At my last Ob appointment, I got the fattie lecture.
At 23 weeks, I have gained somewhere between 10-12 lbs according to my scale at home. The 10-12 is because I don't know what my baseline weight is. My Ob decided that it MUST have been 123 lbs, and since I didn't want to get a lecture the first day about trying to lose weight during the first trimester (Because I didn't even know I was pregnant until 13.5 weeks!), I didn't argue with them. In reality my baseline weight was 125 or thereabouts. I haven't weighed 123 in quite some time.
So reality: My net weight gain as of week 14 was about 0.5 lbs.
This morning I weighed 135.4 lbs.
But I figured at the time, meh, 2 lbs. It probably doesn't matter.
Ha. Ha. Ha.
Boy was I wrong about that.
Welcome to ObGyn-land - where they will give you lectures on 2 lbs. 2 lbs! Essentially an amount that is smaller than the error around a single measurement!
Of course this is all according to MY scale. But I weigh myself at the same time every day, right after I get up in the morning. And it's worth pointing out that the weight on my scale matches a) the scale at the gym, b) the scale at the reproductive endocrinologist, c) the scale at the hematologist.
At the Ob's office, their scale consistently weighs me 3.5 lbs heavier than my scale at home.
I pointed this out and they said they knew. The question on MY mind is do they keep it calibrated wrong on purpose.
Add that to the fact that I don't think that they have adjusted (their version of) my baseline weight to their scale. Meaning at my last appt, my weight measured 138.4 for a net gain of 15.4 lbs.
That's quite a bit different from 10-12.
Anyway. I really didn't appreciate being harangued about my weight. Especially since I started off at a BMI in the 19-range. Especially since I weigh exactly what I'm supposed to weigh right now. They were concerned about my "trajectory," i.e. that I put on all the weight in 2 months.
Fair enough, but in my defense, those two months included my quals where I was essentially immobile for 2 weeks, and a trip to Italy where food was shoved in my face for 2 weeks. I think all things considered I'm doing pretty freaking well. Even not pregnant, it would have been impossible not to gain weight that month.
And furthermore, I have been tracking my own weight in Excel, and plotted a regression line of my trajectory and lo! Even if I keep putting on weight at my present rate, I will still end up gaining less than 35 lbs by week 40.
(Don't mind me, I'm an Epidemiologist. Regression equations are what we do.)
Anyway, I knew I couldn't say anything because it would come off as defensive and/or neurotic. Still, it made me furious that they would pick at me over basically 2 lbs. And now I'm terrified of my next visit.
Why?
My next visit is in the afternoon, and I consistently weigh 2 lbs more in the PM than I do in the AM. So unless I gain 2 lbs or less this month I'm probably going to get another lecture.
Do you have any idea how much I hate these appointments?
19 Pearls of Wisdom:
As long as you aren't hypertensive and you don't have gestational diabetes, just nod and smile (or smirk, your choice). Oh but don't be fooled by an "at this rate" approach. I took that approach too and I was gaining about a lb a week (I started at ~120). The slope on that linear regression line got a lot steepr somewhere in the middle of the third trimester when the edema started.
Joy. Well, we'll confront that if and when that happens.
I still hate them. Can I give them the finger too, as long as they can't see?
Just tell them that you are pregnant with a second burrito baby.
Wow- that's so obnoxious. They should save the lecture for the women who actually need it.
Yes, like Carin said, there is NOT a linear weight gain in pregnancy. Most weight is gained in the last trimester. So that's probaby why they're concerned.
That said, it seems arbitrary what ob/gyns are concerned about. In my first pregnancy, I gained one pound in the first 20 weeks and my OB was *freaking out* that I needed to gain more weight. In my second pregnancy, I *lost* two pounds in the first 20 weeks, and the OB didn't seem to care. And I gave birth to two average-weight babies.
And considering all OBs seemed to think it was entirely possible for me to have GD with my pretty much zero weight gain even at the end of 2nd trimester, enough to harass me and make me feel like shit, obviously they don't seem to think maternal weight gain is indicative of the baby's weight.
Wow. Even though I gained way more weight than recommended (50 lbs total) my doctor never lectured. Go ahead and give them the finger.
I will second Carin's response. In the third semester the rate of the weight gain goes up (25 of those pounds was the last month or two).
I realize it's not linear, but since I've gained 1 lb since I've been back from Italy, I can pretty safely say my rate of gain has decreased not increased. I'm sure it will increase again, but still, making me hate them and not want to come in... I'm not sure that's their goal. Plus, EVERYTHING I've read has said my weight gain at this point is completely normal. So really they need to bite me.
Yes please tell them to shove it. I got lectured beginning in the second trimester...I just nodded and smiled until the one visit where I lost it. The midwife I saw was so patronizing. I told her that I really wasn't eating much, and she said "but WHAT are you eating?"....as if I was eating candy bars and fried cheese or something. I see a llot of patients in my practice for obesity, which is also my research focus. I understand what a healthy diet and exercise regimen are. She grilled me about my diet and exercise and told me I was eating too many carbs and needed to exercise more because walking doesn't count if it's TO anywhere...I need to specifically go out and "take a walk". Seriously? When I then mentioned my shortness of breath she said "well honey I'm not asking you to run a marathon!" I think the "honey" put me over the edge. She also told me to take my inhaler more & when I insisted that I didn't think the SOB was asthma related, she came up with "well you know, you don't have to be wheezing for it to be asthma". Omfg I had steam coming out of my ears. And as usual, when I get really mad, I tried to tell her off and started crying. She backtracked and said that it was OK she was just concerned about me losing the weight later (I have always had a nonpregnant BMI close to 20. I lost nearly 40 lbs last time in 3 months just from walking 6+ miles a day with a colicky baby. In the winter.)
