How important is your weight when planning a VBAC?

[justKate]

So I know it matters.  And I know that the "healthier" I am, the better my chances are for a (someday) VBAC.  I'm not pg now, but working towards getting everything lined up so that I'm ready when the time comes.

So I'm 5'6'', 153 lbs. on an average day.  That makes my BMI 24.7, which is or is bordering on "overweight."  I know that overweight people can be healthy and normal-weight people can be unhealthy, but how much is it going to impact my VBAC chances in the future?

I know I can lose 5-8 lbs., but realistically I'm not sure that I can get back down to the 140 that I was pre-DD.  How important is it?

[lawmama1984]

I think just focusing on being healthy is the most important thing, personally. As I'm sure you know, BMI is often a poor predictor of true good health. It doesn't take into account people with denser bones, a lot of muscle mass, etc etc.  I, personally, would be underweight at a so called "healthy" BMI.  But I did personally lose about 50 pounds before going for my VBAC--I was much larger than you are :) and, for me, my BP is directly related to my weight. When I have too much weight on, my BP is too high, but when my weight is a healthy range for me (which isn't the same as a "normal" BMI), my pressures are good.

I think some CPs do focus on numbers with a VBAC, but my MWs focused much more on the overall picture of my health, which was good.  So, I would say the exact number really isn't that important as long as you are healthy (and as long as your CP doesn't bring it up as an issue).

PS I see you are in Austin...so am I :)

[Monkey Keeper]

I'm 5'6" and was 148lb at my 6w prenatal with DS.  My weight was never mentioned. :)

[AlexisT]

I have a BMI of 35 and my OB has never brought it up in relation to VBAC. It does put me at risk of increased complications before labor (pre-e and GDM) but IMO that's really a non-factor in my decision; if I get sick and need to be delivered early, that will be true regardless of how I planned to deliver initially, and the problems with early delivery would also still be true if I had a BMI of 22.

The only real factor with weight is the increased difficulty of performing surgery and that comes into play at a much higher BMI than 25. The studies on surgery in morbidly obese patients often look at BMIs of 45+.

[akind1]

No idea what my BMI is (and don't care; as a PP said, it really is a poor indicator of health) - that said I know I am quite overweight by most standards. For my son, weight was never brought up at all with the CNM's, I gained a reasonable 25 lbs with that pregnancy.

For this one, only the fact that I had not gained any weight since seeing them (8 weeks through 17 weeks) was mentioned by the nurse, but the OB said she was not at all concerned. Honestly, I am not either. While weight can play into having complications like pre-e and GD; Nearly everyone I know that has had either or both complications was a healthy weight (even BMI) prior to pregnancy. So healthy weight is no guarantee of lack of complications or early delivery. (FWIW, I had no complications at all with my first pregnancy, still ended up with a c-section due to a failed induction - which I now believe largely failed due to malpositioning of DS)

Do try to be healthier in habit, it will be far easier to continue those habits during pregnancy if you start now. Don't focus so much on your weight.

[justKate]

Thanks for the reassurance.  I know this stuff, in my mind, but its sort of hard to internalize emotionally when I'm wanting "optimal conditions."   

I ended up gaining 45+ lbs with DD (all at the end, when I got lazy about my diet), and I think I'll need to be more aware of that next time around.

[lawmama1984]

Kate, are you involved with our local ICAN group at all? It is a really great group. We have monthly meetings and a Yahoo group. PM me if you want more info :)

[justKate]

No, we're actually moving to VA in 2 weeks, so I haven't done much here in TX.  I've met the ICAN leader there, and am hoping to get involved once we're settled.  But thanks for thinking of me!

[roadfamily6now]

Your weight really has little bearing on your ability to have a vaginal birth.

I WISH I was only 24BMI!

I have been very over weight with all my VBACs. As long as your care provider has no issues with large/fat/over weight people your chances to have a VBAC are great!

[lawmama1984]

Well, I'm sorry we'll miss you, but I hope you have fun out there with them in VA :)