The real problem

So here I am; pregnant with twins and seeing a midwife who advised me not to put any weight on during my pregnancy (although to be fair that was before she found out there were twins; her advice after that was “take a multivitamin”. I’m still having morning sickness so a day I can eat well is a bonus… dieting isn’t even on my radar).

I’ve been thinking it over (brooding? who, me?) and I think the worst part of it isn’t what she’s advised me to do, but that I now can’t trust anything else she says. Sure, some of it is common sense – eat a good amount of protein, for example – but other parts… well, I lack the medical knowledge to know if I should be worried or not. And that’s the part of the real price of fat prejudice in medical professionals. Not only are we often given bad advice but we lose our trust in the profession altogether, and that’s not good.

Take my blood sugar levels, for example. My non-fasting glucose level was well within the normal range (and interestingly enough, lower than it had been a month before when I’d had bloods done for an unrelated issue). But she was worried about something called the HbA1c, which apparently measures one’s blood sugar level over time. It is within normal, and way below the level that diabetics are recommended to maintain, but she was still concerned and said that pregnancy should have lowered it further and because it hadn’t I was obviously going to develop gestational diabetes. Now, I don’t think I believe her. Looking on Google I see my level is within normal and I can’t find any indication that pregnancy should lower it. But that’s just the rub; I can’t find anything to either prove or disprove her theory. Normally, I would be worried… but her obvious prejudice about weight leads me to suspect her and everything she says.

And that’s the problem with medical professionals who see fat as a health problem. We can’t trust you. And it’s a strong woman who won’t worry when she’s pregnant…

For what it’s worth I’ve decided to not stress over this issue. She’s given me a form to have a fasting glucose test done when my morning sickness is over, and I will wait till then until I begin to worry.

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7 Responses

  1. Pregnancy gave me a respite from my ED. At first I was going to eat all this healthy food and work on my arms so they would be cut by delivery. Then the morning/all day sickness started. I ate what worked for me; bagels, chicken noodle soup and mac and cheese.

    It sounds like your midwife has issues with food. I don’t know if you can change midwives but it would nice if you could find one who is more woman-centered and less “health” centered. Do what feels best for you.

    • What’s particularly funny is that this pregnancy, like the last one, has had an interesting side affect for me: I can’t stand the idea of junk food – it makes me feel ill. She didn’t ask about that, of course 🙂

  2. Just a guess–a lot of measures decrease during pregnancy since your blood volume expands. Expanded blood volume means you look lower in everything else when they stay the same. So 11.8 hemoglobin is low normally but normal in pregnancy. Perhaps that’s why? Can you get a second opinion?

  3. Bingo! You hit the nail on the head.
    “And that’s the problem with medical professionals who see fat as a health problem. We can’t trust you. ”
    This sums up a lot of how mistrusting I am of some doctors.
    Susan

  4. The HbA1c is NOT a reliable measure of anything in pregnancy, certainly not for diagnosing or predicting gestational diabetes.

    And since it measures your average blood sugar (more or less) over about 3 months’ time, and you are not very pregnant at all, it would take quite some time yet before your A1c would be affected much.

    The only thing it’s good for is to establish that you were not truly diabetic before the pregnancy began.

    As for whether it should go down in pregnancy, I have my doubts. Your fastings do tend to go down in pregnancy if you are normoglycemic, but post-meal #s tend to go up a bit even in the normoglycemic. (It’s nature’s way of getting more energy to the baby.) So chances are the two trends would tend to cancel each other out a bit.

    Either way, GD research indicates the the A1c is not an accurate way to diagnose GD, and as long as you are in the normal range, I really wouldn’t worry about it. I think you have unfortunately encountered a midwife that’s got some real issues. Sure you can’t switch to another one locally until you move? You don’t need her negative energy.

    BTW, if you have questions about GD, I have tons of info about it on my Plus-Size Pregnancy Website. Some of it’s a bit older but it’s mostly still good.

    • Thanks for the reassurance! I was sort of set to ignore her – I felt that while the readings were in the normal range all was fine – but there’s always that niggling doubt.

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