Next visit I insisted on a doctor who was shocked that I had been lectured on my weight, it was totally in range!
Sorry for the rant but this needless haranguing of perfectly healthy pregnant women really chaps my hide when I think of all the women at that very practice who really COULD use a simple lesson in nutrition & health.
Can I just say that with their obvious inconsistencies, coupled with attempts to follow each Ib. individually, I'd have stopped the lecture dead and told them to calibrate the scale right, listen to all data and THEN make their esteemed judgement? Cause, you know, a 3,5Ib error is bound to mess you up, if you're trying to figure out the significance of a 2Ib gain.
Ana -- Wait, walking "doesn't count" if it isn't TO anywhere? She sounds like a moron. She gets the gold star for her comment on your asthma. I hate it when they throw in the, "I was just being an asshole to you out of concern," part at the end. Sheesh. NOBODY responds well to a lecture. That's why we have all these classes in med school about how to talk to patients. Because obviously a lot of people don't get it.
I think what upsets me about this the most is that I am very informed, and according to what we learn in med school, I am basically right on target. It's like they have to find SOMETHING to lecture EVERYONE about or they don't feel like they're doing their jobs. I'd never experienced this sort of treatment before becoming pregnant, and am kind of shocked that I'm hearing about a change that is 2 lbs more than it should be.
SS -- Don't even get me started on daily weight fluctuations. Most people have daily fluctuations in their weight of 2-3 lbs. All my I've been told not to worry about those 2-3 lbs because they don't matter. Now they do? WTF?
My doctor never commented on weight gain on any of my pregnancies except my last. That was only because it was super weird how I was gaining, nothing for several months and then about 13 pounds at once, then nothing for a while, then a lot, and on and on. Hilarious thing was that after he was born when he went for his checkups he gained weight the same way I did when pregnant with him. I guess that's just how he grows. I don't understand them telling you that you are gaining too much too fast. I thought that ended in the 1970's and that now they only really care if everyone is healthy and it is normal to gain what you are gaining. You started out on the smaller side so wouldn't it make sense that you might need to gain more in order to support and nourish the growing person inside of you?
Oh, and at the LAST visit, the Doc asked me "how's your appetite? how are you eating?" and I thought...here we go again. But she noted that I had lost 2 lbs since the last visit and wanted to make sure I was doing OK. She said that I was absolutely on target with my weight gain.
A lot of people really really like this midwife, she is all kinds of touchy-feely and "honey" and "sweetie", whereas I cannot stand to be patronized like that. Give me efficient and to-the-point any day.
I usually HATE playing the "i'm a doctor" card...because if I'm coming in to see you, I want your advice and experience...but when I am seeing a practice fairly frequently I would hope they would at least make a note of it and talk to me as such. Most of the docs at the practice seem to realize that I have a medical background, but somehow the NPs and Midwives do not & have given me some ridiculous (and sometimes JUST PLAIN WRONG) explanations & advice.
Ana -- I'm right there with you re: the doctor card (in my case med student). First, my ob rotation was 3.5 years ago. Second, I don't feel like I remember anything from it. I'd rather be given all the information again than not know something. But also, I am not into being patronized, and "honey" would probably not go over very well with me either. And sometimes you're right, the info is just not correct. It is so infuriating to be hassled about something that isn't correct and then have to bite your tongue!
Hang in there...when I was pregnant (many years ago) I LOST 10 pounds in the first trimester. The nurse was reading me the riot act when the doctor intervened and said, "So has your diet changed?" and I said, yes, I was substituting fresh fruit and vegetables for french fries (embarassing, but the truth) and she felt around for a bit and told me I was doing just fine; I might be shrinking, but the baby was growing well. She told me to keep feeding the baby healthy stuff (just add ice cream because I hated drinking milk) and I finally stopped losing weight, gained just a little less than what they wanted and everything was fine....
CC -- That's really funny. And also awesome that you got to add ice cream! I've been trying to eat more fruits and vegetables too. It helps with.... moving things along through the intestines, if you get my point.
Oh also, good thing it was because of diet change and not hyperemesis! I've heard of that happening too, and it is no fun at all.
So... if I may ask, why can't you just tell them to shove it and switch OB/Gyns? The stress with this practise really doesn't seem worth it.
I'm not pregnant myself, but these sound like my dreadful visits to my nutritionist after my surgery. My BMI was 19 as well. So I ended up gaining some weight from being immobile, etc due to the healing process and also from being depressed in school. Not a good year that year. Well She finally got me to gain 5 lbs and she wanted me to be 132-135lbs so I would be a "healthy" BMI. Well I got up to 128-130lbs depending on the day and time, and yet she STILL pestered me about gaining two more measly pounds. I told her several times I don't gain weight easily and once I gain the weight, when I become completely mobile I will lose it all again. I would hate for her to see me now at 123lbs, food diary would be strapped to my waist again. Not to mention I have been considered underweight my whole life, although I could possibly eat more than 5 hungry men in one seating. Not healthy either, but what can I say, I love food. Sorry for the long story and possibly irrelevant one, but reading this just made me laugh because it reminded me of myself a couple of years ago.
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