Has anyone been refused a water birth because of their BMI?

(54 Posts)
SuffolkNWhat Sun 07-Apr-13 11:23:59

My midwife is a bit obsessed with my BMI (currently 29) and has alluded several times that not only will I not be allowed into the MLU but also that I might be refused a water birth because of it!

Surely water is better to keep things mobile if you have a higher than normal BMI? I know 29 is far from ideal but neither am I morbidly obese!

Has anyone else c

VivaLeBeaver Sun 07-Apr-13 23:36:30

We don't have hoists where I work.

It isn't just about overall weight as you're more likely to have a shoulder dystocia if you have a higher BMi. If someone's pushing and has a shoulder dystocia in the pool it's going to be very hard to get them out.

They're unlikely to be able to get out themselves at that stage with the baby's head out. No hoist, I'm not going to pull anyone out the pool.

In an emergency we have to fill the pool to the top and then put a net under the woman to float them out. Would only take about ten minutes I reckon.

5eggstremelychocaletymadeggs Sun 07-Apr-13 23:42:37

My hospital had a hoist but oi have heard of the net thingy as well.

My friend had shoulder dystocia in the pool but her moving to get out dislodged the baby so she was lucky.

I had ds4 in the pool 10lb 13oz didn't even have to push. I am 5 2 and size ten. The consultant who checked on him later (he was a bit grunty as very quick labour under an hour) was horrified I had been 'allowed' to have a pool birth for such a big baby....err we didn't know he was that big, tho all my babies have been 9lb + and I birth easily, wide hips etc.

I am sure being in the water helped re stretching and not tearing, ds4's head was off the top of the percentile chart, another reason he was checked o er. He still has a big head now age 5, like his dad!

Nobody HAS to have a GTT. Like any test or intervention you should be aware of the rationale for offering it and be able to refuse it if you wish.

VivaLeBeaver Sun 07-Apr-13 23:52:14

My BMi is 31 and in the unlikely event I got pregnant again I'd refused to get weighed. grin

5eggstremelychocaletymadeggs Sun 07-Apr-13 23:53:24

Good point northern with preg no 5 the consultant wanted me to have it as ds4 had been so big. I knew this baby wasn't as big, I could feel it and I have never had any sdigns of gd in any pregnancy. My midwife agreed with me and said I just grow good sized, healthy babies.

Turns out dd was only 8lb the smallest of my five but the hardest birth as she came out back to back, still less than three hours and three pushes tho. I wonder if she was just smaller because she is a girl, my first four were all boys.

5eggstremelychocaletymadeggs Sun 07-Apr-13 23:54:01

viva grin

5eggstremelychocaletymadeggs Sun 07-Apr-13 23:54:53

I refused the gtt. I also went more than two weeks overdue... I don't think the consultant liked me very much!

MerylStrop Mon 08-Apr-13 00:00:35

I guess your midwife is trying to do the best for you in terms of managing your expectations.

I'm sure it's BS re the MLU and in your position I would do my darnedest to ensure that decision is yours and not some arbitrary hospital policy. Likewise GTT, you're within your rights to politely decline.

The likelihood of actually getting a water birth depends on so many other things beyond your control that it is not worth planning on it in any case.

Suffolk I would get another opinion. Where I am they only really worry with BMI over 35. I had a BMI of 30 at booking in an was advised that MLU or waterbirth at home are both options for me.

For the people citing midwife having difficulty getting you out of the pool, what nonsense. BMI is based on weight and height. So at 5ft 2 with a BMI of 30, i weigh significantly less that someone who is 6ft with a BMI of 26.

SuffolkNWhat Mon 08-Apr-13 14:51:23

I hear what you are saying about shoulder dysloscia however DD was a tiny 6lb 7oz and my family history is we have small babies.

Seeing the consultant at my 12 week scan so hopefully will be able to get some more answers.

VivaLeBeaver Mon 08-Apr-13 16:02:16

Suffolknwhat, small babies can have shoulder dystocias as well. A large baby is one risk factor, a raised BMi in the mother is another and separate risk factor. Saying that 29 is not that raised. I'm fairly sure where I work the cut off is a BMi of 30 at booking.

PourquoiPas Mon 08-Apr-13 16:38:01

Surely weight at 9 months would be a better measure of whether you can have a pool birth or not? I weighed 1.5 stone less at 9months than at booking (HG), and someone with a high BMI at 5'2 would weigh less than someone with a lower BMI who was 6'.

Regardless, if you can't lift anyone out of the pool at all and they can't get out themselves once the head is out what difference does it make what they weigh?

