obesity and labor- does it limit choices?

[Oorki Galoorki]

IMs generally wont have any issues with taking women (no matter size)
Hospitals do have issues with big women and can refuse to treat you if they feel you are to big for their equipment and staff.

[*Ali*]

Unfortunatley generally yes your options are more limited- alot of hospital have a cut off limit of weight (I *think* it based on BMI of 39 or above). In the hospital system you are generally counted as high risk, but it doesnt always mean you are limited for your actual birth choices. I was counted as high risk because of my weight for both my pregnancies, but I delievered both babies vaginally, DD was a bit intense because she was distressed and it was a get her out quick situation. But I gave birth to DS on all 4's on the bed with only 2 midwives in attendence, no drama no complications.

I guess the best thing to do is to know what you want, and not let yourself be bullied into having any medical intervention that is not absolutley neccesary

[Mummato2]

It'll depend on the policy of the hospital.

I have a higher BMI, but am not in the obese range - and I was warned by two hospitals that if I got to a particular weight (I think they said 110kgs) that I couldn't deliver there because of concerns re: anesthesia if I needed an emergency procedure or epidural

I was accepted by a local Birthing Centre and approved for HB - but like I said, my weight hasn't hit 100kg and I'm already 34 weeks, so weight was less an issue for me than I thought it would be.....

Independent Midwives probably won't care about your weight, whereas a hospital may.

Wait for your first appointment, raise the question on your first visit so you know what to expect and make choices from there.

[LionsandBears]

This is one reason I'm going with an IM. I have no idea how much weight I'll gain, but with a start of 95kg, I figured I'd probably end up too high for the birth centre.

[Mildez]

I don't think you weight would prevent you having a HB if thats what you wanted. I am sure IMs see women regardless of their weight.

As for limited options with birthing it does depend on your hospital policy. Some hospitals especially the smaller hospitals refer you to larger centres if you BMI is over a certain amount. I only know this as I work at a larger hospital and unfortunately we occassionally deliver women with a larger BMI because their local hospital has transferred them to us because of that reason. Which isn't nice for them as we are 200kms away.

The only other area with women with larger BMI's that can get tricky is inserting an epidural if you choose to want one. Anethetists can have trouble inserting the epidural in effectively or not at all. This however is not common even with women in the larger BMI. I haven't seen an anethetist refuse even in women around the 160kilo mark. I have seen them ask for someone more experienced do it but not flatly refuse to try based on weight.

As for equipment all our equipment is suitable for women up to 180kilos. With the exception of the areoplane who doesn't take women over 100kilos which is ridiculous.

Been obese doesn't automatically count you as been high risk but it will be recorded in your notes as been a complication. It also depends on where the weight lies. Some obese people carry weight all in the top half or the bottom half and this does change how difficult some procedures are or are not. Like inserting an epidural.

[Fleur]

I don't know about regional hospitals, but I had a VBAC in July & my BMI was very high by 41 weeks. Over 40 I think. It was never mentioned as a problem
I would just ask at hospital when you go for your first appt.
Antenatal classes are usually later, sometime in the third trimester, otherwise all that info just falls out of a preggy brain

[Schmickers]

Some smaller hospitals will insist you go to a tertiary hospital with a high BMI.

[~*Niadalla*~]

Hi there!
I have birthed both times at the Bendigo Public hospital, and I fit into the category both times.
I had 2 fantastic, vaginal births with very minimal intervention. I was automatically lumped into the high risk category, which I completely disagreed with. I had no complications at all during either pregnancy. I would be happy to talk more about it with you if you would like, but I donj't know alot about homebirth. I don't think you'd get a great deal of support though which sucks.

xx