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9.30.2010

Mothers and Weight Gain

I am torn on this topic.

First of all, I am decidedly NOT Pro-Fat. I don't really understand how ANYONE can be pro-fat, except people who are fat and don't want to do anything about it. I have read from multiple pro-fat people that "it's hereditary, there are many people who eat a healthy diet and are active who are still obese." It's crap. But I'm already getting off topic- my point is, women who are obese when they get pregnant are putting themselves and their baby at risk for a number of complications. Fifty Percent of obese women have c-sections, they are twice as likely to have gestational diabetes, and are at a higher risk of preeclampsia. Their babies are likely to be either large at birth (which may or may not be a risk factor, but I do believe that a woman of healthy weight who has a "large" baby was likely meant to have a large baby, and thus is more likely to be able to birth the baby naturally, whereas an obese woman who has a large baby may not be as able to birth that baby naturally... but this is just my theory) OR underweight due to placental failure, have a higher risk for undetected neural tube defects, are more likely to be stillborn after 38 weeks, and are subjected to the risk factors associated with the mother (above- preeclampsia, c-section, gestational diabetes...).

So obviously I'm clear on that. However I'm less certain about the weight gain guidelines set forth for pregnant women. Depending on who you talk to, it is generally recommended for a healthy pregnant women to gain between 20 and 30lbs. However, I think talking about weight with a pregnant woman is dangerous and counterproductive. First of all, if a woman is gaining too much, she can't exactly diet. Secondly, most women are sensitive about their appearance, even during pregnancy. Implying that they are "fat" (or fatter than they should be) can cause all sorts of undesirable side effects. I know a mom who dieted during her pregnancy because she was scared of being "fat" afterwards. My midwife, who had her first child under the care of a doctor, said that at each appointment the doctor would berate her for the amount of weight she was gaining without giving her any nutritional guidance, so after the appointment she would go drown her sorrow and anxiety in an ice cream sundae. I, similarly, was berated by my doctor with my first pregnancy. At every appointment he made less than sensitive comments about the amount I was gaining, but gave me no tools to combat the gain while maintaining a healthy pregnancy. I can't claim ignorance of healthy eating habits- but mental state, especially for women, is as instrumental in our eating habits as knowledge. Because I was starving and felt out of control concerning the amount I was gaining, I ate, and mostly I ate unhealthy food. I gained 69 lbs. Now, keep in mind that this was due to my diet at the time as well as the ungainly amount that I swelled up late in that pregnancy (which was probably due to the diet, my lack of activity, and the extreme heat of that summer). After birth an average woman who gains an average amount of weight will have lost all of that weight- about 30 lbs. When I was released from the hospital I had lost 60lbs (I had peed a LOT in those three days). So one could argue that only about 10lbs were above and beyond what I should have gained. Of course, the swelling that accounted for most of the rest of the weight was due to unhealthy behavior as well.

In contrast, during my second pregnancy I only gained about 35 lbs. I ate healthier because I was under the care of a firm but supportive midwife who counseled me from day one NOT on the amount of weight I should gain, but on healthy eating during pregnancy. She emphasized the eating of healthy fats and protein with lots of veggies, some whole grains and NO "white" carbs or sugar (which I didn't follow to the letter, but I tried!). I also didn't swell at all, likely due to my increased activity level and my healthier diet. And the fact that it wasn't 120 degrees in the shade that summer.

And my last example- my mother. My mother, before pregnancy, weighed about 110 soaking wet. She gained 70-75 lbs with each of her four pregnancies. And she lost it all, with each child, in the first few months. In fact, after her third child she dropped down to 100lbs from the demands of caring for three and nursing.

My point is that it is unhealthy to simply put numbers to pregnancy weight gain. Instead of telling moms "you should only gain Xlbs" we should give them the tools to have a healthy pregnancy, with guidance on healthy diet and encouragement to stay active. They shouldn't be made to worry and feel anxious about the amount they are gaining.

But here is the part I am REALLY torn about- loss of excess weight after birth. This article, which started this whole train of thought today, encourages dieting almost immediately after the birth of the baby. I think this is the wrong way to address the problem. First of all, I hate the word "diet." I have struggled with eating my entire life. I KNOW what I SHOULD be eating and why, but I don't always do what I know is best. I have impulse control issues. So I have tried diets over and over again, and always failed within two weeks. Because diets are torturous more often than not. Eating should be an enjoyable experience, not something that causes pain or anxiety. In the past few years, however, I have had success with completely setting aside the idea of "dieting" and looking at it as a lifestyle change.

But I do agree that women should return to their healthy pre-pregnancy weight (or loose more, if they were obese before), especially if they plan on having more children, due to the reasons I list at the beginning of this post.

How does one do this without "dieting?" It starts with making small changes. You will only eat what's in your house, so stop buying sugary and processed foods (not even for your kids, because if they're there you'll eat them AND they're no healthier for your kids than they are for you!). Make a meal plan each week so you're not tempted to eat fast food. Start moving more- if you don't like to workout, don't force yourself to go to the gym 5 times a week. Find something that will keep you motivated. For pregnant women and moms, I suggest Stroller Strides (click the link to see if there is a franchise near you, or to start one yourself!). Many people feel it's silly to pay to "run around the park," but it is so much more than that. It is a group that schedules one hour workouts similar to what you would find in a gym, only they are held outside with your kids in a stroller. The workouts are a combination of short bursts of cardio and resistance routines utilizing resistance bands. But beyond that, Stroller Strides is great because it is a social setting. You're motivated to go not only to get the exercise but also to see your mom-friends, and for your kids to play with their friends after the workout. Especially for moms who thrive off of social contact, this kind of setting can be just what she needs to stay motivated for the long term. If you don't have Stroller Strides near you but like the idea of social exercise, look into gyms with classes. Or talk to other moms you know and see what they do, or arrange to do something together. Not only will this make movement more enjoyable for you, but your children will see you having fun and being active.

I think my conclusion is this- weight is an issue for women, especially during their child bearing years. It's not only an image issue, it's an issue of health for both the woman and her children/future children. But the issue must be handled differently- instead of stressing numbers and dieting, a healthy lifestyle and enjoyable movement should be encouraged.

1 comment:

MrsHashBrown said...

As someone who was just chewed out by her doctor about weight, I say this was a GREAT post!

I lost all of my pregnancy weight (27 lbs.) by my 6-week checkup. However, I didn't modify my diet as I began weaning my son. So I had gained nearly all my pregnancy weight back by the time my son was around 1 1/2. Totally my fault and totally lame!

Here's to positive lifestyle changes. . .and a little weight loss too!

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