They're just making $h1t up now.

Shoulder Dystocia
While perhaps there is an element of scaremongering but there is an element of truth to the claim.
http://www.shoulderdystociainfo.com/anticipated.htm

Is that prepregnancy weight?

The spokesperson said " women were fully aware of the situation from the start of their pregnancy." So that implies that it's 34 BMI at initial visit that is used.
But
"The policy also includes women who have gained 44lb (20kg) in 36 weeks of pregnancy."

Dr Foster on Weston General Hospital, Weston-super-Mare
An 18 bed obstetric unit provides low risk obstetric care within a midwifery led maternity service. Three consultants oversee the service and this unit works in partnership with St Michael's Hospital, Bristol, for higher risk cases.

It's surely better for mothers to know there is no back up at this hospital than being transferred to Bristol while in Labour after things have started to go wrong?

Hmmmm. Obese people do tend to have more complications during surgery. And women who gain a lot of weight during pregnancy do tend to have bigger babies and higher incidents of gestational diabetes. If a hospital isn't equipped to handle these, maybe it would be better to deliver in a high risk setting, though it's hard to believe any hospital wouldn't be able to handle a moderate risk birth.

The most disturbing thing I see about this is taking resources away from women who are genuinely high risk. I did have a genuinely high risk pregnancy, and the waiting times to see my doctor were outrageous -- those doctors were SO busy. Forcing women to see perinatologists who don't have a genuine need strains that already very strained system even further.

I am SO glad I don't live in England. What a crazy place! I would have to go to the hospital in this scenario and that's bullhockey. Shoulder dystocia is a phantom- it's the only thing doctors can think of to punish obese women into c-sections. I had three babies at home in my living room with midwives who had really looked at what the research says (an obese woman with no other risk factors is just as likely to have a safe delivery as a slimmer woman).

Optimizing the outcome of pregnancy in obese women: From pregestational to long-term management
Free full text online

There is a section on Complications and morbidity during delivery

Trouble is there may also be an increased fear of potential risk and that leads to earlier and more drastic interventions that may be necessary.

I had my son in a birthing center (I was normal weight back then). Women were turned away for a number of reasons including any high risk pregnancies/deliveries, multiple births, breech birth, etc.

There were also two huge hospitals in the vicinity - one directly across the street - in the event something should go wrong during a delivery. Easier to transport the mom across the street than 20 miles!

So I guess this is a variant on the question I asked the other day about the public health notices that the obese are more at risk from H1N1? It isn't the obesity, per se, but the possibly accompanying conditions, such as diabetes?

Yes, in my opinion. The research just does not bear it out.

I guess I would have been excluded too! My BMI was far from the limit when I got pregnant, but I did gain over 50 pounds when I was pregnant with my son.

Fortunately no such restrictions, and I was able to have my son at the hospital 5 minutes from my house, where he popped out just a little over an hour after I arrived there. Travelling 20 miles is not necessarily all that far if the roads are good. But if you get stuck in traffic watch out! I could have had my son in the car.

My sister had to have her two youngest in a hospital well over an hour from her home across windy, twisty mountain roads because the only obstetrician who lived, practiced and delivered at the hospital closer was forced out of business because she was only delivering 500 babies a year, and did not make enough money from that to pay her malpractice insurance!

Hey, but chubby me had an quick and easy delivery and a healthy baby, but my two skinny sister both had extreme and serious complications with their first deliveries!

Let's make that an n=3 with Debbie and Janine. I gained at least 20 kg and had fast home birth, no problems at all.

Edited to add - My midwives didn't weigh me at all.

The reality here is that as long as doctors and insurance are both liable for the "anything goes wrong" scenario, it is in their best interests to ensure that anything the insurance companies consider higher risk, or that could later in court be construed as high risk, be dealt with where necessary. Remember that getting someone very heavy into a wheelchair is hard, they might not fit, getting them onto a gurney for an ambulance is hard, they might not fit or might be too heavy, making transport in case of emergency a much worse situation. This isn't really about the detail of health except partly; I suspect it is more about liability.

A BMI of 34 is heavy, but not so heavy that the person can't get in a wheelchair or a gurney. I would also contest that the "high-risk" aspect is more from the forced intervention based exclusively on weight.