my dad is an md. last night i was talking to him about my recent diagnoses (at 37 weeks) of gestational diabetes. he basically said i had GD from gaining too much weight during my pregnancy. anyway, here's the letter. let me know your thoughts!
|you (and mom too) need to lay off with the weight stuff. mom seemed to blame my PIH on my weight too. it implies that i'm doing something to potentially harm my child and that really pisses me (and bill) off. please read my whole email so that i don't have to explain this again.|
in the 70s, women were told to not gain more than 15-20 lbs. women dieted and fasted when pregnant to keep their weight down. its not the 70s anymore. the general rule of thumb now is 25-35 lbs. having gained 40 isn't outrageous by any means. dieting and fasting are considered dangerous things to do during pregnancy. the goal is a steady, even weight gain throughout. with ella, and this pregnancy, the only time my weight has been mentioned by the midwives is when i had an abnormal jump in weight between appts. it happened once with ella (water gain) and once this time (mango gain).
mom said she and (friend) talked about how 'fat' their daughters had gotten during pregnancy. if anyone would know about staying within a normal range of weight gain during pregnancy, it would be (friend's daughter who is an MD herself)...and according to mom, she gained a lot of weight too. its part of being pregnant to gain weight.
i completely understand that weight DOES influence diabetes...but i was by no means obese or even overweight when i became pregnant. i dieted last winter specifically to get to a healthier weight for this pregnancy. i know several moms of normal weight who have had PIH or GD. i also know some plus sized moms who had neither. i even asked about my weight yesterday in relation to type 2 later in life, and the nurse said that if i return to my pre-pregnancy weight i'll be fine. she did not talk about my weight or my weight gain as being contributing factors or as being abnormal in any way (even when we talked in terms of future pregnancies).
starving myself, especially now, is just as dangerous as eating too much. in addition to the blood sugar testing, i am also testing for ketones. ketones are acids that build up in the blood when the body doesn't have enough insulin. the nurse yesterday encouraged me to 'eat all day long' - small meals every two hours, and to eat a nice big bed time snack so that my body has something to burn during the night OTHER than any body fat. burning body fat during pregnancy creates lots of ketones, some of which pass through the placenta to the baby. for that reason, it is dangerous and unhealthy to diet or fast during pregnancy, whether or not your have GD.
being that i was at a healthy weight going into this pregnancy, that my weight gain hasn't been abnormal, and that i have been eating a VERY healthy diet throughout this pregnancy is probably what kept the GD from cropping up until now. remember, i passed my 1 hr GD screening just a couple months ago. i was doing something right. it is hard to know why it cropped up now, but since my blood pressure did not go up until the very very end with ella, its possible that my body just doesn't like the last month of being pregnant and/or that my body tends to produce extra high levels of pregnancy hormones towards the end.
the hormones that cause GD (in GD, its pregnancy hormones that cause the imbalance in insulin) may be the same hormones that produce PIH in first time moms (95% of PIH are first time moms, regardless of weight going into or during pregnancy. this is why PIH has not been an issue at all this time). it may also be the same hormones that cause PUPPS rash, which is another thing that i had at the very end of my pregnancy with ella. PUPPS is not caused by being FAT...its caused by being PREGNANT. high levels of pregnancy hormones are also one of the things blamed for morning sickness, which i had with both pregnancies.
dad, you said the baby is about 8 lbs or so...that leaves 32 lbs of me. that's not true. ella was 9 lbs. this baby will prolly be about the same. amniotic fluid, placenta, and extra body fluids and blood are an additional 12 lbs. the added weight in the uterine muscles and breasts can be another 6 lbs. that's nearly 30 lbs of JUST baby and baby support system. with ella, i gained more than 40 lbs, all of which was gone within 3 months of her birth (most within the first few weeks). if it had been all fat, it would have taken me much longer to burn off that weight.
ella was a BIG baby, but she stayed big and is still big, always measuring in the 90th percentile or above in both height and weight. GD babies are big with extra fat. their weight and height usually balance out over time. ella's weight and height were big at the beginning and have remained big. i am still concerned the GD could add extra lbs to this babe in addition to the possibility the baby will be as big as ella, but the midwives left doing the blood sugar thing up to me since a) the baby and i are measuring NORMALLY and b) i am full term.
women today are tested for SO many different things compared to the 70s. bill and his brothers were all between 10-13 lbs. sandy was not overweight at all with any of her pregnancies and the boys were still very big. she believes she had GD with all three, but since they didn't test for it back then, we'll never know. nowadays, it seems like everyone i know has had some sort of 'complication' during pregnancy that might not have been noticed 30 years ago because doctors weren't testing as much. the testing is probably a good thing, since it can keep mamas and babes healthier...but it is also VERY stressful going through SO many tests...and i say this seeing midwives, who tend to do FEWER tests than OBs do. the other reason that all the testing is stressful is that it tends to turn pregnancy into an treated illness, versus a natural, biological process.
add on top of that you basically BLAMING me for having GD is very stressful and hurtful...especially this late in the game, since 90% (bill says 98%) of my pregnancy has been problem free. stress is just as unhealthy for my baby and me as GD or PIH would be...and stress complicates both. what i need from you both right now is your love and support, not criticism for things that are not my fault.