High BMI and epidural ??

[firstangel]

When i was in hospital today the anethesitic ( sorry I cant spell ! ) guy came to see me , I had said I do not want an epidural, but he has tried everything to talk me into one.

He said the following

High BMI patients have a harder Labour

High BMI patients have more chance of having a emergency C Section

High BMI patients have more chance of assisted birth ( forcept etc )

He did say its harder for him to do an epidural on me cause of back fat ! nice !

He was bice about it all has he has a high BMI as well !

He didnt get on at me about my weight at all, just really wants me to have an epidural !!

I really really dont want one if I can help it !!

any advise? anyone had any experiance of this?

Thanx guys

 

[SpaceAngel]

My BMI is about 39 and I have had a normal first labour (only needed paracetemol) and the 2nd was normal but I had an epidural because the contractions were going mental and my BP was high and the 3rd I had an emergency C-Section because the cord dropped down (nothing to do with my size!!)

DO NOT let any Dr bully you into having something you don't want and if your not happy with his attitude, ask to be treated by a more open minded Dr! Flaming disgrace he spoke to you like that. I am getting sick and tired of the medical profession having a go at larger people. I am perfectly healthy and I am loosing weight at the moment but only because Primark has opened in our town and I want to be able to shop there

 

[firstangel]

My BMI is about 39 and I have had a normal first labour (only needed paracetemol) and the 2nd was normal but I had an epidural because the contractions were going mental and my BP was high and the 3rd I had an emergency C-Section because the cord dropped down (nothing to do with my size!!)

DO NOT let any Dr bully you into having something you don't want and if your not happy with his attitude, ask to be treated by a more open minded Dr! Flaming disgrace he spoke to you like that. I am getting sick and tired of the medical profession having a go at larger people. I am perfectly healthy and I am loosing weight at the moment but only because Primark has opened in our town and I want to be able to shop there

Thanks ! he was very nice about it all really just said these were facts, but I fell im perfectly healthy ! and my BMI is about the same as yours, and I really feel I should try with out one and see how I get on !!

he did say he wasnt trying to force me to have one, just telling me the facts ! but he did sound like he was saying this is best for you ! we will see what happens.

Thanx again

 

[chezzabell]

i had epdiural in 1st labour cos id been in labour for 30 hrs, no one said anything then. with my 2nd i had planned section so only had spinal and my weight was never mentioned

i hate it when docs say things like that, as if people with high BMI dont know already they have to make it worse by rubbing it in

 

[SpaceAngel]

I know it sounds a bit odd but I just had a feel where the epidural would go on my back and I think its one of the only places that I don't actually have back fat Your spine is boney ffs!!

I think they are probably just trying to cover themselves tbh huni. Do what you want to do and you may end up begging for one

 

[pickled_onion]

Grrr. You decide for yourself. Please don't let doctors push you into anything you are uncomfy with.

I have a high BMI too and as it stands, I'm set to have a homebirth. I think it's important to be aware that once you start down a certain path you can end up with yet more intervention. Say, for example, you have an epidural, you then have to lie down on your back. You'll be confined to a bed and you can't move around/have an active birth. Lying on your back is the hardest position to try and deliver in. When a woman is asked to adopt the birthing position that feels right for her, she hardly ever chooses to lie down. Anatomically, there's good reason for that. So you're lying down and finding it hard, the likelihood that you'll require an assisted delivery or a section then increases

Plenty of larger ladies give birth naturally and with no complications, if given a chance to that is!

I say go with your gut. You know your own body

 

[carlyr874]

I had exactly the same thing when I had an apt with the aneathetist at about 30 weeks - he was very nice but just didn't get that I didn't want an epidural. He kept saying that it served 2 purposes, it is for your pain relief and in case you have to have a c section - I was like 'Yes I know what an epidural does - but I just dojn't want one!!!' I have a high BMI and am also attempting a VBAC as had emergency section with my first baby but my midwife said it's a loads of rubbish, you do not have to have an epidural just cus of a high BMI and also my consultant agreed with me and said it was actually very lazy on the part of the aneasthetist to insist on an early epidural.

I actually know another lady with a much higher BMI than mine who saw a different aneathetist at the same hospital and they said nothing like that to her! Didn't even mention having to have an epidural at all! SO I think it can depend on the views of the particular person.

Sorry I seem to be going a bit here - but if you don't want one please write it on your birth plan - I have in big bold letters that 'i do not want an epidural!!!

 

[kadesmummy]

I have a BMI of 42 () and have had 2 standard vaginal deliveries with no interventions, no epidurals etc.

Make your own choice , good luck.

 

[firstangel]

Thanks guys for all your replies ! thats helped me think about it more and I spoke to the midwife today too about it all, she said even though my BMI is high doesnt mean I cant have a normal labour, as I may be overweight but im fit, healthy and have no problems !!!

