Sorry to harp on this, but it keeps coming up. My midwife made a big deal again about how I need to "watch that weight gain" and cut out all white flour and sugar from my diet. She acknowledges that some big babies are genetic (um, yeah, I know), but then she had to go and play the Dead Baby card. I hate it when people do that.
She told me about a client of hers who was borderline for gestational diabetes and "cheated" the test by having her OB (I take it she was under some form of coordinated care) coach her on how to avoid testing positive. Once she squeaked through, she, in the words of my midwife, "totally let herself go" and packed on the pounds that last trimester. During labor, the woman admitted she had been baking for herself every day and eating pies, cakes, cookies, and so forth. (The horror!)
She was a small woman, and her 12-pound baby was lodged with an extreme shoulder dystocia that took the midwife seven minutes of hard work to dislodge. The baby was floppy and unresponsive and had to be rushed in an ambulance to the ER, EMTs fighting to resuscitate him.
My midwife was mad at her client, that she had risked her baby's life for the sake of some sweets — not to mention the midwife's practice.
The implication was clear. Either I followed the no-white-flour-and-no-sugar edict, or I would be the one risking the Dead Baby.
Let two things be known:
- I don't take that woman's story lightly. I think that's a horrible situation for all of the participants to have been in. It's possible she had a hand in it for baking too much; I couldn't say because I'm getting only one perspective on the tale.
- I don't appreciate scare tactics.
As my midwife fully admitted, I had a nearly 12-pound baby, with no dystocia, a mere hour and a half of pushing, a vaginal birth with minimal tearing, a pregnancy free of GD, a baby with no blood sugar problems, and a healthy outcome for all involved.
So is the fear that I'll somehow go for a world's record here and try to beat my previous baby's weight? Because, trust me, I won't mind having a smaller one this time around and expect that as the statistical probability.
There are several things niggling at me from her edict. I'm not even sure how to sort them all out, in my mind or in this post.
- She's assuming that limiting maternal weight gain will ensure that the baby's weight gain is also limited. This is not so clearcut.
- She's assuming that limiting the baby's weight gain is preferable to allowing a baby to grow to whatever size it chooses. This seems dangerous to me.
- She admits that Sam and I are large people (tall and broad, and I have a wide pelvis), that I come from a family of occasionally very large babies, that I previously had a large baby with no ill effects on either of us. And yet she continues the scare stories.
- She emphasizes staying active over specific numbers of pounds, which is good. But she discounts how much pain I'm in from this pregnancy in my pelvis and hips, and how challenging it is to exercise daily when it hurts to walk. (I do keep trying to push through.)
- All of my tests so far — blood, urine, blood pressure, fundal measurements — have been fine. I'm scheduled for a GD test this week, so we'll see. (Anyone have arguments for or against having the test? I'm still a little conflicted.)
- I gained 33 pounds last pregnancy and lost it within two weeks postpartum. I don't say that to brag or as an indicator of what I consider normal (I was actually very, very surprised when that happened), and I worry it sounds that way. I say it more as a justification that my body knew exactly how much weight it needed to support the pregnancy, even though I had an unusually big baby. I've already gained that much this time around, and I haven't gone through the third trimester yet, so she might have a point there. Or not. I'm not sure. I definitely am not expecting to lose it all as quickly postpartum this time. (I mean, I have no expectations either way, not that I expect not to lose it; either way is fine)
- She's assuming that white flour and sugar are "bad" foods. I have issues with this that I don't even know how to go into here, in a short time. I find it problematic to demonize foods and assume that because they don't fit our current vision of what righteous food looks like that they have no value, or indeed a wholly negative effect.
- Even if I agree with her that white flour and sugar are to be avoided, she's assuming that I can. I know very few people who, long-term (5 years or more), have cut out easily available, tasty food groups from their diet. The few I do know have a medically unpleasant reaction to such foods and therefore a big incentive not to cheat. Now, my timeframe is a mere three months. But, I know myself. I know that when I'm told I am not allowed to have something, that is all I want. When allowed to eat as I wish, I tend to eat a variety of foods and not stuff myself. Even pregnant and more sharply hungry, I don't believe I've been eating more than usual — just more immediately when hungry, but then I feel full sooner. When told I must eat a certain Right way, I tend to rebel. Oh, I know, the Dead Baby card is supposed to keep me in line. But I'm finding it hard to buy in. I've already found my sneaky diet-mind telling me things like, "She didn't say anything about white corn and white rice. Score!"
- Several years ago, Sam and I did the South Beach Diet, which is my best personal reference for a practice of cutting out white carbs and sugar. We lost about 40 pounds on this diet and were hungry much of the time (and, incidentally, found it challenging to eat hospitably with others, such as at friends' houses or restaurants). I have some reservations about adopting any sort of eating plan that would normally prompt weight loss, considering I'm pregnant and losing weight can be detrimental to the baby's health.
- I'm seriously feeling I'd like to switch midwives. But without the psychological effort involved in switching midwives. I put off choosing one for so long precisely because I was having trouble screwing up the gumption to interview some; in the end, I interviewed exactly this one, and liked her a lot the first time we met. So I'd actually need to visit some other midwife/midwives multiple times, to make sure I liked them better, before firing this one. And the firing part would totally bum me out. Plus, I like her attitude toward low interventions in birth, and that's ultimately more important to me than sparkly-rosy-happy prenatal visits. Though those would be nice, too. I wish the midwives I had last time were still practicing, but they're on an extended hiatus.
I was prepared to ignore the recommendations and try to put it out of my mind. Sam, though, took it on himself (he's our cook) to consider ways we can reimagine meals we like in non-white-flour ways as well as create a list of meals that need no rejiggering to fit the criteria (like one of our favorites: currywurst with mashed cauliflower). He also suggested we cut down on the junk purchases. On the same day he brought home Girl Scout cookies. Bless him.
I know one thing for sure: I would have no luck cutting out white flour without him, so I'm glad he's willing to go through the deprivation with me. He keeps reminding me it's only three months, so maybe we'll make it.
I'm still not sure I'm philosophically on board, though.
What's your reaction when healthcare professionals recommend things you don't like or don't believe in?