Oct 292012

“So, while following the gestational diabetes diet, I think you may be surprised and pleased to see that you won’t gain any weight at all this pregnancy!” - Nurse practitioner to 13-week pregnant woman with no history of or risk factors for gestational diabetes.

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 October 29, 2012  informed consent, prenatal  Add comments

  26 Responses to ““…You May Surprised & Pleased To See That You Won’t Gain Any Weight…With this Pregnancy.””

  1. This nurse is dangerous. Even on the GD diet, I’m sure you gain a little weight… You’re growing a human…

    • You’re right. A lot ofthe quotes here are either dumb or thoughtless, but this one is dangerous.

      And then what happens when she weighs in and has gained weight? The nurse tells her she’s failed?

    • I’m on the gestational diabetes diet. I was in the overweight category prepregnancy. I’m 27 weeks pregnant and have gained 9 lbs. My midwife is neither pleased nor displeased with my weight gain. She is pleased with my fundal height, blood pressure, ketone levels, blood sugar levels, and general feeling of good health, though.

  2. And that is good because…???
    I agree with road2vbac and Jane – this nurse is a menace to pregnant women and their babies.
    Rethink your priorities, Nurse Idiot!

  3. I stopped gaining weight on the GD diet, but I was already overweight and I’d already netted 15 pounds for the pregnancy. (Lost 15 first trimester, then gained 30 when my appetite came back) What an idiot.

  4. When I was pregnant with my first my grandmother-in-law told me I looked great and must have not gained any weight at all. I told her I gained the right amount (for me, at the end I had gained 45 pounds). She then told me that with her first, my FIL, she only gained 8 lbs, and he was 8 lbs 9 oz. I was horrified.

    See, we don’t do that anymore as a society, restrict weight gain like that. What is this nurse up to? The mother should still gain some weight!

  5. I’m confused. While this nurse is obviously a dangerous idiot, *why* is the OP being put on this diet at all?

  6. While I dislike the nurse’s comment and don’t think that weight loss should be the priority in most pregnancies, I have come around to realizing that weight loss or slow weight gain in pregnancy can be normal and healthy. While on the gestational diabetes diet, I have been keeping my blood sugars in the normal range, testing the level of ketone in my urine to ensure that it is not at a dangerous level, and monitoring normal milestones in my baby to make sure he/she is growing normally. Instead of measuring 6-8 weeks ahead like I did in my last pregnancy, I am measuring normal. I am only at a total weight gain of 9 lbs at 27 weeks, and my weight has not really changed for a few weeks now. My midwife is not concerned about numbers on the scale so much as my health and my baby’s health.
    I have to say, I am not trying to start a fight, but I tested normal during my first two pregnancies when I did the usual glucose test. This pregnancy, I did not test. I just tested my blood sugars. It turns out that although I most likely would have passed the test again, my sugars were going out of the normal range pretty frequently. I chose to monitor and control them even though I could have a ‘free pass’ by testing negative, because I want to make sure that my risk of type 2 diabetes and my child’s risk are as low as possible.

    • Yes, for a woman who has risk factors for diabetes such a diet could be helpful. But it could cause actual harm for a woman who does not.

    • It totally depends on where you start out from. For me, maintaining or losing weight while pregnant would not be good at all.

    • I think the ideal object should be good nutrition for the mom.

      If you take some hypothetical woman who eats ice cream for breakfast, has never eaten a vegetable and only gets fruit in the form of fruit snacks, and educate her about proper nutrition, and she begins eating a healthy diet for the first time in her life, she’s probably going to lose weight while growing a healthy baby.

      Now take a woman who has adequate nutrition but is borderline for diabetes and improve her diet — she’ll probably maintain her healthy weight and grow a healthy baby.

      But if you take a woman who has adequate nurition and has no risk factors for diabetes and then force her into a diet that’s not designed for her, it teaches her to routinely override her natural hunger cues, and the diet may end up depriving her of calories and nutrients she actually needs. Moreover, it teaches her not to trust her body to do its job, which sets her up to view herself as a failure.

