[Nataliah]

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?

[Red nut]

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!

[crackles]

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

[Nataliah]

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

[fooiesmum]

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

[MrsLexiK]

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.

[cinnabubble]

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

[Nataliah]

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

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...

[Lausii]

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?

[~Sorceress~]

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!

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 .

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...