What is more risky, advanced maternal age or obesity? - Page 2

[texmati]

Wow! I'm just a tad shorter than you (without my shoes on!) and weigh almost exactly the same. I just wanted to add that I spoke a family practice doctor, an OB and an CNM about my weight after finding out I was pregnant, and none of them batted an eye. So it is totally possible to find hcp that will treat you like ahuman being even though you are fluffy.

[Vespertina]

Originally Posted by flapjack

As far as obesity goes, prepare yourself for nine months of being treated as if you're at death's door, they just haven't figured out what you're going to die of yet. Could be pre-eclampsia, could be GD complications (you are actually not allowed to not have GD and be fat. It's in the textbooks that obese women are more likely to be hyperglycemic, therefore we must all do as we're told and have GD. It's part of being a good patient.) I'm assuming that if you're over 35, they're merely expecting you to expire peacefully of old age before you're done gestating. In both cases, there is a significant incidence of intervention (more c-sections, inductions, augmentations and instrumental deliveries) in addition to actual real life problems like pre-e, shoulder dystocia and so on.

In your shoes, though, I'd get checked out and try and rule out the possibility of insulin resistance when you're not pregnant.

I had my ultrasound today and as the perinatologist was leaving she said, "Be sure to have your diabetes testing done." Uh. I'm 21 weeks and the GTT isn't usually done until 28 weeks or so and the u/s appt. was completely unrelated to that. But, she sees that I'm fluffy so she *must* remind me to get my sugars checked out because all big girls have impaired blood glucose. Whatev.

I've been checking my glucose levels for months now and they're perfectly normal. I've never had impaired blood glucose levels during any of my pregnancies. They just don't think that can be the case. Good thing I'm having a homebirth so I won't have to deal with the testing for a nonexistent disease.

[Storm Bride]

Originally Posted by flapjack

As far as obesity goes, prepare yourself for nine months of being treated as if you're at death's door, they just haven't figured out what you're going to die of yet. Could be pre-eclampsia, could be GD complications (you are actually not allowed to not have GD and be fat. It's in the textbooks that obese women are more likely to be hyperglycemic, therefore we must all do as we're told and have GD. It's part of being a good patient.)

:::

Oh...no...wait...:

I'm assuming that if you're over 35, they're merely expecting you to expire peacefully of old age before you're done gestating.

Sounds about right to me.

I'm actually very impressed with my last OB. Even allowing for the fact that I was scheduling a c-section, she was pretty laid back. She never said one negative word about my age, my weight, the size of my babies (the 3 before dd2 were all over 10lbs. and she only missed 10 by an ounce). Nothing. She treated me like a...pregnant woman! Shocking.

[MidwifeErika]

If you are planning a homebirth, then I would just speak to homebirth midwives in your area and get their opinion on weight and age.

I, personally, wouldn't even bat an eye at either one and if you find a midwife who gives you a very hard time about either one, look around and maybe find someone else. I think many midwives will treat you as perfectly healthy unless your body shows signs and symptoms otherwise.

[Dame]

I was 37 when I conceived DD and was not considered "advanced maternal age" by my OB. She said that these days having children after 35 is really common and the risks go up more starting around 40, rather than in your thirties.

[hempmama]

How late do the women in your family typically go into menopause? Having a child at 35 does not make me blink, but planning for a child at 37 or 38 when you have the (painless) option of earlier makes me wonder about your family history. I wouldn't say it's "risky," but the relative risks- miscarriage, infertility, chromosomal abnormality, multiples (well, for me that's a problem, maybe not for you ) - go up on a much steeper curve at about 37 than 20 pounds seems to be adding risk to you now. So I'd go for it now, and focus on a healthy lifestyle between number 2 and hypothetical number 3.

[kcparker]

Originally Posted by jennica

So, another question I just thought of: when is the cutoff for the higher risks of maternal age? Is it the day I turn 35, or the day I turn 36? If I get pregnant before that time, but deliver after, would I still be considered in that higher risk category (I mean, higher risk for infertility, down syndrome, or other risks associated with age - not just a general 'high risk' label)?