      I think we’re all in agreement that the primary consideration for any of these diets shouldn’t be “Don’t lose your figure while pregnant.” :-) It always should be the health of the mother and the baby, and the right balance of nutrition for mother and baby. :-)

      I did lose weight in my first pregnancy (before gaining some back) because I changed my eating habits from “lousy” to “healthy.” I wasn’t dieting, and I certainly wasn’t trying to lose weight, but I changed my snacks from things like “a bagel with cream cheese” to “an apple.” It’s hard to argue with improving overall nutrition. :-)

      • Agreed. I had my first son at 32 weeks, which after hindsight and all that, I know that my amniotic sac was weak, because I was eating milk and cereal for breakfast everyday and only giving into my whimsical cravings. I ate fruit and vegetables, but not purposefully. I did have gestational diabetes, but my ob/gyn dropped the ball in calling me to inform me of my lab results. (one reason of many why I’m with a midwife now.)

        With pregnancy, I’m 20 weeks in and my sugars have been great, and I’ve lost 11 pounds, then today’s weigh in showed I gained a pound. I’m not fussing over weight, though. I was over weight to begin with, cause I admit I wasn’t good at maintaining my nutrition. But, when I got pregnant with this one, I was bound and determined not to have another preemie. So, I eat really well and I’m walking regularly.

        I’m in better shape now than I was before I was pregnant! the whole idea is fueling your body to be strong enough to carry your baby. Tons of junk food isn’t good for anyone. As they say, everything in moderation!

      • “I think we’re all in agreement that the primary consideration for any of these diets shouldn’t be ‘Don’t lose your figure while pregnant.’ It always should be the health of the mother and the baby, and the right balance of nutrition for mother and baby.”

        This! I know a woman who was so obsessed with not gaining too much weight (and she was small to begin with) while pregnant. She didn’t want to grow out of her normal jeans. She ended up being induced and having a c-section six weeks before her due date because the baby quit growing. Needless to say, her mother is raising her son now and the poor baby is having so many problems. He is 10 1/2 months now and is not much bigger than my nearly 2mo. His grandmother has been giving me the clothes he outgrows, but it looks like my LO is going to bypass him soon.

        • That is such a sad story! :(

          • He is doing a lot better since his grandmother gained temporary custody. There were a few other factors involved in the custody arrangement, but he is thriving now, just small for his age. He also has the typical preemie issues, such as later development, but he seems happy now. I just saw him yesterday and he’s crawling around like a champ. He also tried to beat up his little “cousin” because his grandmother held him. (he’s not blood related, but his grandmother is an honorary aunt to my sons because she’s DH’s stepmom’s best friend)

  7. My doc with my second told me babies/moms have better outcomes if the mom gains at least 16lbs. I gained a net of 8, after losing 10 and gaining 18. Started out with a high BMI, around 37.

  8. Coming from the experience of having HG, I am really sensitive to the idea that zero weight gain is always a positive thing during pregnancy. I am really angered when its a health care professional making asinine comments like this.
    You don’t put people on special diets when there is no need for them. I was more on the diet of “try to eat something that’s not too horrible when it comes back up”

  9. Why do health care providers seem to obsess over weight gain? But then I see so many women obsessing over it and making it like a one-upping game. “I gained X!” “Yeah, well I only gained Y!”

    I was borderline HG throughout my pregnancy. It. Sucked. At least the baby was healthy but I sure wasn’t.

  10. I practically followed a GD diet during my second pregnancy, but healthier. Haha. I did eat more healthy fat. I didn’t have GD as far as I know, but I gained MORE weight than the first where I ate more carbs, but my baby was almost exactly the same size as the first. I really thought that he would be bigger…but nope.
    Nutrition is the key!! Calories, weight loss/gain…etc. Means nothing to me. Mom needs all of the vial nutrients, preferrably in the form of whole foods, not vitamins. If the nutrients are there, the mom’s body will do what it needs to do to keep the mom and baby healthy.

  11. Totally forgot to come yesterday and give the whole story, so who know if anyone will see this. Here’s the (long, sorry) background.

    Last pregnancy, I gained a total of 75 pounds. I was craving sweets the whole time, had just left an active job for a sedentary one, and had preeclampsia– I lost 45 pounds in the week and a half after the birth, so lots of water weight. I figure my “real” weight gain was around 40-45 pounds.

