Max BMI for OB patients in rural setting

Work at a rural hospital with limited resources (currently one midwife on staff, only locums obgyns, no pediatrician on staff but occasionally one will come but with no reliability). A facility that was larger and did higher risk patients recently closed and we are the nearest birthing center so we are getting more and more of their patients. In addition our OR call team is limited to one tech who also acts as the assist which makes call back csections difficult on even normal size patients. Have had BMI of >60 a couple of times recently that I have asked to be transferred out due to these limited resources.

I would like to set up a policy with clear guidelines, but unfortunately I have come up with vague guidelines at best (on purpose I’m sure). Even ACOG says that obesity may be one of the factors that affects decisions to transfer there are no cut off levels. I’ve gone through published literature and professional organizations. Personally I think pre pregnancy bmi greater than 50 or a bmi of greater than 55 at any point during pregnancy should be transferred unless unstable. Any literature/guidelines that I’m missing that I could use?