My Theories about Pregnancy Weight Gain

Drawing by http://www.davidcollinsartist.com/
Drawing by http://www.davidcollinsartist.com/

This morning, I struggled while sorting through my yoga clothes in preparation for class tonight. I am just beginning the second trimester of this pregnancy and am therefore at the awkward point of not fitting most of my normal clothes while still being too small for maternity wear. So I find myself ferreting out the comfier sweatpants and relaxed shirts in my wardrobe that will tide me over until the inevitable belly and backside explosions that will land me squarely in Maternity Town.

For all the women beginning a pregnancy for the first time, I have a couple suggestions. First, I wouldn’t buy all of your maternity gear upfront. Unlike in the movies, where pretend pregnant actresses look perfectly normal except for a perfect little round belly, real-life pregnancies expand your body in unique and unpredictable ways. My feet, for example, grew TWO SIZES larger for the duration of the pregnancy (luckily, they shrank back to normal afterwards, so don’t freak if this happens to you).

My other suggestion is that unless you have an exorbitant clothes budget, it’s good to raid second-hand stores and sales for cute maternity clothes. It could be my thrifty Scottish genes talking, but it doesn’t make sense to spend a fortune on stuff you are only going to use for a few months. Save your money for good maternity bras and swaddling cloths.

But I digress. My expanding body puts me in mind of all the pregnancy weight-gain terror I experienced the first time around, and I would like to share my experiences in case they are helpful to any other pregnant moms currently living in horror of the scale…

There is a lot of pressure on expecting mothers, to say the least. One day, you’re able to throw back pints with your girlfriends after work, dance till the wee hours of the morning, then chow down on cheap burritos in the middle of the night before collapsing into bed and waking up to an IV of coffee. The next, you see double lines on a stick and suddenly you can’t party with your buddies, stay up late, or drink too much caffeine. But it doesn’t stop there… you also can’t have lunch meat, soft cheeses, rare steak, sushi, shellfish, swordfish, or tuna. You feel a variety of bodily aches and pains, but aren’t allowed to take any Advil, aspirin, Motrin, ibuprofen, or Sudafed to relieve them. You can’t ride roller-coasters or enjoy a sauna or spa. Some people even think you shouldn’t dye your hair, take a bath that’s too warm, or eat nuts (allegedly, you put the fetus at risk for nut allergies). You are allowed to have a couple cups of coffee a day, but be prepared for some dirty stares from the self-appointed Preggie Police if you’re visibly pregnant at Starbucks.

As if all of that isn’t enough, you are further bombarded with admonitions against gaining too much weight. A healthy woman, the experts claim, should only gain 25 – 35 pounds. An overweight woman is supposed to gain even less. Anything more than that puts you and your baby at risk for a host of issues, ranging from gestational diabetes to high blood pressure, as well as apparently demonstrating your utter lack of self-discipline and the obvious milking of your pregnant state for an excuse to eat comical proportions of cartoonish food. Random self-important idiots will display their genius by pointing out that since the baby only weighs eight pounds, you don’t need to be gaining any more than that. Textbooks will explain you shouldn’t need ANY extra calories in the first trimester, and a mere couple hundred more during the second. You will hear all of this while at the same time learning about your greater nutritional needs and how this is a wildly inappropriate time to diet.

All of this madness really did my head in during my first pregnancy. I do not come from a family blessed with naturally high metabolisms. Any sloppiness in my lifestyle starts to quickly show up on the scale, and though I have kept myself at a healthy weight for the majority of my life, it is only because of regular exercise and constant dietary vigilance. Whenever my weight begins to creep up to a certain level, I start recording my intake and wrestling the numbers back into submission. I even purposefully wear clothes without much extra slack lest my weight increase too much before I notice.

So I was downright frightened every morning of my pregnancy as I stepped on the scale and watched the numbers inch up, week by week, until they began outpacing the approved schedule. Moreover, though we supposedly need no extra calories, it was obvious that no one had let my body in on this factoid, for I felt an appetite unlike one I had ever experienced in my life. I would suddenly *need* milk, like one normally needs oxygen. One time, my husband casually grabbed food off my plate, which would be a typical thing for him to do, but before I even knew what I was doing, I had nearly stabbed his hand with my fork to protect the precious, precious calories he was usurping. “My goodness… I’m so sorry,” I said, “I don’t know what just came over me!”

