What does having a high BMI in pregnancy mean? Does it make you high risk? Where can I birth with a high BMI?
What is your BMI?
Your body mass index (BMI) is calculated using your hight and weight and the value will be placed into a category:
Under 18.5 - This is described as underweight
Between 18.5 and 24.9 - This is described as being 'healthy range'
Between 25 and 29.9 - This is described as being overweight
Between 30 and 39.9 - This is described as obesity
40 or over - This is described as severe obesity
Source: NHS Inform https://www.nhsinform.scot/healthy-living/food-and-nutrition/healthy-eating-and-weight-management/body-mass-index-bmi/
In pregnancy a high BMI is defined as having a value of 30 and above.
However, BMI is effectively a maths formula developed in 1830 by a Belgian mathematician who said it should never be used as a method of medical assessment.
Furthermore, the origins of the BMI was taken from a small sample size of white men around a similar age - not pregnant females, with different ethnic backgrounds and ages.
Does a high BMI in pregnancy mean you are automatically having a high risk pregnancy?
In short, no.
Having a high BMI in pregnancy isn't as risky as people may lead you to believe. Yes, it may mean there is potential for you to experience certain conditions or outcomes, but there is also lower chances of experiencing other conditions and unwanted outcomes.
According to research conducted by Dr Sara Wickham "most women with a high BMI in pregnancy won't experience any problems and it's also worth knowing that women with a higher BMI have fewer problems and better outcomes if they opt for midwifery-led care in low tech settings"
Where can you birth with a high BMI?
Anywhere you want to birth - having a high BMI does not remove your birth choices and options, this includes birthing on the MLU and access to a water birth.
Having a high BMI doesn't mean you have to do anything at all. This also includes being weighed or any additional tests if it doesn't feel right for you. Declining being weighed should also not become a barrier for you to access the care you want.
I want a water birth. How do I get one with a high BMI?
Mention your want for a water birth to MLU (Midwifery Lead Unit) as early as you possibly can during your pregnancy; "Who do I need to speak to about this?". Don't be put off if they tell you its too soon to be having conversations around birth just yet.
If there are policies around it, ask to speak with the lead midwife
You can request an advocate to attend any meetings when discussing your water birth
Go armed with evidence and do your homework in advance - if you do a hypnobirthing course with Siân at Bloom Hypnobirthing and Wellbeing, she can share a wealth of resources for you to explore and take with you to meetings
Mention how environment is important to birth physiology and improved birth outcomes - all things you will learn with Siân at Bloom Hypnobirthing and Wellbeing - Dr Sara Wickham's website is a good reference point: https://www.sarawickham.com
Still being told you can't have a water birth?
Home birth is always an option if that feels right for you.
Having a home birth will guarentee access to a birth pool - nobody else will be birthing in your home and wanting the pool at the same time! On the MLU and birth centres there is a chance that the birth pools may all be in use, so that is something to keep in mind.
You can hire or buy a birth pool ahead of your birth and your partner can practice putting it up and filling it up prior to birth. You could even use your own bath.
Home births are statisitcally safer as you are less likely to expereience intervnetions and complications as a result. Your birthing environment is safe and familiar too and this is so important for your birthing hormones which will help you birth your baby.
Ultimately, having a high BMI does not make you high risk by default. You still have the same birth rights and choices as someone with a lower BMI when it comes to where and how you can birth your baby and this includes water birth and home birth.
Your pregnancy should be treated as individually as you are. Evaluate your pregnancy, do your homework, have conversations about how you want to birth as early into your pregnancy as you can and always listen to your intuition.
For an in-person detailed hypnobirthing course in Sandbach or Cheshire for you and your birth partner, that prepares you for birth and arms you with knowledge, please contact Siân at Bloom Hypnobirthing and Wellbeing.
Best wishes,
Siân x
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