Pregnant? Great! Just don’t gain weight

My midwife is an idiot.

Yeah, I know that sounds a bit strong, and OK, she is a professional, a very nice lady, and gave me some good advice to boot. But stuck in amongst it was an obsession with my blood sugar levels (which had tested *normal* btw) and my size.

Bugger.

I was hoping that I would be able to avoid all the fat prejudice bullcrap this time but it was not to be. She offered to refer me to a dietician not once but twice. I refused both times of course – honestly, I’ve done enough diets and read enough diet-related crud in my life that I’m pretty sure I could give them a run for their money. But then she pulled out the big guns and asked me my weight. I told her, as far as I know (haven’t weighed myself in over a year, but have been relatively steady until I got pregnant) and she replied that I really should aim to put on no more weight during my pregnancy. She said she wasn’t sure how to achieve that, but people she’d spoken to suggested the way to go was to eat well but just a little bit less than normal.

I mean, what the hell?? The developing fetus (or fetuses, have to have the scan to find out) needs nutrition. What it can’t/doesn’t get from my bloodstream and what I’ve ingested it will ‘steal’ from my body. And pregnancy weight gain is pretty much all baby and other body stuff (like extra blood, etc) it’s not usually fat. And even if it was… isn’t this the time to be nurturing my body, not depriving it? It’s building another person in there!

And the real kicker? She said this to me, even though I’m only 8 weeks along. Hell, I’m still in the throes of morning sickness and here I am being told to diet. Unbelievable.  I didn’t say too much in response – I woke up this morning sans my voice, so talking was difficult anyway! – but I did let her know I was happy with the way I was currently eating.

But there is no point in changing her; we have plans to move to another city in a few months and so I will probably only see her once or maybe twice before I shift and have to find a new midwife anyway. But in the meantime, boy she will have a fight on her hands if she brings up the issue of diet again!

And man – I’m disappointed.

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22 Responses

  1. OMG that is horrendous. There is a blog on the feed called wellroundedmama (or something like that) that you might find helpful. She talks alot about pregnancy and birth related issues. I went through this same crap when I was pregnant with my daughter 3 years ago. Hang in there.

  2. Ugh, I *knew* the “don’t gain weight cuz ur OMGFAT!” was going to come up. It’s ridiculous, and logically fallacious. If you *weren’t* pregnant, you’d be expected to eat like “normal,” but now that you’re, I dunno, nurturing another LIFE you should be eating “a little less than normal”??!!!

    Sorry, this really, really ticks me off. I mean, it’s not only harmful to you and your baby, it’s damned irrational! I mean, this obesity epi-panic Kool-Aid is dangerous stuff. It makes you drunk AND stupid.

    Just do what YOU know you need to do for yourself and your baby. I’m sorry you didn’t get the support you need and deserve (and are paying for with your taxes!). It’s completely, completely unfair, and utterly infuriating.

  3. Heh, when I was borderline for GD my OB sent me to a nutritionist who was an idiot. Borderline GD? Eat lots of carbs! They’re good for you! Make sure you get plenty of fruit! It’s good for you! Don’t eat too much protein or fat, it’s bad for you!

    Yeah.

    So when I told my OB this she whipped out of piece of paper and growled ‘what’s her name?’. And then she was all, ‘Don’t follow her advice, eat plenty of protein and veggies with some fruit.’ Hee!

  4. It’s sad that medical professionals bring personal as well as professional anti-fat bias to their work. I would add another recommendation for Well Rounded Mama. The author also maintains the Plus-Size Pregnancy website – do take a look (http://www.plus-size-pregnancy.org/). It’s full of good information, including advice on choosing providers.

    Since you’re moving and choosing a new provider, this is a good opportunity to think about how you’ll find a good one. When I was making choices for my two pregnancies, I asked prospective midwives (both hospital-based nurse-midwives and homebirth midwives – a U.S. distinction) whether they had had many patients my size before, and whether they had any specific recommendations based on that. That worked very well, and I received excellent care. FWIW, I’ve found homebirth midwives to be less fixated on weighing patients (I chose not to be weighed my second time around), testing for gestational diabetes (didn’t do it!), and in general just emphasizing nutrition, understanding what my body was doing, and emotional preparedness. I had a strong idea how I wanted to do things, so that helped.

    If I had to recommend one book, it would be Henci Goer’s A Thinking Woman’s Guide to a Better Birth. Best of luck to you! I hope your morning sickness resolves very, very soon.

  5. Been there, done that. Except my doctor told me I could gain 9 pounds. I’m expecting my third child in April and my two previous babies were 9 pound babies. So basically, I’m not supposed to gain any weight from increased fluid, placenta size..just gain a baby. Um. Okay. Fine. I feel your pain.

  6. I’m appalled by the current trend of telling women over a certain BMI that they shouldn’t gain weight while pregnant. Hello, you’re growing a whole new person in there who will risk terrible life-long problems if not properly nourished in utero!

    And as you point out, most pregnancy weight gain is directly related to the growing fetus and the support system necessary for its healthy gestation. It’s not fat. It’s a baby.

    Besides, there are few crueler things allowed in our society today than telling a woman with morning sickness that she needs to go on a diet.