I wouldn't think of it as a hard line drawn that happens on one's XXth birthday - it's more of a gradual slope of increases or decreases in various things - your eggs and partner's sperm get older year by year as you age, your body may not have the same physical strength at 40 that it did at 27, fertility tends to decline as you age. Really, your individual risk can't be extrapolated from the data of 100,000 other women -- you just have to look at your own personal state of health and go from there, understanding that there is a statistical trend towards older women and their fetuses having a greater chance of X, Y, or Z as compared to a woman bearing children in her mid-twenties.

Consider the following: what is your level of cardiovascular fitness, what's your diet like, what are your stress levels like, how much do you smoke or how often and in what quantity do you drink alcohol, anything happened with previous pregnancies that might affect future pregnancies, any chronic conditions that will affect a pregnancy...these may give you more meaningful information about your individual risk than statistical information gleaned from a huge number of women who are merely the same age as you are. And remember, doctors are all about "evidence-based medicine" - if their latest data set shows that women with X characteristics are at risk for Y and they think there might be a problem, they will monitor you very closely if you have X characteristics, whether or not your individual situation necessarily warrants the monitoring.

[thismama]

I'm another anecdote of healthy pregnancies while 'obese'... in my own case I qualified as 'morbidly obese' during my first pregnancy : and severely obese during my second. Two boring pregnancies, natural births, healthy mid weight range babies. I'm 5'5" and just under 200 now, similar to you OP, and I feel downright skinny. I tell ppl this is my 'Kate Moss look' and I wouldn't think twice about my weight if I got pg now.

[pampered_mom]

I would caution against trying to lose a bunch of weight before getting pregnant. It's one thing if your fertility is impaired (and then losing something like 15-20lbs might help), but if your cycles are fairly normal I think the risks of losing all that weight may just outweigh the benefits.

Why? Because if you lose a bunch of weight before getting pregnant, and then get pregnant, it's super easy to put all that weight back on and then some. Your body is going to hold on to every extra bit that it can which could potentially mean you'll have more weight to lose than if you'd just gotten pregnant at the weight you were at. IME that's far worse than any supposed risks (which more often than not seems to be more about provider attitude than actual reality).

As others have suggested...your best bet is to interview prospective midwives.

[zoebird]

it entirely depends upon the individual. everyone is different, so one or the other could be no risk or a great risk or anywhere along the scale.

your best bet is to research what about being over 35 is considered risky--that is, what risks exist for women over 35--and what is risky about being overweight, obese, etc (i don't agree that BMI is a good determinant of obesity, btw. in my mind, it means health problems caused by being excessively overweight. many overweight people do not have health problems due to their weight, and therefore do not fall into the obese category imo).

so, if you research these things, you'll see whether or not either one is a risk for you or riskier for you. if it is weight, then you can decide to loose the weight. if it is age, then go with sooner rather than later. if it is neither, then it really doesn't matter which you choose.

and, i think that if you go in educated, a successful homebirth will be in you future.

[ChristSavesAll]

Originally Posted by mwherbs

go in and get a physical including a glucose tolerance test, thyroid function

The fact that she is overweight is already a big indicator that she has a thyroid problem. Hypothyroid which is what I'm referring to is dangerous to a growing baby, it can cause m/c, stillbirth, developmental problems as well as delays.

So how do I know you are hypothyroid based on your own admission of being overweight? Because you thyroid controls your metabolism as well as your hormones.

Do you know what the food for your thyroid is? Iodine, and not 150mcg like the RDA says. Due to fluoridation, bromide (in breads), chlorine, mercury, lead, arsenic and an already low intake of iodine, our bodies have become severely deficient. This results in a low functioning thyroid (at least at first, given more time and exposure to higher heavy metals you can become hyperthyroid) and adrenal fatigue, this leads to obesity, junk food cravings, fatigue or a feeling of laziness, cold hands and feet, lack of energy or stamina, so much more to list but poor health in general.

I was 205 pre preggo with dd and 215 afterwards, I began supplementing vitamins and minerals with an emphasis on high iodine (32.5mg) and lost 60 pounds in 5 months while bfing dd. On top of that, tons of health issues I was having slowly vanished one by one.
Aches and pains stopped, cravings stopped, headaches stopped, fatigue was gone, anxiety and depression also gone, mood swings gone. I became a whole new person, or at least back to the person I was when I was in highschool, a fun, happy, peppy person.

