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Saturday, July 24, 2010
I Want a Healthy, Natural Childbirth...
This was said in the same appointment that the women also said she would try, but wasn't promising, she wouldn't gain 70 pounds with this pregnancy like the previous ones. Uh, ok.
9 comments:
Micah
said...
I gained 70 lbs with my first and had a healthy, natural childbirth. Even with a 10.5 lb baby and a compound presentation. :)
I gained about 65 pounds with my second baby. I also had a wonderful homebirth and easily birthed my 9#2oz baby in the water. It took about 8 months of healthy eating/exercise/breastfeeding and the weight fell off. My midwives didn't blink at eye at my weight gain, though they did discuss healthy eating habits. I would be very put off by a midwife who focused on weight gain during pregnancy.
And this patient gained 70 pounds with both pregnancies, both babies 10+ pounds, and one with a shoulder dystocia with lasting damage to the child. So just because you didn't have any problems, doesn't mean everyone will. Research has shown increased risk for complications when women gain too much weight. So why not optimize your chances for the best possible outcome by controlling your weight gain during pregnancy?
Could be that their bodies just grow big babies and gain more weight. Plus shoulder dystocia can happen with any sized baby, it would be typical of an OB to automatically say it was the babies size. Most women I know who have home births have "big" babies (9 lbs or more) and none are too concerned with "controlling" their weight gain. Plus if the patient had an epidural (which most do) she would be on her back pushing which can also cause shoulder dystocia.
Micah - I did not say that she had the shoulder because the baby was big. In fact, her next baby was bigger with no problems. However, it's been well researched that large weight gain can be a risk factor for shoulder dystocia. Not to mention having a previous shoulder is a risk factor for this current pregnancy. Any midwife who is not aware and counseling patients on weight gain and nutrition during pregnancy is not a midwife I would think highly of. I don't harp on the weight thing (and I'm sure your midwife didn't either, but I damn well bet she didn't like your 'healthy' weight gain) but it is an important part of prenatal care.
Making comments that no one worries about their weight when having a homebirth is a great way to establish more ammo for the anti-homebirth crowd - which I am mostly certainly not part of - would love to be doing homebirths if I could afford to.
This particular patient had natural childbirth (as about half the women I work with do) both times. I have no idea what position she pushed in, and I know there were likely some improper manuevers on the part of the OB she had at the time. So yes, other factors may have played a contributing role...BUT my point was that careful weight gain may actually minimize the chance of another shoulder. Especially since she is declining any gestional diabetes testing (I bet you don't believe in that either?).
I am an awesome midwife and will go far beyond what others would for my clientele (to be supportive of their hopes and desires) so don't come on my blog thinking you know anything about me. Because what you see on this blog is a fraction of who I am. And because it's anonymous, it can be wahtever fraction of me that I wish to show.
Oh and Anonymous? Why would you be put off by a midwife who was doing her job by including nutritional counseling and discussions about weight gain? I don't 'focus' on it but geez, it's a component of the well-rounded prenatal care that I provide.
I certainly appreciated the education and information given to me by my midwives during my 3rd pregnancy. I start out at about 255 lbs, and knew I was at high risk for GDM, macrosomia, preeclampsia, and dystocia. I listened to and followed their dietary advice to keep my weight at a healthy gain for the pregnancy, as well as doing an early 1 hr glucola test, in addition to the standard 28 week 1 hr GTT. My weight gain was about 25 lbs total, borderline elevation of the 2nd 1 hr GTT for which I meticulously followed a GDM diet, and went on to give birth to a 6 lb 9 oz baby without any dystocia issues (never had them with my other children either). I did have gestational hypertension at the end of the pregnancy though.
I, for one, appreciated everything my midwives did to help encourage me to maintain a healthy environment/pregnancy for myself and for my baby.
I definitely don't think my comment called for the tone of your reply, I obviously love your blog as it's on my favorites list and I check it every day. My point was that some women gain more weight. And I think that can be a variation of normal. My diet hasn't changed a bit since I was maintaining before I got pregnant, yet here I am at 27 weeks having gained 32 lbs already. I eat practically no sugar and don't drink juice or cokes. I just gain a lot! And have big babies, which I'm glad for now since my baby has a 2 vessel cord. He'll probably be "average" sized.
