a) the next person who says, “Oh, you’re still vomiting several times a week and feeling nauseated every day? That was supposed to stop weeks ago,” will be vomited on by me.
b) the nutritionist I saw yesterday gave me sound nutritional advice which was not, in the end, really worth my time and money, since it amounted to, “Eat lots of protein, consume more calcium than usual, take a prenatal vitamin each day, and slavishly follow any silly ass warnings the US federal government distributes.” None of which was new information.
c) on the plus side, I did not have to pay for this advice, thanks to the miracle of health insurance. I had to be in town anyway for another, much more worthwhile, appt later, and the nutritionist was very nice, friendly, and apparently quite competent at her job, which was to dispense nutritional advice. It is not her fault I already knew most of it, and the gentle tweaking she suggested for my diet will probably be to the good.
d) on the minus side, I got hassled about my weight. I have it on good authority (mine) that I look fucking hot and feel fine. My blood pressure is great, my cholestrol is great and I do not have gestational diabetes. I can still wear some of the looser cut size 6 pants in my wardrobe.
The first question was what my pre-pregnancy weight had been. Answer: 20 pounds less than my current weight.
“That’s a little much, don’t you think?” she asked. I told her I’d gained 60 pounds when I was pregnant with Rio, and lost all of it by her first birthday without the benefit of any diet or exercise changes. I agreed that I would prefer not to gain so much weight, but said repeatedly that it was very, very low on my priority list. She responded by showing me a little chart that indicated I was WAY above the normal range for weight gain at this stage of pregnancy. I should gain 25-35 pounds through the whole pregnancy, she said. Whatever, I said.
We talked about risks: gestational diabetes – no family history, and not an issue with my first kid. lasting weight gain – see above. It seemed to be almost a moral point, that the chart should inspire me to want to be like the medical model of normal womanhood. I was not impressed.
So she tried another tactic. “She must have been a big baby,” she said of Rio. I told her Rio’s birth weight – nine pounds, six ounces – without registering an opinion about whether or not she was large. She asked me if it had been a vaginal birth, and if I’d had a lot of tearing. Answer: Yes, and no, none. Several disbelieving comments. “I’ve never heard of a baby that big not tearing the mother.”
Uh…”I guess I just have super powers,” I said, flexing my arms. What was I supposed to say, “I have the biggest vagina in history. Quick, call Guiness!” ?
Finally, she got to her point, “Well, we’d like to avoid you going through all that again, wouldn’t we?”
“Sorry, what?”
“You don’t want to have such a big baby this time, so you should try to gain less weight.”
Uh….no. World of no.
As I said, the advice she ended up giving me was very sound, and she came back many, many times to the calorie cutting idea, but all in sane healthy ways – water down fruit juice, choose low-fat dairy products, skip cookies in favor of an extra serving of fruit, that kind of thing. If I follow exactly the advice she gave me, I might gain a little less weight and I will certainly have a healthy pregnancy. She didn’t tell me to do anything bad for me or the baby when she was doing the part that was actually her job.
But her logic in trying to get me on board with this ‘weight control during pregnancy’ scheme left a lot to be desired.
e) while I am ranting about this visit, let me also rant about listeria. In the past two months, I have been warned twice by my midwife and once by this nutritionist that I should not eat any sushi or any raw milk products (like Brie cheese) while pregnant because of the risk of contracting listeriosis, a potentially fatal bacterial infection.
Out of the roughly six million American women who become pregnant each year, approximately 800 of them will contract listeriosis infections. One in five of those infections is expected to be fatal.
As a contrast, not one health care professional has spoken to me about the risks of postpartum depression or how to avoid it, although the CDC (the source of the above statistics) estimates that 13% of pregnant women will experience that each year. This is around 800,000 cases out of that same population of six million women. Of those, 7% or around 60,000 women, reported being severely depressed.
What is going on here? Why am I being shanghaied into changing my lifestyle to avoid a treatable, albiet serious, illness that affects only 800 pregnant women a year, and no one has even mentioned the existence of one I am a thousand times more likely to suffer from?
[edit: made me look up listeriosis rates for France and Japan, places where the foods I am being told not to eat are staples of the diet. In contrast to the US, where we have about 8 cases per million residents, France has a little less than 4 per million, and Japan has only .65 cases per million. WTF? I am tempted to do a big expose article about this for some crunchy/ranty mama magazine.]
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