I recently saw this photo of me at about term, right before I birthed an almost 10 pound baby. (I was 9 1/2 pounds at birth, her dad was 10lbs 2 oz, and her great-gramma was over 10, so it’s in the genes…)
Anyway, it got me thinking about pregnancy, and weight gain, and how the obesity hysteria that is freaking out moms of even infants (I have heard many, many stories of even breast-feeding mothers being advised by health care professionals to restrict…) is now starting even earlier- pre-conception and pregnancy. All the worry, much of it misplaced, isn’t helping.
There is a lot of talk now about pregnant women and weight gain and childhood obesity. Gain too much weight and your baby will be obese! or have diabetes, or die! Fat already? Well then don’t gain any weight! Think of the children!
Much of the current advice and panic around weight gain and pregnancy appears unfounded and confusing in terms of the science. Doctors are well-documented to suffer from weight-bias, or should I say, their patients suffer. (“Well-rounded Mama” blog has several better-researched thoughts than this on her blog. Here’s one to get you started. Poke around. It’s interesting.) Asking an “obese” mother not to gain any weight during pregnancy has not been shown to improve outcomes, and may worsen them, for the infant and mom. I am all for supporting all mothers with healthy and competent eating, but again, we have to make sure as professionals that we are not making things worse in our attempts to make them better.
I started my pregnancy “normal” weight, and gained about 25 pounds in the first 2-3 months- probably WAY more than I was “supposed to.” I felt sick on and off, ate well for the most part (for a few weeks I would cook a yummy, balanced meal and then ask hubby to bring fries and coke home for me. I didn’t eat fish the entire pregnancy because it did not appeal.) I gained about 5-8 pound for the remaining 6 months. Had I been “obese” to begin with, the same Coke and fries might have elicited concerned lectures, hints at child-engangerment even perhaps.
What I am grateful for is that no one pressured me, or told me my weight gain was too fast, or that I needed to limit what or how much I was eating. I ate based on what was appealing. Some days, the big bowl of cut up melon was what I craved, others it was the fries and coke. Overall I made an effort and did eat balanced meals and snacks, and offered myself plenty of delicious whole foods, but I didn’t make myself eat something that didn’t taste good, or less than what I had appetite for. (see end of this post for discussion of competent eating.) I walked regularly, enjoying that time with my changing body (until premature contractions meant no more walks…)
I worry, that with all things weight-related we are losing our common sense, we are possibly and probably messing things up even more. It’s perfectly OK to help a pregnant mother have access to a variety of foods, to screen her for distorted eating attitudes or behaviors, to discuss barriers to enjoyable physical activity or regular, rewarding meals and to encourage healthful behaviors for all pregnant women. (Interestingly, disordered eating behaviors improve with pregnancy for many, such as purging, but others, perhaps who restrict chronically might also increase some behaviors such as binging as it is the first time they feel “allowed” to eat.)
Oh, and do you think that if I was “obese” and had given birth to an almost 10 pounder that anyone would have believed it was due to anything other than my gluttony and inability to watch my diet, even for the sake of my unborn child!!!
I liked this quote about growth charts in kids, and wonder if it might apply to pregnant women and weight gain as well…
“Growth charts are not intended to be used as a sole diagnostic instrument. Instead, growth charts are tools that contribute to forming an overall clinical impression for the child being measured.” (CDC)
Perhaps a rapid weight gain or loss will be part of the picture, along with inquiring about exercise, eating, genetics, etc.
Do you remember your weight gain pattern in pregnancy? Did you get “the lecture?” What was your experience? Am I off base? (Again, I am not saying, it’s a free-for-all, it’s really a health at every size approach to pregnancy…)