High BMI pregnancy feeling miserable and guilty

[Concernedcitizen98]

I had my booking appointment/scan this week and my bmi was calculated at 33.5 (I calculated it at home as 32.9 but that’s a different matter) I was told I’d have to have the GTT, fine. Now I’ve had an email saying I’ve got 3 additional growth scans and have to see a consultant, at the hospital which is a lot further away rather than the maternity unit. I also wanted a home birth and no idea whether this is possible now as I have a 7yo and no childcare and no family really apart from my partner so if I can’t have a home birth it means a taxi to a hospital miles away in labour alone and labouring and birthing alone at the hospital where with my first I didn’t have a good experience. I also have mental health problems asd and anxiety so this is just so frightening and overwhelming to me.
I’m 5’7 and used to weigh 17st2lb and managed to lose over 3 stone over the past year or so by massively cutting my food intake and walking 10-12k steps a day and I even started running and was running until I got pregnant and due to being so unwell during pregnancy I had to stop. I couldn’t even walk very much because I have been so so ill. I’ve gone from 14 stone to 15 stone from Christmas to now mainly due to having such a horrific first trimester with sickness and fatigue I’ve been eating way too much as it was the only way to curb the sickness and not being able to exercise. Im still about a size 16 at 5’7 and fit enough, not that it makes a difference to the bmi system.
I’m now 13 weeks and I feel horrible, guilty and like I’ve ruined everything for myself. I didn’t want to have loads of interventions and ideally I didn’t want to be under consultant care as logistically the hospital where the consultants are is a lot further away and my sons going to be on summer holidays when I need these growth scans so it means going alone probably on a bus full term as I don’t drive and kids aren’t allowed to scans.

With my first pregnancy I had practically no interventions not even a GTT as I started with a bmi of around 30. I’ve text my midwife to ask her what’s going on as the midwife at the hospital where I had the scan didn’t mention consultant care or extra scans and only mentioned having a GTT but she hasn’t replied yet.

I feel completely depressed if I’m honest and like I’ve let myself and my unborn child down by not controlling myself. I have a history of eating problems and dropping weight rapidly though I’ve never been particularly small. I’m aware to many of you it may sound very first world problems and pathetic but I have ASD and struggle to cope with changes or unexpected outcomes and the hospital letter really didn’t explain much and I didn’t realise my BMI had gotten that high. It seems the pregnancy and birth I wanted is now hanging in the balance because of my own stupid choices. For now I’m going to cap my calories again and walk everywhere to either stop gaining weight or lose a bit of weight before the 20 week scan.
im not sure what the point of this post was I just feel so down and guilty and just wanted somewhere to rant 😞

I've just had a pregnancy with a BMI of 39. Extra growth scans are nice - more chances to see the baby! You can decline anything that doesn't work for you, and I believe you can insist on a home birth. My pregnancy was completely complication free, and my birth was in a midwife-led unit and ended up being intervention free, which I'd hoped for.

Strongly recommend Plus Size Pregnancy by Sara Wickham, and remember that even though some risks are higher they're still tiny, and also that your higher BMI, oddly, is protective in some ways - if you haemorrhage, for example, you're at slightly less risk of adverse effects because you've got more blood to lose. 😁

(And trying to lose weight and cap calories during pregnancy really doesn't sound like a good idea. Your body is amazing, let it be for now.)

Thank you for replying :) I’ll have a look at the book and glad you had an uncomplicated labour.

I had growth scans for my second due to high BMI and it was great! Much more reliable and good to see the baby more. For my current (third) baby, I'm somehow just below the BMI cut-off (weight not changed but think my trainers had quite a big sole so came up taller) and I'm gutted! Had a straightforward normal delivery last time and hoping for the same this time. First baby was an emergency c-section but it wasn't weight related as I was smaller then.

Also, the "high BMI" cut off in my hospital trust is 35 so you would be under it if you lived in a different place. It's just a number. There are many other uncontrollable factors. Wishing you all the best!

P.S. I had gestational diabetes with my second as well and it was fine so don't stress about the GTT. Lots of scare stories out there but it basically just meant changing my food for a few weeks as mine was able to be diet-controlled. There was no adverse affect on baby at all.

Well done for losing so much weight previously, that's amazing! You're only 13 weeks, plenty of time to get on top of things and minimise your weight gain for the rest of the pregnancy. The sickness will go and your energy levels will come back. Don't beat yourself up about the tests etc, that is what it is. Focus on what you can control which is what you're eating and how active/much exercise you're doing.

The home birth situation doesn't sound ideal on your own with a 7 year old anyway to be honest, how would she manage during the whole process and what happens if something goes wrong? I'd start working out a plan for who she can be looked after by when the time comes. She must have friends whose parents would probably be happy to help if asked? If not, start arranging to have her friends over and build relationships so you can ask.

Ps in response to previous pp it's perfectly safe to manage your weight during pregnancy in a sensible fashion, crash dieting etc obviously not recommended but that is different to ensuring you don't put on any more than you need to (9-12kg in total).

I've had 2 home births with a higher BMI than you. Both went really well. It was classed as out of guidance because of my BMI but no other risk factors besides that. I was booked the gtt but I declined in favour of checking my sugars for a week with a glucose monitor and finger prick testing. My 2 year old was at my second birth but she had grandma as her designated person and I had my husband for me.

Thank you for your message :) just to clarify my partner would be here for a home birth for childcare - that’s why I’d have to be alone for birth in a hospital as my partner would be with our child at home. He has a few friends at school etc but we’re new to the area and not sure really if anyone would be comfortable to watch him and the only other option is my dad who’s in a different town and is a pensioner that relies on public transport so not a very reliable option unfortunately.
im already feeling a lot better sickness and energy wise so I’m kicking myself for putting on so much weight already but I’m just going to monitor it and do what I can.

That’s reassuring to hear. I decline the GTT with my first as I was offered it because he was measuring 1cm big but he came out 9lb at 42 weeks so not huge! I’ll probably have it this time just in case but fingers crossed all goes well and if there’s no other complications I’ll still request a home birth or even the local birthing centre would be a better option as it’s much closer to my home rather than the big scary hospital 🤣

Before accepting I'd listen to the midwives cauldron podcast about gestational diabetes. It's very interesting.

Don’t sweat the GTT test OP. I had to have it because of my weight and policy where I live and my bmi was only 25 at booking in. It’s not the most fun in the world but it’s nothing to feel guilty about and if you do develop diabetes is much safer to know about that not.

I have had a BMI of over 40 with both my pregnancies. There's no point in feeling guilty about it, you just have to look after yourself as best you can and IMO, stick to most of the clinical recommendations to minimise risks.

I was diagnosed with gestational diabetes, again all you can do is manage it of that happens. You can only control what you can control. You're early enough on to try and find some reliable childcare for labour wherever you may end up giving birth? Because even with a planned home birth, sometimes women have to be transferred to hospital and having a plan in place is something you can control and which will hopefully help manage some of your stress.