Well, that’s not exactly what I said. It was actually something more along the lines of: “WHAT THE HELL ARE YOU DOING!? GIMME THAT,” shrieked fiercely as my wide-eyed husband dropped the tasty morsel and offered to bring the ravenous she-beast whatever she needed. Not only was I hungrier than I ever imagined I could be, but if I went too long without food, i would become increasingly nauseous, light-headed, until eventually throwing up. I tried my best to snack on light cheese sticks, or a handful of nuts, a couple crackers, or any other modest portion of light food. I rarely ate full-on crap, like cheeseburgers or brownies, yet still my weight crept up and up and I was absolutely miserable with the idea that years of self-discipline were collapsing under the heft of pregnancy hormones. A sense of failure and doom haunted every mirror and imagined stare.

The final straw, however, was during my second trimester when a Nurse Practitioner started lecturing me on my weight gain. I had gained the full recommended amount at that point and had no more room to expand during the final months. “But I don’t know what to do!” I cried, “I eat healthy food and I’m not supposed to diet and I just keep gaining weight anyway!” She asked me to detail the sorts of things I was eating so she could suggest better alternatives.

My diet roughly consisted of blended fruit and yogurt smoothies, a couple handfuls of nuts, three or four glasses of milk, fruits and veggies, meat, skim cheeses, and salads with olive oil dressings. The nurse practitioner first informed me that I was drinking far too much milk, and that diet sodas would be preferable. Fat-free dressings and rice cakes would make a nice alternative to olive oil, nuts had too many calories and fat, and the fruit “needs to stop.” “Fruit,” she smugly informed me, “is nature’s candy.”

I was absolutely scandalized, and this is the moment I decided that the weight-shaming of pregnant women has gone too far. We have been eating fruit since we were primates. Now, I can understand avoiding fructose if you have insulin problems, but for everyone else, it represents an ancient source of vitamins and fiber. We NEED fat to be healthy, especially when building people, and what better means than unsaturated sources like nuts, avocados and olive oil? I didn’t say I was eating friend candy bars, after all. We also have higher calcium needs when pregnant, and if our baby doesn’t get enough calcium, it will be leeched straight out of our teeth and bones. My great grandmother used to say that women lost a tooth with every baby… I figured if my body was craving milk that badly, it probably needed it and I’d rather have to exercise off a few more pounds after childbirth than deal with weakened teeth or premature osteoporosis.

The climax of this unholy lecture, however, had to be the suggestion to rely on diet soda and fat-free dressings. There is something terribly wrong when people think avoiding a few extra pounds is worth pumping your body full of artificial sweeteners, coloring, and chemicals, particularly when you have a developing, vulnerable fetus in your body. This was my breaking point, when I decided everyone had gone insane and that I would just continue eating “real” foods, let the pounds happen as they may, and worry about the extra weight after I the baby was born.

I ended up gaining about fifty pounds, though my blood pressure and blood sugar levels remained excellent. Out of curiosity, I asked many other women how much weight they gained during their pregnancy, and was comforted by the fact that nearly everyone admitted they had gained more than they were supposed to. It occurred to me that many celebrities, even while under constant scrutiny from paparazzi hoping to catch them at their worst, were known to have gotten too big while gestating. For example, Jessica Simpson is famous for gaining too much and Jenny McCarthy put on 80 pounds, If these professionals, who are paid millions of dollars to maintain their superhuman ability to keep their weight well below what most of us can manage, couldn’t keep their gain at recommended levels, then maybe something greater than self-discipline is at stake. Those folks are champions of staying in shape, with top-dollar chefs and trainers on staff.

After all the agony I went through during pregnancy wondering what would become of my ballooning figure, I lost about thirty pounds without trying a few weeks after delivering the baby. Much of that was actually peed out, I believe. Since it happened almost immediately, logic suggests that thirty pounds of my gain had been comprised entirely of baby, placenta, and extra fluids. You tend to swell up when pregnant, and you double your blood supply. Either way, I was only about twenty pounds above my starting weight. By six months later, I had lost an additional forty-five pounds, leaving me twenty-five pounds lighter than I had been when I became pregnant.