    So, this pregnancy, my first visit in a midwifery practice was with this nurse practitioner, who does prenatal visits when the midwives’ schedules are full. The NP had my records, and selectively ignored things. She “diagnosed” me as a diabetes gene carrier based on family history, the fact that I apparently have wide pores on my chest, the fact that I am hairy “down there” (excuse me for not shaving!) and… my favorite… the fact that my first baby was SO BIG. She was born at 41 weeks, quite water logged from my constant IV preeclampsia induction, and weighed a grand total of 8lbs5oz. Average for a 41-weeker is 7.9 pounds!

    So, after ignoring my explanation of how much of my weight gain was clearly swelling from the pre-e and how I wasn’t eating fantastically that time around, she told me that I clearly had undiagnosed GD in my last pregnancy. I said I hadn’t had any symptoms and had passed the 3 hour glucose test just fine, and she said that the tests miss a small percentage and a small percentage of women with GD don’t have symptoms.

    I said I respectfully disagreed, and she gave me a packet of information about the GD diet to look over. I said I was concerned that a 2000 calorie diet wouldn’t be enough during pregnancy, particularly because I get a lot of activity chasing my toddler, and am still breastfeeding. That’s when she spouted this gem: I’d be surprised and pleased (what?!?) to see that I wouldn’t gain any weight at all with this pregnancy. Since I know that even obese women are advised to gain a few pounds (and I was seven pounds over a healthy BMI pre-pregnancy, some of which can be attributed to extra skin from the last pregnancy, H cup lactating breasts, etc.) I was somewhat horrified.

    When I got home, I did some number crunching. On the chart the practice gave me about healthy weight gain, I’m in the “healthy” category even at slightly overweight. So I “get” to gain 25-35 pounds. If I didn’t gain any, I’d assume that after giving birth and the first few months of breastfeeding, I’d be at an absurdly low weight for my height, about 160 pounds. I haven’t been that since 10 years and 9 inches ago. I’m six feet tall.

    And the worst part of it all? Not once did she even ask what my current nutrition is like. Not once did she ask about my activity level. She just saw a weight starting with a 2, and assumed I’m unhealthy and lazy.

    Luckily, I don’t have to see this NP for any more prenatal visits. My midwife is sane, listens to me, and isn’t alarmist. Much better.

    • And that looks even longer than I anticipated, sorry!

    • And another note, the thing that angered me most about this comment was the “pleased” bit. If I didn’t gain any weight in a pregnancy, I’d be scared, not pleased. Pregnancy is for the purpose of the child on the way, not a fashion choice on my part. Sure I don’t like seeing the scale climb, but that doesn’t mean that I’m shallow enough to potentially endanger my baby by not gaining any weight.

      And for the risk factors: I’m not more than 10% overweight, I have no close family members with diabetes (two grandparents). I’m 25, and I’m white.

    • wow, agenda much!! i had to see a dietition because im technically obese (im short and a bit chunky but definitely not what i would class as obese, i think the word is used to much) but other than that no one even commented on my weight gain!! glad everything has worked out with your midwife, i really think some nurses who work in midwifery have a complex,

  12. While I agree this person is talking nonsense, and most women should gain weight, lets not get overly “horrified” by cases where women don’t gain weight. It can be perfectly normal. I’m my first pregnancy I was two stone lighter the day after I gave birth than I had been the day I conceived – yet I had a perfectly healthy 6.15 baby. I am currently 36 weeks preg and I’ve once again lost weight since my booking appointment at 10 weeks. Baby was in normal ranges on last scan, bump is measuring correct, and no one is concerned about my lack of weight gain at all. Lack of weight gain is not necessarily bad or dangerous, it can in fact be normal and healthy.

    My first pregnancy weight loss was due to sickness and not great for me, though it didn’t effect baby. My very minor weight loss this time is perfectly healthy and not a concern.

    So while the nurse is not doing a good job at all, automatically claiming that lack of weight gain is dangerous is just as misinformed. Weight is not what a healthy pregnancy should be judges on. Try scan measurements, bump measurements, actual medical indicators…

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