Well I am not going to be forced into it ! and the midwife was disgusted when i told her today what he said !

I want an active labour and I do not want to give birth lying down ! I def do not want an epidural unless I have too !

She has written in my notes that I had a car crash a few years ago and I should not be sitting or lying on my tailbone for extended periods of time ! which is good, as after my car accident it took years for my tail bone and back not to be sore ! and dont want it going back the way it was !!!

So hopefully sorted !!

 

[lem89]

I've had this problem as well, an "anaesthetic review" with the consultant, after already being refused a waterbirth as id wanted because my bmi was 1 point higher than they deemed "safe"....i talked to my midwife about this (who works for another hospital) and she went off her head, seems theyre doing it to cover their own backs incase anything goes wrong.... i also got told that i may be kept bed bound and told which positions to get into incase i couldnt "open my legs wide enough to deliver because of excess fat layers", my reply? stuff off!! Don't let them recommend anything for you, it's a joke!

 

[serenitylove]

im only early on but have already requested my epidural i had one with my first and due to other reasons than my weight i was over 21st then i had an emergancy csection and to this day the speed which i was whisked into theatre and deliverd amazes me and im so scared it will happen again i want the epidural in ready although i will be trying for a vback this time round good luck to you hope you get the birth you want

 

[Pudds86]

stick to your guns girl! My BMI is high and I am worried about being forced into a delivery I dont want. I am determined to do it the way I want to do it. If you trust your body fully there will be no problems xx

 

[evajo]

Grrr. You decide for yourself. Please don't let doctors push you into anything you are uncomfy with.

I have a high BMI too and as it stands, I'm set to have a homebirth. I think it's important to be aware that once you start down a certain path you can end up with yet more intervention. Say, for example, you have an epidural, you then have to lie down on your back. You'll be confined to a bed and you can't move around/have an active birth. Lying on your back is the hardest position to try and deliver in. When a woman is asked to adopt the birthing position that feels right for her, she hardly ever chooses to lie down. Anatomically, there's good reason for that. So you're lying down and finding it hard, the likelihood that you'll require an assisted delivery or a section then increases

Plenty of larger ladies give birth naturally and with no complications, if given a chance to that is!

I say go with your gut. You know your own body

I have a BMI of 31 and really want a homebirth - this is my third and had one planned with last but ended up in hospital as they didn't have enough mw's, but i wasn't over weight. Just wondering if you had any opposition at wanting a homebirth because of your BMI? Only occured to me the other day that they may be against it because of my weight, although i have had three un complicated births before?

First angel i would say deffo stick to your guns - your more likely to have probs with epidural as you can't move about and it can make labour longer especially with first x

 

[titch]

I've had this problem as well, an "anaesthetic review" with the consultant, after already being refused a waterbirth as id wanted because my bmi was 1 point higher than they deemed "safe"....i talked to my midwife about this (who works for another hospital) and she went off her head, seems theyre doing it to cover their own backs incase anything goes wrong.... i also got told that i may be kept bed bound and told which positions to get into incase i couldnt "open my legs wide enough to deliver because of excess fat layers", my reply? stuff off!! Don't let them recommend anything for you, it's a joke!

urgh I get so sick of the bloody BMI thing. They gave me leaflets with lists of things which can go wrong for overweight women who are pregnant. My BMI is 30. I got so paranoid about it, I honestly thought I was going to be a terrible parents because Im overweight, and Ive struggled with my weight since puberty, Strangely, now that Im pregnant Im losing body fat but maintaining my normal weight, presumably due to little bump forming, without even trying, Im eating junk Id never normally eat thanks to sugar cravings!

I got really upset about the birth pool thing when i read it, Im 22 weeks so havent had the chance to ask yet but I have my heart set on a water birth, and I cant seem to find a good reason why someone with a high BMI would be at more risk in water?!

Do you mind if I ask what the BMI cut off for your hospital was?

 

[evajo]

Things have really changed with this BMI thing - when i had my first 3 nothing was mentioned (although i was not over weight but not slim either) but this time i was told i had to go to 2 healthy eating groups and if i didn't i would have to see a consultant. I wouldn't mind but i know i'm over weight and like you said have always struggled but its hard to get to the gym with three children and when i did and lost all my weight i was absolutely exhausted and getting ill all the time from staying up so late tring to get things done. WISH THEY WOULD GIVE US A BREAK.

 

[Rosie's Mummy]

It makes me mad how they never ever tell you how an epidural can lead to more intervention - it can give you a temperature which is what happened to me resulting in an emergency C-section. I wish they would give women the choice of their own birth - I notice how it was a man anaesthetist, not a midwife or consultant..good luck in whatever you choose to do

 

[PippaJ]

My BMI was high when I was carrying Evie (30). I was under normal MW home care, had a normal labour, a normal vaginal birth without intervention and was not pushed into having an epi.