How did this happen? Well, I started a postpartum exercise class, ate a reasonably healthy diet, and exclusively breastfed my baby. I have been in many exercise classes before without dramatic results, but this time you could practically see the weight fall off my body. I became so thin, in fact, I started getting concerned looks from my friends, who told me I absolutely wasn’t to lose another pound. I even needed to make an effort to eat more food because my weight was dropping too much. This is not normal for me. I also lost the weight differently than I typically do. Usually, I’m a bit pear-shaped, carrying any extra pounds in my thighs. But my legs became unusually slender. I measured them one day just to make sure i wasn’t imagining thing and lo and behold, they were about four inches thinner than they had been previously, when I was at a similar weight.

Here, gentle readers, is my theory: We may have formula available in the modern age, but our bodies don’t know that. Our bodies still think we are cavemen, and that we will need a constant supply of breast milk for our offspring to survive. Most sources estimate the caloric expenditure of exclusive breastfeeding at 500 calories a day, which is a hefty chunk on top of our usual daily needs. Our caveman planners also expect we might be somewhat incapacitated after pregnancy, having neither our typical freedom nor energy to hunt and gather food.

Our caveman DNA doesn’t care how cute we look during pregnancy. We did a solid job looking cute already. After all, we’re pregnant: mission accomplished. We can’t get any more pregnant, so now our body’s top concern becomes our survival and that of our infant. If we run out of calories, our milk will turn off and our baby will starve to death. So… walla! We build a food source packed right into our backsides in case the cupboards go lean.We aren’t just putting on weight to make a baby, we are also creating a calorie supply to make sure our baby makes it through the winter.

I have come across studies that seem to support this theory by demonstrating that breastfeeding appears to specifically target the fat in our butt and thighs. Here are a few links, in case you are interested: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3006166/

http://www.parenthood.com/articletopics/does_breastfeeding_really_help_with_weight_loss.html

http://www.examiner.com/article/breastfeeding-oxytocin-and-weight-loss

Therefore, frightened pregnant women, my advice is to eat quality food throughout your pregnancy, get a reasonable amount of safe exercise, and don’t worry too much about a few extra pounds unless you are already at risk for some reason. If you breastfeed your baby, you will have a automatic caloric deficit working in your favor. It isn’t infinite–you can eat more than 500 extra calories if you really try–but it should help out a lot without forcing you onto a strict diet. It may not work for everyone, but it sure worked for me, and for many of the breastfeeding moms I’ve spoken with. If you aren’t going to breastfeed, you will lose that caloric advantage and it may take you longer to shed the post-pregnancy weight, but I still believe you are better off eating properly and taking good care of yourself than shorting yourself out of a panic about extra pounds. Stay healthy!

A public service message to all the pregnant ladies out there…

Pregnant Woman Awaiting Baby Boy Or Girl Royalty Free Stock Photo - Image: 18511245   So here I am, pregnant for the second time after giving birth to my beautiful daughter in March 2012.   Last time, the fatigue and nausea had gotten to me so much that I became a sleepy vegetable throughout the pregnancy… and as you get weaker, you fall into a vicious cycle of inactivity and bodily aches. I managed to get into good shape after the baby was born by attending a postpartum sculpt class where you could bring your crying infant and take a break to cuddle your baby or even breastfeed any time you needed to, without feeling self-conscious about it.

The class was wonderful.  Not only could we reclaim our shape after the ravages of pregnancy, but we could get out of the house without worrying about our babies going ballistic and having to suffer awkward stares.  Beyond that, we could hang out with other new moms who were similarly stressed, sleep-deprived, and talk about our baby experiences to our heart’s content.  So for this pregnancy, I decided to be proactive and take a prenatal yoga class.  So far, it is keeping me flexible and getting me out of the house to relax a couple of evenings a week with other women who are at various stages of pregnancy shape.  I highly recommend these kinds of classes.

An interesting aspect of the class is that after every woman delivers her baby, she writes about her delivery and everyone in the class gets to read an email about her birth story.  This is wonderful, especially for first-time mothers who are nervous, not knowing what to expect and undoubtedly being routinely terrorized by random women coming out of the woodwork to share every birthing horror story imaginable (seriously, when I was pregnant the first time, I don’t think a week went by without some strange women telling me about her third degree tear, which is the last thing you want to envision throughout the nerve-wracking countdown).

