Introduction
Water birth has become increasingly popular and for good reason. But time and again, I am hearing clients with a higher BMI having push back due to their size.
Having a high body mass index (BMI) should only be a consideration of your pregnancy, rather than you automatically being told you're high risk because of your weight. Yes, some individuals will have other health complications, that do make them high risk, but that isn't the case for everyone, nor should you be treated that way. Check this blog out below....
Likewise the safety and feasibility of you using a birthing pool may come into question, yet the benefits of using a pool. In this blog post, we'll look at considerations, benefits and potential challenges of water births for folks with a high BMI.
Understanding Water Birth
Water birth is simply the term used for giving birth whilst immersed in water. It's actually a fairly new concept, as historically, and still in many parts of the world, water is/was a luxury. And how wonderful that it's now another tool in our box, of natural pain relief options.
Water can be used in many ways during labour. Birth pools are a popular option and generally the only available option that allows you to be fully immersed. You can use a pool at any stage of labour, though I generally suggest to clients using it later down the line, exploring other tools earlier on, so that once you're in the pool, you can stay there if you'd like (spending many hours in water can cause dehydration and fatigue so generally isn't advisable). Of course the choice is completely yours, and as you know, we have absolutely no way to know how long or fast your birth will be, so when you get in the pool is unto you, you know your body and what you need. Trust your instincts.
The buoyancy of the water can ease muscle tension and offer relief during contractions. This can aid relaxation, which in turn helps to build your birthing hormones, such as oxytocin and endorphins, which as well as helping labour to progress, are your body's natural pain relief. Anything that helps will feeling calm and relaxed in labour, is perfect.
BMI and Water Birth
A high BMI is generally the term used for a BMI of 30 and above. Health professionals will often argue that there are unique factors to consider for using a birth pool with a high BMI. And yes, perhaps there are things to consider, and having a plan for different eventualities will ease anxieties for all, but in no way does this warrant a knee jerk reaction of "no you're too big". I call bullshit.
Sometimes the concern of high blood pressure and wanting that monitored will be raised as a reason to not go in a pool. But actually being relaxed and comfortable in water can actually help with keeping your blood pressure the same and even reducing it. Only your arm is needed to monitor this, so that's easily done in a pool.
Alternatively, water immersion can often cause to lower blood pressure. At times this could mean it dropping a bit too low and you feeling a bit 'funny' or 'faint' and this would be an indication to get out of the pool. Thinking through how you'd get out of the pool in this instance would be sensible, and can often be a consideration for health professionals. So chat with your partner if you have one, or whoever is supporting you in birth (friend, family, doula) about what support they can offer in this instance (are they happy to get in the water with you if needed? Are they able to physically help with getting you out?). Deflating the top ring of the pool (if you're at home) to allow for easier access to get out can be a great option, and is preferable to 'slashing' the pool as I've heard previously advised, as this risks flooding the electric as well as the house.
Have you thought about having more than one person supporting you in your birth? This has to be my top birth tip, having more than one birth partner, Here's my blog post talking more on this
You could be told that it might be harder for you to move around in labour, when actually water aids this, supporting you and allowing you to move around with much more ease.
Benefits of Water Birth with a High BMI
Pain relief: as well as supporting you and helping ease the sensations of contractions, the buoyancy water provides can help ease pressure on joints and muscle tension
Enhanced relaxation: warm water can promote a calm and relaxed environment, relieving stress and anxiety
Improved mobility: water can facilitate movement, making it easier to change position during labour
Reduce Interventions: water births are associated with lower rates of interventions, so this can be a big selling point for choosing one
What about the Tub itself?
Hospitals and birth centres generally have rigid birth pools that look a bit like a hot tub, but without the jets. Each centre will have different equipment, so perhaps having a visit to check out the suitability for you, in terms of it's size and how easy it is to get in and out etc. might be a good option.
Alternatively having a home birth is a great option and will allow you to have a pool of your choosing. WAIT... if the term home birth makes you want to keep scrolling, just hear me out for a moment. Research shows that home birth is just as safe as hospital birth, and many would argue it's safer, as the likelihood of intervention is greatly increased if you're in a hospital setting. Not only does it mean you can birth in an environment familiar to you, it's where you're likely to feel most relaxed, least observed (key for building those shy birth hormones) and more able to tune into your body and intuition (your body knows exactly what to do, yet sometimes our heads get in the way of this. Mindset plays a huge role). The more relaxed you are (we need to be in our rest and digest part of our nervous system to labour effectively), the more smoothly birth tends to go.
If you'd like to explore options for how I can support you with your mindset around birth, go here
You can hire birth pools, buy them new, or buy them second hand (they have a disposable liner that's used so the pool remains like new after use), which often you can find cheaper than the price to hire them, on places like Facebook market place and ebay.
Is Home Birth Really Safe?
Research shows that you are more likely to have medical intervention if you're in a medical setting. It also shows that home birth is just as safe as hospital birth in terms of outcomes and maternal & infant mortality. Go check out the references below for more information on this.
There are loads of home birth Facebook groups and forums out there you can explore. Even if it's just a case of finding out more, and seeing what home birth could look like, it's a great use of your time, however you choose to birth your baby.
Often I am asked, 'what if there aren't enough midwives available to facilitate my home birth when I go into labour?'
Occasionally people are told there aren't enough midwives and that instead you need to go into hospital. Yet, I haven't heard of any instance, where the pregnant person has replied 'I am choosing to give birth at home and won't be going into hospital , so would appreciate you supporting me with this and providing a midwife' and not had a midwife come and support them. Yes, they may have to shift around staffing a little differently to accommodate this, or pay for an agency nurse to come on shift, but you're likely to labour more effectively, more quickly and need a midwife present for a much shorter length of time when in the calm of your home, than you would in a medical setting, so it really isn't such a big inconvenience for them is it?
What If I Am Told I Am Not Allowed A Water Birth?
It's incredibly frustrating when I hear pregnant women/ folks being told that they are 'not allowed' to do or not do something. It's your body, your birth and your baby. You're the best placed person to make these choices for you and it's your right to have a water birth if you choose. Of course in hospital and midwife lead units/ birthing centres, there is a possibility that all the pools are already in use, but if they are available/ you're birthing at home, then you have the right to use them. Have discussions with your midwife and healthcare professionals, and be prepared to put up a bit of a fight if needed. Often people are told "no you can't" and then the conversation shuts down, but I would encourage you to state your wishes and ask how the service can support you. You don't have to ask permission, instead state what you'd like and ask how can it be facilitated by the midwifery team? It may be that you need to raise things with the Head of Nursing and Midwifery if you're getting a lot of push back. It's your body, your birth and your baby. You get to choose. Spending time fighting for the birth of your choosing is time well spent, and getting it out of the way sooner rather than later, means you can then spend the later time in pregnancy relaxing and preparing your mind for the journey of birth.
If you'd like to explore options for how I can support you with your mindset around birth, go here
Conclusion
In conclusion, water birth can be a viable and empowering option for individuals with a high BMI, seeking a natural childbirth experience. By addressing potential challenges and leveraging the benefits of water birth, women /folks with high BMI can explore this gentle birthing tool with confidence and informed decision-making.