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BMI & Birth
is this legit?


38 replies to this topic

#1 Nataliah

Posted 10 January 2013 - 09:47 PM

I am a little upset at the moment and would like some opinions on whether I am justified or not.

Some facts about me:
I am 33 years old
I fell pregnant naturally it was unplanned
I have had a very normal pregnancy
All my blood results have been fantastic
I have never had any health problems in my entire life
Pre-pregnancy I trained 7 times a week doing Crossfit and powerlifting
I am physically fit and very very strong
Since falling pregnant I still train, but only about 4 times a week
I have eaten way too much, indulged and gained too much weight (20kgs at 32 weeks)

My BMI is now deemed to be in at a risky level and I need to be independently assessed by a specialist as to my suitability for giving birth at my low-risk hospital.

Personally I think its bollocks, I am the first to admit that I have put on too much weight, I am fat.  However I just don't see how that, by itself, is enough to cause me problems with birth.  I would accept this if there was any medical symptoms at all, i.e. diabetes, swelling, high blood pressure, cholesterol, anything... but on BMI alone? (which isn't very accurate for me given my weightlifting background)...  Is there something I am missing?  Can fatness, by itself, cause birthing issues?

#2 Red nut

Posted 10 January 2013 - 09:58 PM

Not usually, but if something goes wrong, which it can in even the most low risk pregnancy and may have nothing to do with your weight, then dealing with it may be much harder. From the IV, to the epidural/ spinal/ GA, to the surgery, everything is much harder when you are overweight.
Try not to take it personally, people only want to see that you and your little one are safe. And we'll done on keeping yourself so fit, I bet that is why you have avoided all the complications of your weight gain!

#3 crackles

Posted 10 January 2013 - 10:00 PM

Bmi is a load of rubbish IMO. There's a lot of things it doesn't take into account.
I don't reckon u have anything to worry about if u don't have any 'abnormal' symptoms

#4 Nataliah

Posted 10 January 2013 - 10:21 PM

Just as a point of clarity about my size/weight/fatness, I am currently wearing size 14 maternity clothes.

#5 fooiesmum

Posted 11 January 2013 - 02:47 AM

A BMI of 35 (sometimes 40 in larger regional areas) is the cut off for "low risk" pregnancies and being able to access midwife led care/birth centre's.  If you are over that point you will usually be referred to a larger tertiary hospital.  Not unusual - just not talked about http://www.couriermail.com.au/ipad/too-fat...j-1225962014007

#6 MrsLexiK

Posted 11 January 2013 - 06:02 AM

My hospital is low risk, once you reach a BMI of a certain amount you have to birth at the public hospital. Things like epis can be harder to guide in if you have too much weight on you. I am guessing I am about your size (I'm in a size 14 mat clothes as well) I am right on the edge and have been working my butt off to ensure I stay below the BMI so I can birth at the hospital of my choice.

#7 cinnabubble

Posted 11 January 2013 - 06:22 AM

Surely they can't use the BMI of a 30 week pregnant woman as an indicator of true weight.

#8 Nataliah

Posted 11 January 2013 - 06:27 AM

Thanks for the responses ladies.  I should be able to keep it where the doctor wants me to maintain my place at the hospital.  I guess I just find it so embarrassing, especially as someone who feels so utterly physically capable of doing this.  It's hard when you know in real fitness terms you could run rings around most women, this number cutt-off seems so arbitrary.  Particularly given it takes no account of build or muscle mass.  I asked if they could assess my body-fat percentage instead, but BMI is it.  My Obstetrician had been good about it, its clear he thinks it a beaurecratic thing and has praised my health and fitness.  I am feeling less upset today...  I do wish they would have told me about it earlier though.  I could have been more careful over xmas which is when I did lots of the damage sad.gif

Off-topic, my mum is an ED nurse and was saying they've bought in new BMI rules for her too.  They have to calculate BMI for every patient who enters the ED.  She said its insane, trying to get the height and weight of an elderly patient who is presenting with a suspected fractured pelvis...