Now, in a prenatal yoga class, especially one in which the members are enthusiastic breastfeeding advocates, there tends to be an inordinately high concentration of women trying for a “drug-free” natural birth.  Some of them even want to deliver the baby at home, instead of a hospital.  Many have read “The Business of Being Born,” and regard the medical community with great suspicion.  I am more of a moderate in these matters, believing there are times when natural methods are the best tools, but also times when the scientific advancements of the medical community are the way to go.  For example, I think you are much better off controlling your cholesterol with diet and exercise, if possible, than relying on a drug. I also think popping an antibiotic every time you have a sniffle weakens the immune system and breeds antibiotic-resistant diseases.    However, if your heart suddenly stops or you come down with a dread disease, you need to be in a hospital with trained professionals, because Mother Nature doesn’t concern herself with weak members of the herd.  Likewise, I believe breastfeeding by far the best method of nourishing an infant. But, like growing your own organic fruits and vegetables, it isn’t always feasible and formula has been a literal lifesaver for many.

Having given birth to one baby already and gotten to the hospital too late to receive an epidural, I can tell you from personal experience that doctors are not offering to numb your entire lower body via the spinal cord because labor is merely “uncomfortable,” or something you can simply “breathe” away. People aren’t getting offered epidurals for gas pain or splinters…. you get them for childbirth or lower body SURGERY.  In other words, labor pain is potentially one of the most physically excruciating experiences a person can have, and can last a very, very, very long time. Yes, it is “natural,” but so is being eaten alive by lions, being crushed to death by an anaconda, or bleeding out during a problematic delivery.

And yes… you *can* do it without pain reducers, just like the women of yore. You can do a lot of things if you really need to, like saw off your own arm if it gets trapped under a boulder and you need to get free to survive.  I think it is a particularly nasty form of cruelty to make a woman feel as though she somehow “failed” by accepting pain medication during childbirth.  We don’t call people “losers” for wanting Novocaine when getting their teeth drilled or numbing shots before receiving stitches, yet some people will actually point to a woman who has suffered through constant nausea, back pain, hip pain, and fatigue for nine to ten months, and consider her selfish for using pain relief to help her through what might be 20+ hours of physical agony.  These women probably denied themselves everything from booze and soft cheeses to lunch meat and too many cups of coffee for the better part of a year, and then risked their lives in order to create new ones for the betterment of the entire species. How on earth could they be considered weak?

That being said, there are many women for whom natural childbirth remains a goal.  Sometimes they describe a natural birth as their version of climbing Mt. Everest…. a physical achievement that gives them great confidence and an understanding of their own strength.  Some want to feel connected to the many generations of women who came before them by experiencing the same natural process.  Others want to be fully “present” during the birth process and believe that anything that drugs or numbs part of them will cloud the experience.  This is a deeply personal and valid decision, and my hat is off to any woman who manages to get through the entire episode without begging for the sweet, sweet release of anesthetics…

BUT… for the love of all that is rational and holy, PLEASE do not attempt to do this at home. Please deliver your baby in a hospital filled with trained professionals and equipped with state-of-the-art medical equipment… in case something goes wrong.  Because this is the one thing home birth advocates tend to forget: women may have been having babies without doctors for centuries, but they also used to die in childbirth ALL. THE. TIME. Sometimes in agonizing yet preventable ways.  So did the babies.

If you are in a hospital, no one is going to force you to have an epidural. You can have the baby as naturally as you want. Many hospitals now come equipped with midwives, birthing balls, and all the other nifty gadgets so beloved by the natural birth crowd.  You don’t need to have an epidural, but it is nice to have available, just in case you change your mind.  But far more importantly, you need to be in a hospital in case something goes wrong.  What if the baby is coming out the wrong way and is going to break its arm on the way out, and cause you to tear from the vagina through the anus? What if the baby’s umbilical cord gets wrapped around its neck and is going to rapidly suffer brain damage and then  death if no one can fix the situation? What if your placenta tears away from the baby and you need an emergency C-section because you are hemorrhaging to death and both you and the baby will die without one?

