In celebration of the baby bump

30th September 2009

In celebration of the baby bump

posted in Rachel |

I think I might have mentioned here (only about a dozen times) that I am set to be the proud aunt come December. This baby, Chase, is the first on my side of the family, so we’re all especially excited. It was kind of ironic when my sister-in-law announced her pregnancy in late April, because she had just completed the tail-end of a new diet and fitness regime in which she had dropped a couple sizes. I was worried about how Amber would feel about her expanding body, but she seems to have completely embraced the bowling ball she now sports.

Since cultural ideas about fat began to shift more than a 100 years ago, it has only been in pregnancy that women are culturally “allowed” to be fat, but now even those standards are changing. The recommended weight limitations for pregnancy are becoming more stringent* and doctors are limiting the amount of calories pregnant women should consume. My other sister-in-law, who is pregnant with twins, was told by her doctor to limit her diet to an additional 300 calories per baby — or the equivalent of a serving of Raisin Bran with reduced fat milk. Amber has already received lectures from her doctor that she’s gaining too much weight even though she says she tries to eat healthy and hasn’t been prone to many 3 a.m. ice cream and pickle cravings. Reader Sharon recently emailed me with her maternity dilemma. She lives in Australia and the hospital in the state she is moving to is turning pregnant women away if they have a BMI above 35. This means that Sharon, a recovered bulimic who weighs just under 200 pounds, can only gain about 14 pounds during her entire pregnancy — and that’s including the weight of the baby! Sharon said that she’s read recommendations that actually encourage fat women to diet and lose weight during their pregnancies. “I am very fit and healthy with great cholesterol levels and able to run for 3 hours without stopping, but I am going to have to diet in this pregnancy to ensure I can give birth in the hospital I have chosen as I arrive in the country too late to look around for another hospital,” said Sharon. And it’s not just Australia. For more on pregnant women and weight issues, check out the blog Well Rounded Mama.

I met my brother David and Amber at a local park the other weekend with my new Canon DSLR to take some quick maternity shots of the expectant couple. I usually don’t do portraiture-type photography and I was especially clueless on how to do maternity poses, but I’m happy with how some of them turned out. I’ve since looked up some ideas and we plan to meet soon to get more shots. If only all women were as embracing of their curves…

* The Institute of Medicine recommends that women of “normal” weight should gain between 25 to 35 pounds and underweight women should gain 28 to 40 pounds. Overweight women should limit their increase to 15 to 25 pounds and obese women should gain about 15 pounds.

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This entry was posted on Wednesday, September 30th, 2009 at 9:45 am and is filed under Rachel. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

1 On September 30th, 2009, erin said:

you are so BEATIFUL in these pictures. radiant even (i know cliche)

posted on September 30th, 2009 at 11:11 am

2 On September 30th, 2009, Monica said:

Especially ridiculous considering the evidence linking obesity to restricted calories in the womb. Also, 300 calories per baby is RIDICULOUS. She is growing TWO ENTIRE NEW HUMAN BEINGS.

posted on September 30th, 2009 at 12:01 pm

3 On September 30th, 2009, Forestroad said:

Both of you are radiant!

posted on September 30th, 2009 at 1:17 pm

4 On September 30th, 2009, Kelly said:

First of all, lovely pics!

Secondly – I’m glad I didn’t diet before being pregnant. And I never worried about being “fat” while pregnant (WTF anyway?!) – I enjoyed the experience. I ate gloriously and loved my appetite (nursing two kids at the same time was even MORE fun for being hungry and loving food!). I gained about 25 lbs. each pregnancy. I am about 10 – 15 lbs. heavier than I was before breeding. Life happens. I love my kids and my body is awesome.

posted on September 30th, 2009 at 1:30 pm

5 On September 30th, 2009, Rachel said:

Haha, just a note to say that that isn’t ME in the photo. That’s my brother and sister-in-law. I’m behind the camera.

posted on September 30th, 2009 at 1:31 pm

6 On September 30th, 2009, Piffle said:

How beautiful!

I’m a bit baffled though, an Australian hospital will turn away a woman in labor if her BMI is over 35? That’s unethical.

posted on September 30th, 2009 at 1:41 pm

7 On September 30th, 2009, Piffle said:

That’s the people in the pictures that are beautiful!

posted on September 30th, 2009 at 1:43 pm

8 On September 30th, 2009, Rachel said:

@Piffle: A public hospital at that. According to Sharon, there are other centers that specialize in fat women pregnancies, so I guess they’re turned away to seek help at one of those facilities.

9 On September 30th, 2009, Charlotte said:

Rachel, those are great pics!

posted on September 30th, 2009 at 1:53 pm

10 On September 30th, 2009, PlusSizedFeminist said:

Ok, this is getting ridiculous. Why don’t they just come out and say it. “Fat is bad. No matter what, so if you aren’t thin, society wants nothing to do with you.” I’d respect the “experts” so much more if they did. This whole “we’re worried about your health” crap isn’t cutting it.

posted on September 30th, 2009 at 4:45 pm

11 On September 30th, 2009, Lisa said:

How lovely! I recognize the park – it’s one of the most beautiful places in the area.

posted on September 30th, 2009 at 5:20 pm

12 On September 30th, 2009, Gimligirl said:

I get absolutely livid when I hear about women being told to maintain a certain weight or even lose weight during a pregnancy. It’s complete and utter bullshit.

