, so will freak out if they start suggesting I'm obese. I'm so concerned about the stress this will cause me that I'm considering not having her there at all, so this has emotional consequences as well.

Exactly. Which is why I kept telling the managers I didn’t think this was right but they were adamant it was.

Definitely get it corrected as it majorly affects your care options!

I had similar in that our area had no permanent midwife so it was a locum each time, one read my notes from a previous birth and put my BMI at 32 when it was 28 - I pointed out that was 4 years out of date! She corrected it but it still showed on the notes and I had to go through the same thing with every subsequent midwife - nearly stopped me using the Birth Centre because of her error!

Similar experience, they entered my weight as 10kg over what it actually was taking my BMI from 22 to over 30. I just spoke to my midwife and she corrected it

I’m really surprised that at a BMI of 30 and age >35 you’re considered high risk at all. Most places aren’t interested until your BMI is well over 40. Your current weight (not BMI) will have some implications for some drugs that may be given that are calculated on weight (eg blood thinners if you need them post-delivery) but a BMI of 30 (Even if was correct) shouldn’t change anything in your birth plan. Some Trusts have rules on weight (not BMI) for using the pool for safety reasons which is often why they reweigh you at 36 weeks. This is one of those things that is slightly irritating but really doesn’t matter in the long run.

Definitely bring it up with your midwife and ask for it to be changed.

It’s also not normal to weigh you at 36 weeks, they should not be weighing you after your booking in appointment and definitely shouldn’t be working out your bmi after booking in. It’s not the most accurate system anyway but it’s not designed to factor in pregnancy.

I was weighed during my pregnancy to see how much weight I’d gained. I thought this was normal? It also helps them know if retaining fluid etc for certain conditions.

BMI over 30 is a risk factor for gestational diabetes, so you’d be offered the glucose test. But again, I believe that’s only if this was your BMI at booking.

Yes exactly on booking, not at 36 weeks. At original booking I was well within the healthy range.

@PickledScrump I was weighed at my 36 week appt, it’s normal for my trust (however BMI did not get changed based on this).

@Bunny44 I would speak to your midwife to see if it can be changed, however, my BMI at booking was just over 30 and it has never been mentioned by anyone, so I can’t imagine it being mentioned at your birth, hopefully this gives you a bit of reassurance to have your mum with you!

@Houseelf90 im currently pregnant with my third, with my second I was weighing myself at home and I didn’t put on any weight at all so I asked my midwife about it. She said pregnant women should not be weighed after booking in appointment as it can vary so much. There’s a list on the nhs website of what happens at each appointment, weighing is only at booking in.

@PickledScrump that may be the case for you - but I had my 36 week appointment last week and was weighed - as is normal in my trust. I don’t have a problem with being weighed.

@PickledScrump this is not my trust but shows other areas also weigh at 36 weeks:

I did actually correct the consultant when I was there and said my booking BMI was 24 not 30.1 but I think even she got confused at that point and so just left it

One of the more surreal experience in my life was having a consultant insist my then youngest child was a decade older than there were - despite me and DH insisting he was just 2 with photos to prove it- he'd read the notes you see and they were more reliable than us .

Our persistence did get him to re-read them and realise he'd actually read them wrong.

I would follow up and try and get things changed as it could have treatment implications.

@Houseelf90 ah that’s a university hospital which I believe can do things differently. Obviously if the midwives have concerns about excessive gain or loss they will tend to check, or perhaps if a woman was close to the weight limits for using things like the pool. Generally though weighing stopped happening in something like the 90s as it was found to be ineffective at providing any worthwhile information. If you’re happy to be weighed that’s great, going back to the poster’s original point though it’s not standard in nhs and it shouldn’t be used to change bmi.

@PickledScrump mines not a university hospital though. I just don’t think you should say it shouldn’t be done when in some trusts/areas it is done.
I think there’s a difference between “not regularly” and “not done” - but yes, absolutely should not be used to recalculate the BMI.

You should correct it, it will follow you, I was weighed at 36wks, weighed 75kg which was incorrectly put down as 95kg.

For the next few years, when I was weighed at hospital appointments I was made to talk to someone about my rapid weight loss - 30kg in a month or two. 20kg of typo and the rest a baby.

Six years later I had a nurse say "you have a history of rapid weight loss" so you really want the "high risk pregnancy" off your notes.

I don't know the answer but I was only saying to my mum yesterday how odd I found it that the midwife keeps calculating my BMI. I have gone up from 21.99 at booking to 28.something (that was at 34 weeks) so I'm now 'overweight'. Surely there should be a pregnancy version of the BMI chart if they're going to use it?

@Houseelf90 theres a difference between what should be done and what is done. Dopplers shouldn’t be used at 16 week appointments anymore but at some trusts they still are. Again look at the maternity appointments on nhs website, it’s only on there for booking in. Not sure why you’re arguing with me about it, hormones? Anyway all the best and I’ll leave it at that.