What if someone with a high BMI was on the floor or birthing stool and had shoulder dystocia - would a hoist be called for then? Should all women with a high BMI be stuck on the bed in lithomy or mcRoberts in case something happened?

FWIW I had a BMI of 31ish, as with you OP I have ginormous boobs and wear a 12/14 on bottom, 10/12 at waist. I was very fit and healthy before pregnancy, in good shape. I had a GTT and was consultant led due to issues with previous birth, then was discharged to MLU for water birth (didn't get one due to super quick labour but can't complain about that, it was running but not quite deep enough!).

VivaLeBeaver Mon 08-Apr-13 16:48:44

I wouldn't manhandle anyone out the pool if they weighed nine stone or nineteen stone. They get themselves out, or wait ten minutes to be floated out whatever weight they are.

Shoulder dystocias can be managed on the floor as I can reach their vagina and see what I'm doing. I suppose I could always jump in the pool myself but it would be hard to see what was happening.

Blimey. My BMI is 35 and I just had a home waterbirth.

I had a stand alone MLU waterbirth with a BMI of 33 for my previous child.

Are you sure this is the only reason?

No midwife mentioned it might not be recommended.

Oh yeah. I had the glucose rigmorole thing too which I turned down.

Viva Is it really difficult for most women to move/stand/change position with the baby's head out?

Only despite being pretty fat, I've always been pretty mobile and flexible in labour and every time have change position at that exact point (confusing the poised midwives each time, despite the fact that I actually told them I would do that with the 3rd). confused

'I suppose I could always jump in the pool myself but it would be hard to see what was happening.'

Lol, - or if it is one of those blow-up pools you could just pop it!

VivaLeBeaver Mon 08-Apr-13 21:45:58

Dont laugh, we used to have a blow up pool and one of the consultants always used to say that we could slash it if needed.

I've never had to ask a woman to move when the heads been out and I really don't know if I've seen anyone do it of their own volition. Don't think I have. Maybe lift a leg a bit further up, or sit a bit more upright but not a proper position change.

Ah yeah. It appears I like to push the head out on all fours, and the shoulders out on my back. confused

I TOLD the midwives I would be doing that for my 3rd but they still missed the birth again being at the wrong end of the pool - lol

I even talked them through it as I was doing it. 'Right, I'm gonna sit back now so you might want to go round the other side of the pool'. Perhaps they were wondering what the frig I meant if it isn't that usual. They already knew I was planning to feed the baby in the murkey water with the placenta still attached so they were probably just staring at each other with confused expressions.

I didn't see them though, coz they were behind me grin

VivaLeBeaver Mon 08-Apr-13 21:57:46

You would think midwives would learn to listen to women. grin

Perhaps they were. They were pretty fab in general so maybe they just saw a woman who seemed to know what she was doing given that she was able to articulate it, and so left me to it.

But I kind of push out the head in the position that feels most comfortable for getting out, but once the head is out I have an uncontrollable protective urge to bring them to me and 'cage' them with my knees and arms and receive them myself iyswim. I'm not really on my back but sitting upright with my elbows sharped against intruders etc.

MiaowTheCat Tue 09-Apr-13 12:27:14

I worked on the assumption I'd be allowed nowt for my first birth - got to ante-natal classes and made that comment to the midwife there... got looked at like I was daft and told that yep, there was a possibility I could have a water birth (wasn't in the end cos I had a slow puncture).

As for midwives listening - the one delivering DD2 has admitted to me that I totally and utterly caught her out on that one! (All very good natured though - think she was slightly worried I'd be cross but I just saw the utterly funny and mildly absurd side of everything that had gone on!)

I just wanted to pop back after having had a good chat to my midwife about this. I explained my concerns about the bloody awful labour I had last time, getting stressed and not dealing very well with the pain etc. Turns out at my local labour ward and MLU, they have recently reassessed the limits, and have increased it to BMI 35 from 30. My midwive is all for me starting in the pool to help with the pain and keep me relaxed.

Lora1982 Sun 14-Apr-13 18:46:28

Ive not read all the posts but heres my story: chose hospital one then found out their pool was broke so my midwife said to swap to the other one so i could use their pool. She did say i couldnt go mlu but said i would be allowed a water birth because its how i want to do it not the hospital. Then i roll in january in labour and wanting promised pool to be told no cos of bmi... I was offered a bath hmm well anyway long and short of it the gas and air didnt help me so i got the epidural which i wouldnt of been allowed in the pool. So even though i was falsely led it worked out best for me in the end

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