posted on September 30th, 2009 at 6:13 pm

13 On September 30th, 2009, Katie said:

i agree with gimligirl. i get so ANGRY when i hear such things! Society these days is ridiculous. and it angers me more that i cant do anything about it!

posted on September 30th, 2009 at 6:36 pm

14 On October 1st, 2009, Emma B said:

A 14-lb weight gain, in an obese woman, DOES require dieting and fat loss. Per http://www.americanpregnancy.org/pregnancyhealth/eatingfortwo.html, the baby weighs 7-8 lbs, the placenta weighs 1-2 lbs, the amniotic fluid weighs 2 lbs, the uterus weighs 2 lbs, the extra blood in the mother’s system weighs 4 lbs, breasts weigh 2 lbs, and maternal fluid stores (aka water weight) weigh 4 lbs. That’s 18-20 lbs of non-negotiable extra scale weight — fat women can’t choose to have less extra blood, y’know? — even if the mother doesn’t gain an ounce of fat.

So, the 15-lb recommendation IS saying that obese women should maintain a negative energy balance and lose 3-5 lbs of fat, at least. After that, they should tightly restrict their intake to be fat-stable, accounting for the extra demands of the baby. And God help them if they have preeclamptic tendencies and gain a bunch of water weight, or hyperemesis gravidarum that nobody wants to treat because it’ll keep them from getting too fat…

Drives me Up. The. Wall.

posted on October 1st, 2009 at 11:01 am

15 On October 1st, 2009, wellroundedmama said:

Thanks for the link to my blog!

Yes, more and more practices are now turning away “morbidly obese” women and forcing them to attend clinics or hospitals that specialize in the new field of “bariatric obstetrics.” It’s not mandatory everywhere yet, but it’s becoming more common.

This is a high-tech, high-intervention, high-cesarean-rate approach to the crime of being Pregnant While Fat, with the chief tools being strongly restricted weight gain, excessive testing and monitoring, and interventions like early inductions and “elective” cesareans….”just in case.”

Even more alarmingly, fat women are now being precluded in some areas from choosing alternative care, like midwives, birth centers, and home birth. In fact, some midwives and GPs who have attended fat mothers have been prosecuted or censured for doing so, and some feel increasingly pressured not to see fat women in their practices.

Yet anecdotally, many fat women have better results from the midwifery model of care (proactive prevention of problems, intervention only when truly needed, emphasis on spontaneous and natural labor as much as possible, weighing the risks and benefits of each choice carefully), but in many places are now being denied access to it.

The emphasis on (and in some places, requirement of) the highly-interventive “bariatric obstetrics” model is in effect, “ghettoizing” fat women and preventing them from having any other choices. In the name of “safety” and “concern,” it may even pressure them into less-safe pregnancies and births.

And now we have the new pressure on fat women to gain little or no weight in pregnancy, and in many places, “morbidly obese” women are actively encouraged to LOSE weight during pregnancy. Other practices strongly encourage fat women to have weight loss surgery before pregnancy.

All these factors add up to a chilling effect on fat women who want to have children, BUT IT DOESN’T HAVE TO BE THAT WAY. We can continue to demand access to alternative models, we can refuse to patronize doctors who urge restricted weight gain in pregnancy, we can refuse early inductions and unnecessary cesareans, and we can take our business to size-friendly midwives in droves.

You can read more about this approach on my blog in my pieces on Bariatric Obstetrics and the series on Weight Gain in Pregnancy.

http://wellroundedmama.blogspot.com/2008/07/bariatric-obstetrics-part-1.html

http://wellroundedmama.blogspot.com/search/label/weight%20gain%20in%20pregnancy

There’s lots more material on the subject on my blog and on my main website, http://www.plus-size-pregnancy.org. Check it out.

Thanks for the shout-out, R!

posted on October 1st, 2009 at 1:33 pm

16 On October 1st, 2009, Elizabeth said:

That silhouette photo is just lovely. The others are also nice, but that one is really special.

posted on October 1st, 2009 at 4:20 pm

17 On October 5th, 2009, Mark said:

I know of a few women who were harrassed about weight to the point of normal birth not being “allowed” (they had to schedule a c-section) so they gave birth at home with a midwife. One woman weighed about 400 at term and gave birth normally at home to a healthy baby. She was refused everywhere else. I refused to get on a scale during prenatal visits, but I do think my weight had to do with the OBs decision to do a section at the last minute.

posted on October 5th, 2009 at 1:45 am

18 On October 6th, 2009, bri said:

Gorgeous pictures Rachel! And please tell your brother and SIL they are gorgeous!

I wanted a home birth with my second (and last!) child. No go. Because of my weight.
I wanted to use a particular delivery room at the hospital (it had a double bed rather than a hospital bed, that was the only difference). No go. Because I had had ONE slightly high BP reading during my entire pregnancy. It was infuriating. As it was, I had a 2 hour labour and a natural delivery with only nitrous to distract me (it sure didnt get rid of the pain!).

posted on October 6th, 2009 at 7:28 am

19 On October 8th, 2009, a girl running said:

Thank you for posting about this. I spent a couple of weeks very stressed about the BMI issue in my pregnancy. Eventually it made me angry. I have decided to enjoy this pregnancy and embrace my changing body. I continue to eat Intuitively and if that means I end up being directed to another hospital for the birth because I am considered high risk, than that is just what will have to happen. I was the same weight with my last pregnancy, I felt fantastic, I had a very safe no risk natural labour that lasted 43 minutes and I went home happy and healthy with my beautiful little girl.

posted on October 8th, 2009 at 2:28 pm