My mother, husband, sister, brother-in-law, and many friends and new acquaintances have all had the same results after starting on my regimen.

I have a website that talks about all the ways iodine deficiency effects your body, with links from multiple sources in case your interested. I can't post it but pm me if you'd like to check it out.


BTW this is not intended as an attack in ANY way, I too battled with weight and did not understand why, now that I am aware of what is actually going on I want to help other mommas to educate themselves.

A lot of women feel healthy, heck I used to too even at 215 though I did not like being ummm fluffy. My whole view of healthy changed when I began to actually FEEL healthy after giving my body what it needed.
Also I never took a vitamin while pg with dd, and unfortunately our water was fluoridated just after becoming pg with her, which I had no idea about until after she was born.
Consequently, dd had a protruding tongue when she was born that has only just now "gone away". Now that may not seem like a big deal to most mommas on here but if you look up cretinism (severe iodine deficiency) that is one of the symptoms. Fortunately I found out about iodine and the necessity of it when she was a couple months and began supping then, she has not suffered in any other way and is even ahead of the curve for her age.

Japanese get around 13.8mg of iodine per day, which is 13,800mcg and we are told that we only need 150mcg... yet they are smarter, healthier and even thinner than we are.


BTW the thyroid tests that are run are useless, I was tested and told I was fine, my husband who was going between hypo and hyper was told he was fine... funny cause all our troubles went away after supping. I don't do tests, what I do is checking symptoms, look up the symptoms of hypothyroid and you can see for yourself that you are indeed hypothyroid.

Oh and hyperthyroid is also cause by iodine deficiency, it is actually the more extreme of the two. Slowly building up your iodine dose will reverse hyperthyroid and all symptoms associated with it.

[Monarchgrrl]

Like you, OP, I've been trying to figure out when is the best time to TTC. I'm almost 32, so I'm not the least bit worried about age, but I'm overweight. Maybe you have thyroid issues, maybe not. I don't understand the PP who said that you must have thyroid issues because you're overweight. I get mine checked all the time because I WISH that was why I'm fat. Nope. Perfect numbers every time. I hope and hope that it's my thyroid. That would be so much easier than to have no reason why I'm fat and not be able to lose weight. And my DW has always been overweight and she was diagnosed years ago with Graves disease (HYPERthyroid). Just because you're overweight doesn't mean you have health issues. And, unfortunately, I've found more fat-phobia from midwives than doctors. I'm already so sick of it and I've never been pregnant. And I'm trying to decide what tests I will allow in pregnancy because I know most of them the midwives will just want to do because I'm fat. Like a PP said, they already assume I/we will have GD, despite the fact that I'm routinely HYPOglycemic! : I don't get it! I know I'm going to have to really fight to have the kind of pregnancy and birth I want, even from midwives. Anyway- rant over. I say try for that baby anytime you feel is right, weight or age be damned! Only you know how healthy or not healthy you really are. Good luck!!!

[cristeen]

Originally Posted by Monarchgrrl

I know I'm going to have to really fight to have the kind of pregnancy and birth I want, even from midwives.

You just need to interview some midwives. Some do have issues with it and some don't. Mine doesn't weigh me, doesn't discuss nutrition with me (past the first prenatal), didn't require me to take the GTT, etc. She loaned me a glucometer after I asked about it, and asked about what results I got (also hypoglycemic), but never asked to see log sheets or anything of that nature. We have had some more in-depth discussions about the difference between IR and diabetes, but in part that's because she's inexperienced with PCOS, and in part because I am a student, and she knows she can talk about these things with me. She doesn't routinely do the GTT or GBS tests, and actually is extremely hands-off. I'm at 35 weeks and the only times she's touched me is to take BP, palpate and do fetal heart tones (and I get hugs, too). PM me if you want her info - I'm sure she'd be able to recommend someone on your side of the bay. And FTR, I'm pushing 300 lbs at 5'4".

[Monarchgrrl]

Thank you, Cristeen!! PMing you.