Sunday, April 14, 2024

The Motherhood Diaries: BMI & Babies Pt 1– Who’s Allowed To Gain Weight While Pregnant?

In this first part of a three-part series, Capsule’s Emma Clifton writes about her own experience of having her weight be ‘a problem’ during her pregnancy, and why this experience has opened her eyes about who’s allowed to gain weight while pregnant.

Welcome to our series, The Motherhood Diaries – a safe space for you to share your experiences, advice, hopes and heartbreaks. We’ll be hearing from industry experts giving practical advice alongside Capsule readers (You!) sharing your firsthand experiences. We’re looking at everything from fertilitytrying to conceivepregnancythe fourth trimester, newborns, toddlers, children’s mental health and teenagers, fertility issues and everything in between! 

It was only when I started my pregnancy journey that I realised how little trust I had in my body. How much I had internalised the idea that it was an unruly creature, just waiting to get out; like Godzilla taking over a screaming inner city. The idea of getting pregnant was pretty scary for me because of this – what if this experience was the culmination of all of my worst fears?

I had expected that due to my BMI putting me in the overweight category, getting pregnant would be hard – all of those carefully worded, ‘hey, have you heard of vegetables?’ pregnancy articles had implied as much. So, when I got pregnant much faster than expected, I was shocked. When I was able to keep exercising and eating the same as I had before (on the days when the nausea didn’t have me lying on the floor/vomiting in the shower), I was also shocked.

There’s nothing like having two of society’s most loaded words – geriatric AND obese – hovering about your fertility to make you feel all warm and fuzzy inside.

If anything, I realised how restricted my previous diet had been when suddenly I needed to stop avoiding things like dairy and carbohydrates in order to give my baby a wide-range of nutrients. But what I didn’t realise was that my trust in my body was growing at a time when I was going to need it the most. Because for the next few months, I was going to have to become a defender of my body – and of my size – to some of the medical professionals who would be monitoring my pregnancy.

High Risk

It was only when I was in my mid-thirties – and deep into therapy – that I realised that it wasn’t okay that every time I visited my family GP when I was growing up, the first thing he did was say ‘let’s have you jump up on the scales.’ Strep throat, acne treatment, low iron… it didn’t matter. As a sturdy teenage girl, my weight was clearly the over-riding factor. This mentality stuck with me for a long time.

When early last year I blurted out to my nutritionist that I knew that my weight was a risk factor for my fertility, she gave me an odd, but kind look, telling me, “You should prepare yourself for the fact that you’ll probably get pregnant very quickly, because you’re very young and you’re very healthy.” I was about to turn 37 at the time, and my age also felt like a potentially scary factor.

There’s nothing like having two of society’s most loaded words – geriatric AND obese – hovering about your fertility to make you feel all warm and fuzzy inside. My new GP – a man who has never weighed me and simply described my body as ‘robust’ (accurate!) – told me the same thing as my nutritionist. But I refused to believe it. How could this body be trusted to do ‘the right thing’, when it took great effort to have it look something even close to ‘the right way’?

For my first OB appointment, 12 weeks in, I was nervous. At that three month point, you’ve gone through the fragile early months and getting to see proof of your baby is exciting but terrifying. I would say that it was this cocktail of emotions that distracted me when, two minutes into that first appointment, the OB said, “Now, you’re going to have to be careful, because you’re already carrying some extra weight… not that we want you to get an eating disorder, hahaha.”

Hahaha!!

After 16 years of being a journalist, there are times when I react to something as a writer first, rather than a human (it’s not always a good thing). And it was a flippant comment – made thoughtlessly, not maliciously – in an otherwise pleasant appointment. But when they said that to me, I felt a giant wave of shame, mixed with a tiniest sliver of ‘you’re going to write about this’ rage. So, I made a note of that quote as soon as I left the appointment. And I had the same instinct four months later when I questioned why I had been given the more extreme glucose test on the first go and was told it was because I was considered ‘high risk.’

The glucose test is to test for gestational diabetes, because one of the many whackadoo things that happens in your body when you’re pregnant is that you can start handling insulin differently. Gestational diabetes can happen in any body type – some studies do show the risks are higher with higher body weight – but when you are bigger, it can start to feel like a bit of a canary-in-the-mine situation for how your general body is being viewed.

It was only a week after doing the Oral Glucose Tolerance Test (OGTT) – which is the one normally given to people after they’ve failed the less extreme one – that I realised I had been tested differently to, frankly, my thinner friends and decided to check the government regulations. The test had gone badly – in that I had passed, but also passed out; I fainted five minutes into it, and started spotting that afternoon, with the bleeding lasting for the next three days. (Every single OB would tell me this was unrelated but… it never happened again and boy, did it scare the bejesus out of me at the time).

The test itself was deeply unpleasant, but so was realising that I had been classed as high risk, without a conversation, and despite my normal-to-low blood pressure and blood sugar (tested every appointment at the OB). It was an eye-opening moment – not only was my weight ‘a problem’, but it also meant that I could be given different treatment, or different options than if I was in a smaller body… and without any warning.

A few months later, after going to the emergency room with abdominal pain and being put on a drip overnight, I went to my normal OB for a follow-up appointment and the first thing – the FIRST THING – they did was look me up and down and say, “God, it’s so good that you passed your glucose test, isn’t it?” This was the same week that ‘Emma/Capsule’ was emailed a complimentary Jenny Craig trial from a PR and I think it’s a testament to either personal growth/exhaustion, that all I could do in both instances was laugh (coldly, like a serial killer).

Because by this stage of my pregnancy, I wasn’t distracted by nerves, or anxiety, in the face of more weight-related comments. This time, I went straight to rage. I thought about the layers of privilege that have accompanied me for this pregnancy – I’m Pākehā, I’m able-bodied, my partner and I were (just) able to afford the money it takes to go private, I’m able to access straight-sized maternity clothing, I didn’t have to go through the weight-related battle that can accompany IVF, and I don’t have experience with disordered eating, where having your weight monitored – and having that number on the scale be linked to the health of your unborn child – can be unbelievably traumatic.

All those factors were in my favour, and yet I consistently felt like I was on the back foot in my pregnancy, due to my body size – even though I freaking loved the way my pregnancy body looked. I thought I looked like a fertility statue – sure, maybe one of the Palaeolithic era ones, rather than the sylph-like Greek ones, but something to celebrate nonetheless.

When I reached out through my very small, private Instagram account and asked if any of my community had had similar experiences where their weight became an issue during pregnancy, I was inundated with the kind of replies that make you want to burn the world to the ground.

Mothers who had been told they were too big to have the birth they wanted. Mothers who were told, after getting through the BMI restrictions that come with IVF, not to get too excited because they were ‘an obese and geriatric’ pregnancy. Mothers who were given the glucose test four times because their doctor simply wouldn’t believe that they didn’t have gestational diabetes, due to their body type. Mothers who lost too much weight, post-partum, and were told they ‘were just one of the lucky ones,’ only to find out it was a giant health red flag, later on.

This was a tiny, tiny sample of mostly NZ-based women, who found that the spotlight placed on their weight overshadowed huge parts of their pregnancy experience. That’s when I knew I had a story.

In part two of the Babies & BMI special, we talk to four mothers who each experienced weight bias during their pregnancy – whether it was being told to prioritise weight loss 72 hours after giving birth or had severe pain written off as being due to their weight. Then in part three, we’ll be talking to a nutritionist, a fertility specialist, a midwife and an OB about about where the BMI is a very important measure, and where they would like to see the system changed when it comes to a hyper-focus on weight.

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