  7. What a load of crap. I read that suggestion recently in the news (guidelines on how much weight women “should” gain during pregnancy). Yeah, that’s the key to healthy children: starve them. Brilliant.

    Oh well, at least she won’t be your midwife forever.

    Good luck!

    Peace,
    Shannon

  8. The hell? Everyone’s been tutting at me for my BMI (21 weeks and several frustrating appointments along), but they’ve all also told me specifically not to try dieting when I’m pregnant. Your midwife gives lousy advice.

  9. Sad. Possibly atypical. My midwives were from a waterbirth center and I was the only one who was concerned about my weight. They didn’t even weigh me there. I was vexed about weight so I weighed myself at home. I was gaining weight at the rate of about 10 lbs a month initially and was worried I’d gain 100 pounds before the baby was born. My midwives told me to forget about the weight gain and just focus on getting enough nutrition. One of them (a slender woman, maybe a size 6) told me she’d gained 90 pounds with her pregnancy, and she lost all of it over the next year or two – not by dieting, but just by eating healthy and normally. Her body gradually returned to its comfortable weight. I ended up gaining 75 pounds and I had a chunky, 9lb baby who was very healthy!

    There is this big focus among many about weight gain during pregnancy – keeping it under 25 pounds and such. I don’t know where this came from. I did meet a woman training to be a midwife when I was pregnant who went off about women gaining “too much” weight when pregnant, then having a net gain of 25 pounds, and getting pregnant again, and after three kids they’re “obese.” This woman was maybe a size 2. I remember listening to her talk and feeling like a huge slob. She wasn’t MY midwife, thank goodness.

    I guess my point is: stick with finding someone who is truly concerned about the health of your baby and you. Don’t pay someone money to disrespect you. There are plenty of good midwives out there.

    • I think it may be atypical; certainly I didn’t encounter this last time, when I was roughly the same size I am now.

  10. I was told that when I was pregnant with my second and my BMI was in the normal range. What was I suppose to be underweight after I lost the weight of the baby, extra fluid, placenta extra. I didn’t listen and gained as much as I could which was only 22 pounds. I lost far more without dieting after having my baby.

  11. Sorry about that. I’ve had some similar experiences. I went for my 36 week visit today, and my doctor told me that I should be proud of myself for being the same weight now as when I started the pregnancy.

    Yep. I’m really proud of myself for having awful morning sickness for 16 weeks and losing 9 pounds. I’m even more proud of myself for eating whatever the heck I wanted after the morning sickness was over.

    • You should be proud of yourself! I believe pregnancy is definately a time to nurture ourselves, as well as our babies.

      • I actually am somewhat proud of myself for the eating whatever I want thing. I had just started on the HAES bandwagon right before I found out that I was pregnant. Good timing!

  12. Her reaction is based on the new US guidelines on wt gain for pregnancy and a lot of recent studies obsessing about wt gain for pregnant women of size. Lots of posts on my blog about this whole topic and more to come to boot. You can read up on them to get the gist of my concerns.

    Alas, I only have a moment before I have to rush off but wanted to send a hug of sympathy to you and to let you know that the new guidelines are why this midwife is saying this.

    And really, they could have been worse; I was girding for the possibility that they might recommend that “morbidly obese” women actually LOSE weight during pregnancy, which some docs have been pushing. They didn’t go that far, just suggested no gain outside of baby/placenta/ etc., and maaaaybe no gain at all.

    Good nutrition and regular exercise DO help prevent a lot of problems in pregnancy, but that doesn’t mean starve yourself so you don’t gain weight. Duh.

    I’m glad you are sensible enough to know not to freak out about this and to take her advice with a grain of salt. And glad you will be getting a new midwife when you move! Email me sometime via my website and tell me where you are going; maybe I can contact my midwife friend in NZ (herself a woman of size who totally gets it) and she can recommend someone in your new area.

    • Thanks, I will.

      I have no problem with nutritional advice; in fact she did give me some good tips about how to maximise my nutrients while minimising my morning sickness. But to not gain at all? Unbelievable.

  13. Ugh, I wish I could send you my nurses and doctors. They haven’t mentioned my weight once except to let me know my weight gain is within normal parameters. They have gowns that are too big for my size 22 self. They are a lot more concerned with whether the baby (I’m 20 weeks pregnant) and I are healthy and doing well than with anything else.

  14. I want to know: Has it actually ever happened for a fat woman to get pregnant, diet during her pregnancy, give birth to a healthy (i.e. not malnourished) baby, and wind up thin because the baby just ate all her fat? You’d think this was a common occurrence, the way this advice is shoveled out to so many fat pregnant women. But it’s dangerous. The midwife could very well be sued for malpractice if someone follows her advice and has a kid who’s low birth weight. And seriously, telling someone to diet when she can hardly keep anything down in the first place? The hell?

  15. I had a kid of low birth weight before that wonderful advice, not to gain weight. I asked how much I should gain during my second pregnancy to prevent that from happening the second time around. I was barely overweight if we use today’s standard for BMI and I wasn’t overweight by using the standard of that day when I was told to harm my second baby the way that I did harm my first. Of course, I did my best to gain weight as I mention in a previous post.

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