Pregnancy and the Larger Lady

You're overweight and you've just found out you're pregnant! Woot! Way to go! What to do now?

Firstly, don't stress about food or your weight. It's just counterproductive. When I found out I was pregnant, I went straight out and bought several books on pregnancy. The diet section of the first one I read had me in tears - though to be fair so did car insurance ads. This is what it said:

3 servings protein
3+ servings vitamin c
4 servings calcium
3+ servings green & yellow vegetables
2+ servings other fruits and veg
6-11 servings whole grains and legumes
More iron rich foods
Limit of 4 high fat foods
8 glasses of water
Prenatal vitamins
(Thanks to What to Expect When You're Expecting by Murkoff, Eisenberg & Hathaway - which is really a great book)

!!!!! I stressed out.
It was a diet that was so widely different to mine. I was tired, emotional, grumpy, everything was changing in my life and I didn't see how I could possibly fit it all in! I was only 4 weeks pregnant and already I felt like a terrible mother growing a sub-optimal baby.

Those kind of feelings do nothing for you, and get in the way of productive changes. Also, stress and anxiety can actually cause problems in your pregnancy.

A relaxed pregnant lady is a fabulous pregnant lady.

Researching pregnancy, birth and birthing methods is one of the most important things a pregnant woman can do. Are you looking eagerly forward to being cared for by hospital staff with an epidural on arrival, or does having your baby in your own bathtub at home sound more your scene? How do you feel about the cutting of the cord and the delivery of the placenta? I love reading other people's birth stories, they let you know how the experience might feel and raise issues you might never have considered before, such as whether to agree to the Vitamin K injection.

Don't start from the point of view - 'I'm too big, what am I allowed to do?', instead work out what kind of birth you are interested in having and then work through any issues your weight may raise. Always keep in mind that giving birth is a dynamic situation which won't follow any concrete plans you've laid out, but it's good to know what your aims are. Of course you want a healthy baby, but don't let anyone tell you that your experience isn't important.

Having done your background reading is also a bonus when it comes to dealing with the medical profession. You will understand better what you are being told, and will be able to ask more intelligent questions. Don't regard any decision you've made about what you might like as being irrevocably set in stone. If you come up with questions after your appointment is over, get them answered and don't be afraid to change your mind.

Chances are, given your size, you are going to hearing a lot of very negative things at the moment. Some people will make snap judgments about you because of your weight. I was straight out told by a doctor (who knew nothing about me except my name and Body Mass Index) that my diet was so bad my baby would be malnourished.

It's imperative that you pick a team to help you through your pregnancy who believe in you and want to help you achieve the birth you are aiming at. Personally, I am aiming at as natural a birth as possible. At my first meeting with the doctor at the hospital, I was told that was not going to happen because of my BMI. I would need to be induced, have a drip in my hand for the entire process, would need a medically managed third stage, intensive physio for mobility in the last trimester (for the record, 37 weeks and still moving around fine on my own), an epidural and to consider the possibility of a cesarean. The first thing I did was get a second opinion.

Talk to anyone who is likely to be around at the birth. If you are going to the hospital, talk to the doctors and make sure you are on the same page. Ask questions of your family doctor. Go and talk to the midwives at your local birth center. Make sure the people you will have around you at the birth are going to be respectful and supportive. If your partner wants and is able to be at the birth, have them at as many discussions as possible and include them in decision making.

When talking to care-givers, bring up your weight and ask if it will change your options. Ask what will be essential in their eyes and what can be negotiated. Don't assume that their general information applies. I booked into the local birth center, but afterwards found out that under their general policy my BMI makes me a 'high risk pregnancy' and so I have to give birth in the main hospital, though my midwife will still be my primary carer. Don't let these things come as a surprise to you when you're already having contractions!

As mentioned above, I went and got a second opinion. My doula, a wonderful lady, suggested a meeting between all of us (including the midwives and my family doctor) to negotiate. She helped me come up with questions and made sensible suggestions about alternative paths. The outcome was that I compromised on some things that weren't as important to me, but retained all the things that were. My midwife was also fantastic, agreeing that the ultimatums put to me by the hospital doctor could be treated as 'could happen if medically needed' suggestions, rather than our starting point.

Speaking of my doula, I had never heard of the phrase before I became pregnant. A doula 'is a trained and experienced birth attendant, with extensive knowledge of the physiology of birth and what is needed to support the natural processes of the body, both emotionally and physically. A doula is not a midwife, nurse or doctor, and as such she does not give medical advice, make recommendations or medical decisions or perform clinical tasks such as monitoring baby's heart rate, vaginal exams, assessing baby's position, or others. A doula can help interpret the information and advice provided by medical staff and assist the couple to make informed decisions.' In my personal experience, a doula has been an invaluable support for both myself and my partner. Definitely worth looking into.