#9 Feral-Lausii

Posted 11 January 2013 - 06:29 AM

I have been in the overweight or obese category for 4 of my 5 births. Size 16-18. I have  not had one issue with anything. No GD, no blood pressure problems, easy and quick labours with little or no pain relief and no interventions. I did stay active during my pregnancies though, which I think helps with my quick births.

I just roll my eyes inwards when a midwife brought it up, the doctor then saw me and looked at my history and said I didn't need to see the specialist.  I also wasn't planning on a epidural so I suppose that may be the one thing they were worried about.

Did the doctor refer you or a midwife? Do they know your fitness background?  



#10 ~Sorceress~

Posted 11 January 2013 - 06:31 AM

Makes me so glad I have a light frame and mostly homebirthed, because I put on 27kg with my first pregnancy (from a starting weight of 50kg - so more than half my weight!) and gained about the same with each subsequent pregnancy! My midwives concentrated on my overall health and didn't even weigh me! original.gif

Excess weight does make things harder for your caregiver - palpating the baby's position, assisting you into position when you're in labour, any surgical procedure - but it's a shame they use a non-discretionary cut-off point instead of actually assessing whether an individual woman is carrying weight in areas that would make these things problematic sad.gif .

OP, perhaps start working to keep the BMI down because it's going to be healthier for you and your baby to be treated as low risk...

#11 Carmen02

Posted 11 January 2013 - 07:04 AM

would be nice if they took everything into account, 2 of my 3 births i was considered high risk because of my size. my 3rd is the only birth where I came into trouble (6 weeks early) so kind of glad i was in a big public hospital. Hope things go well OP

#12 MrsLexiK

Posted 11 January 2013 - 07:39 AM

OP I am fit as well and felt like crap for a few weeks. My OB would prefer me at the low risk one as his rooms are there. But they can't be sure a doctor will be there that could get an epi or spinal in if it is an emergency. They have to have a cut off or a measurement. Yup it sucks (especially when you are short with big boobs original.gif )

#13 Nataliah

Posted 11 January 2013 - 02:31 PM

QUOTE (MrsLexiK @ 11/01/2013, 08:39 AM) <{POST_SNAPBACK}>
OP I am fit as well and felt like crap for a few weeks. My OB would prefer me at the low risk one as his rooms are there. But they can't be sure a doctor will be there that could get an epi or spinal in if it is an emergency. They have to have a cut off or a measurement. Yup it sucks (especially when you are short with big boobs original.gif )


I am choosing to not let it get me down from now on.  If the BMI is the biggest injustice I have to deal with then I can't really complain... plus baby is going to come out the same whether I end up at another hospital or not.

#14 redmum77

Posted 29 January 2013 - 02:11 PM

Hey, the only cut off I know is 100kgs for a water birth in my birth centre. It's purely health and safety, they aren't allowed to lift you out of the water at that weight etc. Seems practical to me and just a policy to protect the midwives. But that's totally different to BMI.

Muscle weighs more than fat, doesn't it? Surely a fat % test is more accurate? Hmmm I hope it works out, gee they like making us paranoid hey?

#15 CallMeFeral

Posted 29 January 2013 - 02:20 PM

QUOTE (cinnabubble @ 11/01/2013, 07:22 AM) <{POST_SNAPBACK}>
Surely they can't use the BMI of a 30 week pregnant woman as an indicator of true weight.


This is what I'm wondering! Surely there would have to be at least some kind of different 'pregnant-woman-only' scale. This makes no sense???

#16 MrsLexiK

Posted 29 January 2013 - 02:28 PM

QUOTE (redmum77 @ 29/01/2013, 03:11 PM) <{POST_SNAPBACK}>
Hey, the only cut off I know is 100kgs for a water birth in my birth centre. It's purely health and safety, they aren't allowed to lift you out of the water at that weight etc. Seems practical to me and just a policy to protect the midwives. But that's totally different to BMI.

Muscle weighs more than fat, doesn't it? Surely a fat % test is more accurate? Hmmm I hope it works out, gee they like making us paranoid hey?


