If you have a high BMI you may find it difficult to get a water birth agreed. Different NHS trusts may say different things and have varying criteria when making a decision as to whether they’ll permit you to birth in their birthing pool. If you are refused a water birth, it’s important to know you still have options.
Firstly, what are the reasons you may be refused a water birth due to BMI? Well these could be any of the following:
Difficulty manoeuvring the pregnant person
Risk of shoulder dystocia
Difficulty getting access to monitor the fetal heart rate
Emergency situations that may require the labouring person to get out of the pool quickly
High blood pressure and risk of collapsing
Risk of a prolonged labour
If you are told you cannot have a water birth, the first thing to do is write to the head of midwifery at the hospital. State your case, set out the details of your unique pregnancy, and ask for an explanation. Do your research and if you believe their response isn’t fair or sufficient, back it up with evidence. Many of the risks associated with a higher BMI are actually alleviated by water, so it’s worth finding out specifically why they’ve refused and refuting any reasons you believe are unreasonable. Things like high blood pressure, length of labour and positioning are all helped by birthing in the water. Birthing in a pool aides the birthing person by keeping them buoyant and more able to shift position. The water is soothing and relaxing can help lower blood pressure. It’s also shown to shorten the length of labour.
If that results in a dead end, research other hospitals and other NHS trusts to see if there’s an alternative locally to you that WILL permit you to birth in their pool. You can also consider a home birth, as is your right, either supported by NHS midwives, independent midwives, or free birth (without any midwifery support).
If you are declined a water birth, don’t give up and try some of the above. Every person has the right to birth the way they wish, so it’s worth fighting for the kind of birth you want. As with everything it’s really important that you make informed researched decisions and you’ve assessed the pros and cons, risks and benefits of each option.
If you’d like further information about high BMI and birth, I recommend reading the following: