Why have I been referred to Obstetrics?

[BeingATwatItsABingThing]

I had my 16w appointment on Wednesday and she didn’t say anything was concerning but she did say my BMI was okish. I’m 5ft5 and about 13st so I am overweight. Could this be why? She didn’t say I would be referred and the first I knew was a text appointment today.

This is my third pregnancy and I’ve had uncomplicated pregnancies with my last two other than concerns DD2 would be a big baby. DD1 was 8lb 6oz at 40+5 and DD2 was 8lb 2oz at 40+2. This baby is a boy and DH was born at nearly 10lb. My labour with DD2 was also very quick and the midwife said they would discuss what to do if this baby is too fast to get to the hospital.

The only other thing I can think of is she said she thinks I might have an anterior placenta because she could hear my heartbeat too when she was listening to the baby’s.

Sorry! Lots of info but didn’t want to miss anything.

How old are you?

I’m 29. That would have been helpful too!

5ft 5 and 13 stone is obese (just) so I'm afraid that's the most likely explanation. Depends on the referral criteria in your trust.

An anterior placenta wouldn't be a reason for the referral.

I figured it probably was.

Any idea why I need extra care for this?

Didn’t think so but I didn’t want to leave anything out just in case.

Obese women are at greater risk of gestational diabetes so you would be offered a glucose tolerance test, and potentially extra growth scans towards the end of the pregnancy.

That's only if it is the reason, of course. In many trusts the threshold for referral is BMI >35 or in some >40.

Right. Thank you. Guess I’m going to be trying to lose weight between now and my appointment then.

You might find its just a one off appt. I was referred to a consultant due to the type of tear I had with DD1. Even though my BMI is 30, i met with the consultant, we had a good chat and then she said she was happy to discharge me back to being midwife led. So please dont do any mad dieting or anything as it isnt good for baby. In fact after booking, ive never been weighed in pregnancy again, so they wouldn't even take any weight loss into consideration. Just eat a healthy balanced diet as we all should be doing anyway.

Thanks @NoIncomeTaxNoVAT

I won’t do anything silly but I will try and exercise more and eat healthier in the mean time.

Goodness me, do not do that! It may not even be the reason! Do you have a phone number for your midwife team that you can call? If you have the NHS app or if your trust uses 'My Pregnancy Notes' or similar you may find that there is something in there which explains the referral.

It is fine to slowly and safely lose weight in pregnancy.

What about those who can't help it, anyway? I lost 2 stone due to sickness.

Sounds like a good plan 🙂 Im finding swimming is working well for me in this pregnancy.

In my trust everyone is referred and has an appointment with a consultant or registrar at their 20 week scan. If they think they need to keep seeing you you are kept shared care, or they discharge you to midwife led.

Lots of reasons to refer you, as it was I have had lots of pregnancy issues but I would have been kept shared care anyway as I have lots of allergies to medications. Could also be your weight/health/age, previous babies being small/large, pregnancy issues such as gestational diabetes, previous issues with labour/birth such as c section or assisted delivery or tears. Even an immediate family member having pregnancy complications can be grounds.

Almost no one is midwife led only these days.

Why would losing weight not be a good idea? As I said on a later post, I’m not going to go on a fad diet or starve myself. Just reducing the amount of crap I eat and trying to move more.

Even if it’s not that, I know I’m heavier than I should be so losing some weight can’t hurt.

Thanks. Really not the norm in my area though so it’s unexpected.

My babies have been on the bigger side but not crazily so. Both vaginal deliveries that came on naturally if very fast for DD2. Minor tears both times but no complications from this. Both babies head down and in the right position. They’re not even close together pregnancies as DD1 is 9 and DD2 is 3.

My mum had an EMCS with my older sister but surely that would have triggered something with my last two pregnancies.

I’ll see about swimming. We cancelled our memberships due to how expensive they were.

You’ve clarified how you might go about it so I’m slightly less alarmed. Eating better and moving more is a great idea. Dieting specifically for a medical appointment isn’t!

I thought that the BMI wasn't valid in pregnancy. Only the weight you started with/had in the booking appointment. With+10kg as a minimum pregnancy weight gain, we're most likely all be obese by the end.

But I guess at 16weeks, it's still a bit early. Have you put on a lot of weight since the booking appointment?

Regarding "dieting", "reducing the amount of crap I eat and trying to move more." sounds good for everyone. I eat worse that before the pregnancy due to stomach feeling weird all the time, but I try to think this to motivate me:
Imagine that what you eat, you are feeding it to a small baby, that depends on you to learn to eat well, and what they eat will be very important in determining their long term health.
(I don't think that 100% of the time because it's too much pressure, but it helps making some better choices occasionally)

Even though I used to move quite a bit before the pregnancy, I find it very hard to do any exercise these last few weeks with constant exhaustion, but I try to force myself to a weekly yoga (where I only do what feels comfortable). I should probably look into swimming too...

I've also been referred to an obs, even before my booking appointment, and I don't know why either. I'm 10+1 now, BMI is normal (when started pregnancy and still, although just a couple of kilos away from overweight), 38 yo, first pregnancy. I had a uterine polyp that I was planning to get removed due to fertility but got pregnant, so I don't think it's that.

Midwives are very keen to refer.

I got referred because of an under-active thyroid. Had nice chat with the consultant about taking thyroxin and making sure I had regular blood tests. I never had to go back. It could well be just a one off but it’s common for women with high BMI to get an extra look after - they may be concerned about the risk of gestational diabetes. This is totally controllable btw.

I didn’t get weighed at my 16w appointment so I don’t think it’s because I suddenly put a load of weight on.

I really struggled in the first trimester with nausea but also massive food aversion. I ate significantly less than I normally do and I could only really face toast and plain crisps. I tried to eat other things but they made me gag and heave. I seem to have moved past this finally and I’m trying to eat a lot more fruit and veg now I can stomach it.