I booked into the public hospital as back up and even though I wouldn't be going through there went through the birth centre part/midwife program to book in.  They did laugh at the BMI restricition though and said they don't have a BMI cut off and how stupid.  

I do think that the fat test would be a good one, but as it currently our hospitals use BMI, and you have to suck it up unfortunatly.  I know there are some hospitals which do some test to fill a particular bone.  When it comes down to it though I would feel much more comfortable at the hospital where it is clear the experienced anthiests are as opposed to one who has never put an epi into someone whose bone you can't feel.

#17 Fright bat

Posted 29 January 2013 - 02:31 PM

I think, before everyone gets hysterical, that we should remember that the OP has only been asked to see a specialist. She has not been denied the opportunity to birth at her local hospital.

If she is a weightlifter and a specialist deems that she just has a high muscle mass and is not obese, then he or she will give her the green light. This is a totally reasonable 'lets seek an opinion', in my opinions. She has not been excluded sight unseen.

And BMI IS relevant in pregnancy, as the added weight due to baby/placenta/boobs/uterus/circulating volume etc is actually reasonably universal (there might be a variation of a few kg either way, not 20 kg either way).

And all the research into risks and outcomes are done with term BMI.

#18 FeralFP

Posted 29 January 2013 - 02:42 PM

From your OP it sounds like they just need the specialist to sign off on you not being high risk? That seems fair enough to me. If you ARE actually pretty healthy (which sounds to be the case at only size 14, its probably a lot of muslce cos your train giving you a high BMI) then they should say you're right to go.

If the specialist came back and said you are too high risk at size 14 I would be very surprised and then would think that's quite strange. But I can understand the need for someone other than the normal staff to make that call.



#19 Nataliah

Posted 30 January 2013 - 05:54 PM

Sorry I haven't been back to update the thread.  I saw the specialist, all prepared to defend my health and fitness.  It was a total non-issue original.gif  He basically checked my file, blood pressure and tummy, then asked me some questions about how my pregnancy has gone.  He said that he had no reason to think I would have anything but a normal birth.  He said the only real issue in relation to weight (when no other symptoms exist) is that obese people can sometimes react badly to anaesthetic, but that I was clearly not obese and would be fine.

So yeah, PPs were right, it was just a referral to a specialist where common sense prevailed.  This is a touchy subject for me for many reasons, hence my semi-vent.

#20 FeralFP

Posted 30 January 2013 - 06:13 PM

Glad to hear it OP original.gif


#21 Soontobegran

Posted 30 January 2013 - 08:32 PM

Glad it worked out OP but honestly I can not imagine anyone still wearing size 14 clothes being deemed too obese to deliver in any environment........unless of course they were extremely short.
BMI at the beginning of the pregnancy is usually the number focused on unless there is extreme weight gain and there are associated medical issues. Very many women end their pregnancies with a BMI that would deem them high risk and unless the hospital is very low risk there are always exceptions made.

#22 Sancti-mummy

Posted 30 January 2013 - 09:30 PM

I was not weighed in either pregnancy by hospital or obstetrician - and I wasn't size 14 maternity in either case.

#23 MrsLexiK

Posted 30 January 2013 - 09:43 PM

QUOTE (soontobegran @ 30/01/2013, 09:32 PM) <{POST_SNAPBACK}>
Glad it worked out OP but honestly I can not imagine anyone still wearing size 14 clothes being deemed too obese to deliver in any environment........unless of course they were extremely short.
BMI at the beginning of the pregnancy is usually the number focused on unless there is extreme weight gain and there are associated medical issues. Very many women end their pregnancies with a BMI that would deem them high risk and unless the hospital is very low risk there are always exceptions made.


Can you tell my hospital that STBG?

#24 MissingInAction

Posted 30 January 2013 - 09:51 PM

Someone I know was told that if she wanted to give birth at her local (small town) hospital that she'd have to weigh under 100kg otherwise she'd have to be transferred to the closest regional hospital.  She lost the weight in time (seemed strange watching someone get smaller when they were pregnant!) and was able to give birth at her local.

#25 Soontobegran

Posted 30 January 2013 - 09:54 PM

Sent you a PM LexiK



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