I'm sorry Micah - I think I was getting defensive because I perceived your tone and that of the anon poster to be critical of my practices as a midwife.
9 comments:
I gained 70 lbs with my first and had a healthy, natural childbirth. Even with a 10.5 lb baby and a compound presentation. :)
I gained about 65 pounds with my second baby. I also had a wonderful homebirth and easily birthed my 9#2oz baby in the water. It took about 8 months of healthy eating/exercise/breastfeeding and the weight fell off. My midwives didn't blink at eye at my weight gain, though they did discuss healthy eating habits. I would be very put off by a midwife who focused on weight gain during pregnancy.
And this patient gained 70 pounds with both pregnancies, both babies 10+ pounds, and one with a shoulder dystocia with lasting damage to the child. So just because you didn't have any problems, doesn't mean everyone will. Research has shown increased risk for complications when women gain too much weight. So why not optimize your chances for the best possible outcome by controlling your weight gain during pregnancy?
Could be that their bodies just grow big babies and gain more weight. Plus shoulder dystocia can happen with any sized baby, it would be typical of an OB to automatically say it was the babies size. Most women I know who have home births have "big" babies (9 lbs or more) and none are too concerned with "controlling" their weight gain.
Plus if the patient had an epidural (which most do) she would be on her back pushing which can also cause shoulder dystocia.
Micah - I did not say that she had the shoulder because the baby was big. In fact, her next baby was bigger with no problems. However, it's been well researched that large weight gain can be a risk factor for shoulder dystocia. Not to mention having a previous shoulder is a risk factor for this current pregnancy. Any midwife who is not aware and counseling patients on weight gain and nutrition during pregnancy is not a midwife I would think highly of. I don't harp on the weight thing (and I'm sure your midwife didn't either, but I damn well bet she didn't like your 'healthy' weight gain) but it is an important part of prenatal care.
Making comments that no one worries about their weight when having a homebirth is a great way to establish more ammo for the anti-homebirth crowd - which I am mostly certainly not part of - would love to be doing homebirths if I could afford to.
This particular patient had natural childbirth (as about half the women I work with do) both times. I have no idea what position she pushed in, and I know there were likely some improper manuevers on the part of the OB she had at the time. So yes, other factors may have played a contributing role...BUT my point was that careful weight gain may actually minimize the chance of another shoulder. Especially since she is declining any gestional diabetes testing (I bet you don't believe in that either?).
I am an awesome midwife and will go far beyond what others would for my clientele (to be supportive of their hopes and desires) so don't come on my blog thinking you know anything about me. Because what you see on this blog is a fraction of who I am. And because it's anonymous, it can be wahtever fraction of me that I wish to show.
Oh and Anonymous? Why would you be put off by a midwife who was doing her job by including nutritional counseling and discussions about weight gain? I don't 'focus' on it but geez, it's a component of the well-rounded prenatal care that I provide.
I certainly appreciated the education and information given to me by my midwives during my 3rd pregnancy. I start out at about 255 lbs, and knew I was at high risk for GDM, macrosomia, preeclampsia, and dystocia. I listened to and followed their dietary advice to keep my weight at a healthy gain for the pregnancy, as well as doing an early 1 hr glucola test, in addition to the standard 28 week 1 hr GTT. My weight gain was about 25 lbs total, borderline elevation of the 2nd 1 hr GTT for which I meticulously followed a GDM diet, and went on to give birth to a 6 lb 9 oz baby without any dystocia issues (never had them with my other children either). I did have gestational hypertension at the end of the pregnancy though.
I, for one, appreciated everything my midwives did to help encourage me to maintain a healthy environment/pregnancy for myself and for my baby.
I definitely don't think my comment called for the tone of your reply, I obviously love your blog as it's on my favorites list and I check it every day.
My point was that some women gain more weight.
And I think that can be a variation of normal.
My diet hasn't changed a bit since I was maintaining before I got pregnant, yet here I am at 27 weeks having gained 32 lbs already. I eat practically no sugar and don't drink juice or cokes. I just gain a lot! And have big babies, which I'm glad for now since my baby has a 2 vessel cord. He'll probably be "average" sized.
I'm sorry Micah - I think I was getting defensive because I perceived your tone and that of the anon poster to be critical of my practices as a midwife.
It's ok, it's hard to perceive tone via internet. :)
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