BMI and Pregnancy


Dear Midwife,
I am 23 years old and currently 27 weeks pregnant. I was recently called in to see a consultant at my hospital who has strongly advised me that I should have an epidural during labor as my BMI is 44.5 They are saying I am at greater risk of complications so should have an epidural because of this.

The only thing I was sure about my labor was that I really do not want an epidural. What do you suggest I do?


What she is really saying is that you are at greater risk for a cesarean, so you should have the epidural in place. It is true that larger women do have a somewhat higher risk for surgical delivery. Here are some things you can do to prevent that:

The suggestions would be the same for preventing an epidural.

-- Cynthia, CNM. PhD.

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.