Because these things DO happen from time to time, even to healthy women with normal pregnancies. For example, one of the leading advocates of the “freebirth movement,” a group that argues for unassisted childbirth at home, is a woman named Janet Fraser. Though Fraser demands that other women be “drug free,” she herself ran to a hospital for her first delivery to request not only epidural anesthesia, but also a medically-unnecessary C-section.  More tragically, in 2009, Fraser gave birth at home and her baby died of cardiac arrest. The coroner’s report indicated that the baby’s death would have been prevented in a hospital (http://en.wikipedia.org/wiki/Unassisted_childbirth).

Every 90 seconds, a woman somewhere in the world dies in childbirth. In Afghanistan, where regressive gender politics have effectively forced women away from doctors, a woman faces a one in ten chance of dying during childbirth.  Childbirth is no joke… it used to be one of the most dangerous times in a woman’s life and we have the medical and scientific communities to thank for so dramatically dropping those risks over the last century. I believe much of the rhetoric of the natural/at-home birthing movement is akin to faith healing… the idea that childbirth only becomes dangerous or painful because you “believe” it will be implies that any suffering is your own fault and you wouldn’t be having these problems if you just had more faith in the process. It’s an emperor-has-no-clothes belief system, because any failure of its promise of painless, easy childbirth is blamed on the poor mother, who is apt to deny any problems because they would supposedly prove failure on her part, rather than the problematic belief system itself.

I suppose the ultimate show of faith is having a baby by yourself, at home, with no professionals around in case anything goes awry. But, gentle readers, this is simply a dangerous thing to do. How would you feel if something horrible happens to your baby and you then have to live with the fact that you could have prevented it if you weren’t trying to prove something?  If you absolutely, positively insist in having the baby at home, at least be sure you are reasonably close to a hospital and DO NOT have the baby by yourself. Make sure you have a doula or midwife on hand who can figure out if an emergency situation is taking place so that you can be rushed to the hospital if need be. Even in the days of yore, when women routinely gave birth at home, there was ALWAYS someone hanging out with her, making sure she didn’t pass out or suddenly need assistance.

Because, dear readers, some of the birth stories I’ve read from the prenatal yoga moms have made my blood run cold, though obviously, I cannot reveal the mothers’ names without compromising their privacy. One woman labored by herself for hours, in the bathtub, while her husband was at work. She was in labor for several days before finally being rushed to the hospital. Her water had broken long ago, her baby was leaking meconium (baby poo) into her system, and she was going into septic shock. She was given an emergency C-section, which saved her life and that of her baby’s. Do any of you guys watch Downton Abbey?  Septic shock is a horrible way to die.

Another friend of mine was a huge advocate of natural, at-home birth. She is young, extremely healthy, and had to be rushed to the hospital while delivering her baby because she was bleeding to death.  They saved her and her son. She doesn’t like to tell anyone about the experience because: 1) it embarrasses her that the method she was so gung-ho about worked out so poorly, and 2) she feels like a failure because she didn’t give birth the way she wanted to. This is tragic, in my opinion, because women should not feel like failures after struggling through a naturally hazardous process, and also because women need to be aware of the real risks they are taking.

I also wish to point out that of the many mothers who wanted a natural birth in my class, the majority ended up begging for an epidural somewhere around 4 centimeters of dilation, which is not even when things start to get really rough. There is no shame in this.  You cannot be expected to truly know whether you will need pain management if you have never experienced this type of pain before, and it is good to have all options available. There are also a couple of mothers who made it all the way through… they gave birth with nary an anesthetic in sight and they feel fantastic about their accomplishment. No one forced them to get an epidural, you see… it is always your choice.

Just because something is possible, does not mean it is always desirable.  Mother Nature is very harsh. She weeds out members of the herd by killing off members prone to physical problems and removing them from the gene pool. But Nature also made the human animal a brilliant creature who could invent new medications and methods of preventing many deaths and illness. So you could also view medical practices as natural, in that they are the natural extension of human ingenuity and invention. Some might even argue that taking unnecessary risks, rather than relying on your species’ ingenuity, makes you a potential candidate for weeding out.

If you wish to forgo the epidural, that is a valid choice. But please… keep yourself safe.

That is all.