You do what you feel is right for you, there is no reason why you can't have a normal and natural birth if you choose to, as long as there are no issues with you or baby and I can't see why you'd need to have an epi just because your BMI is high?? x

 

[lem89]

-I got really upset about the birth pool thing when i read it, Im 22 weeks so havent had the chance to ask yet but I have my heart set on a water birth, and I cant seem to find a good reason why someone with a high BMI would be at more risk in water?!

Do you mind if I ask what the BMI cut off for your hospital was?[/QUOTE]



I also had my heart set on this so i seriously hope you arent put in the same place i am....i movedpart way through my pregnancy from one PCT to another, orignally my bmi was 39, and when i moved tothe other PCT a consultant requestes my bmi be checked again....bear in mind this was 3 months on so weight had gone on! my bmi was now 41.... he said any less than 40 should have been ok but now i was classed as "high risk", i had to go and have a crisis chat with my MW because of this as the guy wouldnt explain what this meant! she seemed to think that he meant high risk of needing assistance at some point and the MW's on duty at my labour wouldnt be able to help me out of the pool if i needed it.....sheer cheek i think, im still having a fit over this, as all the MW's ive seen through my pregnancy have told me it should be no issue.
Have the chat early on and see what they say, i really hope you get the birth you choose let me know how you get on xx

 

[titch]

-I got really upset about the birth pool thing when i read it, Im 22 weeks so havent had the chance to ask yet but I have my heart set on a water birth, and I cant seem to find a good reason why someone with a high BMI would be at more risk in water?!

Do you mind if I ask what the BMI cut off for your hospital was?

I also had my heart set on this so i seriously hope you arent put in the same place i am....i movedpart way through my pregnancy from one PCT to another, orignally my bmi was 39, and when i moved tothe other PCT a consultant requestes my bmi be checked again....bear in mind this was 3 months on so weight had gone on! my bmi was now 41.... he said any less than 40 should have been ok but now i was classed as "high risk", i had to go and have a crisis chat with my MW because of this as the guy wouldnt explain what this meant! she seemed to think that he meant high risk of needing assistance at some point and the MW's on duty at my labour wouldnt be able to help me out of the pool if i needed it.....sheer cheek i think, im still having a fit over this, as all the MW's ive seen through my pregnancy have told me it should be no issue.
Have the chat early on and see what they say, i really hope you get the birth you choose let me know how you get on xx[/QUOTE]


Ahh thanks for this info! I actually lost weight after my first 'weigh in' so my BMI should be changed to 29, which is a whole category different, but they wouldnt change it from 30 cos aparently they dont change it! I was furious,a nd its ridiculous that it doesnt work the other way, of COURSE you'll gain weight while pregnant!!

Are you still battling this then? I did a lot of research last night, got sucked into googling for hours! But basically there are 4 reasons put forward for why they exclude whole categories of women using the birthing pools;

1) High BMI mothers are more likey to have high blood pressure and therefore have some kind of haemorrhage and require resucitation during labour. Now, if you're like me, my blood pressure is well within normal range, so actually this has nothing to do with BMI and everything to do with blood pressure. Converesly you can have high blood pressure and low BMI

2) High BMI mothers are more likely to have a larger baby and therefore require forceps or other assistance incase baby gets stuck. This is hard to do in the pool. Larger babies are associated with gestational diabetes with high BMI women are more likely to have BUT I had a glucose tollerance test which showed that Im not even nearly diabetic and my little one is measuring small on scans (but within 'normal' limits)

3) High BMI mothers are more likely to end up having caesarian births. A lot people on the web attribute this not to the actual weight but the fact that intervention such as eppidural is practically forced on women and they are more restricted in their birth options (i.e. use of pool!) and therefore get on the viscous cycle of interventions and end up having birth problems because of this.

4) in the unlikley event that a woman crashed (less than 0.5% likely aparently) medical staff have to be able to get the woman out of the pool for resucitation. If a woman is heavy its harder to manhandle someone out of water in time to save them. I think that in some way this is fair enough but it should not be based on BMI but a weight limit. My BMI is 30 (or 29) but Im 5ft 1. If I were 6ft tall and weighed the same, they would not even consider restricting me. But it would be the same amount on strain in terms of manual handling.

So..Ive prepared my arguement as you can see. Actually if they try and throw evidence base at you, there really isnt one, and the only new evidence emerging seems to suggest that birthing pools are MORE beneficial to women with higher BMI because it allows you more flexibility to get into a suitable position, lowers blood pressure, and reduces risk of needing any kind of assistance in birth.

Some birthing centres now do not restrict any woman based on BMI category. Each woman is individually assessed. They only ask that you can get yoursef in and out of the pool without assistance (which to be frank is quite an ask for any full term pregnant woman!)

Sorry that was such a long essay but like I said, I spent hours preparing my evidence! Im prepared for a fight and I hope that everyone on here get the safest birth but also the birth THEY choose.