A podcast that redefines what it means to be informed in your pregnancy and birth.
This can seem like you are on an overwhelming journey. Breathe. Always come back to the breath. And read on. We are here to help.
In this episode you will learn:
What is BMI
When is it measured in pregnancy?
Recommended weight gain in pregnancy
What complications might occur if someone has a high or low BMI
Does having a BMI change pregnancy and labour management?
[1:37] A listener request from someone who is 15 weeks pregnant and wants to know whether she should be concerned about being overweight in pregnancy.
[2:38] Dr Pat defines BMI or Body Mass Index and how it is an imperfect tool for someone who might be short but isn’t carrying a lot of extra body fat.
[3:32] A BMI is weight in kilograms divided by height in metres, squared. Brigid talks about how there are many BMI calculators online.
[4:02] Most women who are classed as overweight will generally have the same pregnancy management as someone classed as having a normal body weight. Dr Pat talks about what happens for someone with a BMI of 30 and 40+ and how for most women, their pregnancy management needs different considerations.
[4:44] Your BMI should be compared to people in your same genetic backgrounds. For example, Asian population classification of high BMI is lower than the non-Asian population.
[5:25] Dr Pat talks about the special risks that might apply for someone with a 30+ BMI. For example gestational diabetes, and preeclampsia.
[6:20] Dr Pat talks about the difficulties for some women with high BMIs to have Ultrasound surveillance of their baby.
[6:58] Some regional hospitals have BMI limits due to a resources issue where there is not enough specialised equipment or extra surgical training for women with high BMIs.
[7:59] Brigid asks Dr Pat if there are any complications or issues with a newborn if a mother has a high BMI. Dr Pat talks about the difficulty in diagnosing birth defects and how a growth restricted baby can sometimes be undiagnosed.
[10:44] Dr Pat talks about how a care provider needs to ‘throw more’ in to change the level of care. For example, a gestational diabetes test might be done earlier in pregnancy. Surveillance is higher.
[11:49] Obesity brings an increased risk of stillbirth and often an early induction at 38 and 39 weeks is recommended even if there is no other indication.
[13:05] Brigid relays that 45% pregnant women in Australia are overweight or obese.
[13:36] Dr Pat talks about having a low BMI due to body shape, e.g taller or if there is malnutrition or drugs and alcohol. The main complications with someone with a low BMI is perineal tears.
[16:39] Brigid asks Dr Pat if someone with a 30+ BMI can still have a healthy pregnancy and birth.
[18:07] Do we treat someone who is overweight or obese differently? Dr Pat talks about how in labour we need to still be encouraging someone to be active during labouring.
[20:57] Dr Pat talks about how the heavier you are the harder it is for your cervix to dilate. A woman with a high BMI may need more augmentation through syntocinon drip which may impact the baby.
[22:40] How a water bath for low intervention pain management is often not available for someone with high BMI.
[23:37] Dr Pat talks about how difficult an epidural is to do with someone with a BMI over 40+ and how special equipment is needed and why an epidural may not be as effective.
[25:00] Dr Pat talks about when a Caesarean section might be recommended.
[25:59] Dr Pat talks about how a provider talks to women who is recommended to have a Caesarean due to a high BMI.
[27:38] Extra risks for vaginal and Caesarean birth of deep venous thrombosis and pulmonary embolus and how anti-coagulation is often recommended
[28:43] After Caesarean, there is an increased risk of infection in the Caesar wound and how after Caesarean, a woman with a high BMI may stay longer in hospital.
[30:26] Myth or fact: Do pregnant women need to eat for two? 300 extra calories ½ half avocado and toast.
The top 3 mistakes EVERYBODY makes in their pregnancy and WHY they cause you overwhelm you don’t need
Our expert tips to get the best out of your healthcare team to set you up for success
Our 4 step MAMA framework to help reduce the overwhelm
In this class you will learn:
We work and live on Wadawarrung land. We acknowledge the Elders, past present and emerging. We also acknowledge the rich birthing history of aboriginal women and the connection to country that this has been and always will be.
We have 15+ years of running a busy obstetric practice, helping more than 4000 babies to enter this big beautiful world. We live and breathe babies and we are here to help you become MAMA.