The Renewed Obsession With Weight Gain During Pregnancy

“My doctor told me no more carbs and no more candy in the afternoons.”

The women telling me this is 7 months pregnant, and she’s gained 40 pounds. She looks great. She continues, “But I don’t even eat candy in the afternoon.” She is supposed to gain about 25-35 pounds in total. She’s still got two months to go.

I remember the good old days back in 2004 when a 50 pound weight gain would pass muster. Sure, there were weigh-ins and doctors and midwives would offer regular advice about staying active and eating well–and What To Expect would admonish you to eat five servings of leafy greens a day–but there was still a kind of freedom associated with food during pregnancy. You could forget the damn scale for a year and follow your appetites with actual, gasp, joy.

I recall a pregnant friend saying something along the lines of, “It’s awesome, I can eat like a boy. It turns out when you take the guilt out, you actually don’t eat cheesecake from 7am onwards.”

I know a formerly anorexic woman who found her pregnancy to be life-altering– she had never in her life looked at a menu and just thought, “What do I want?” It turned out that when she asked herself that question the answer was usually “a good meal.” Not a binge. Not a purge. Not a guilty pleasure. Not the “right thing to eat,” or the “wrong thing to eat.”  It reminds me of the studies where they give patients total control of their pain medications with a clicker and they end up using less medication than the hospital would have administered.

But it seems the crackdown on weight gain is back in full force, and we’re being forced– like we are in so many other phases of our female lives– to see meals as portions, not pleasure. And I have to wonder if this is going to help or hurt us?

The women in my childbirth classes, like the one I quoted above, tell me of regular (sometimes stern) conversations with care-providers about keeping the numbers down. Sure, we’re not back to the 1950s when women were literally given speed to control weight, but, pregnancy is losing it’s special status as a time to eat like “a boy.”

In a great piece today over at Jezebel, Tracy Moore writes about  “pulling a deuce” (aka hitting the 200 lb mark) in her pregnancy:

“By the final week of pregnancy, I was powerless to stop the pile-on. I dodged gestational diabetes, or any single pregnancy complication for that matter, in spite of my cavalier food forking. So I wasn’t fazed when at my last checkup, I clocked in at 208. “Call off the dogs, already!” I cried out to the pregnancy weight-gain warlocks.
But hey — wasn’t this supposed to be “my time” where I got whatever I wanted and ate whatever I craved and lived it up and everyone was beholden to my weirdest whims and desires? Or am I confusing pregnancy with a wedding day?

Then I realized that, for the first time, I got it. I truly understood the power food holds over anyone who’s struggled with it. For me, the eating had felt so unimaginably good. It had felt like a warm blanket of comfort during 9 months of discomfort. It was what had kept me going as I deprived myself of every other vice that pregnancy refused me.”

From what I can tell, the renewed interest in keeping weight down came around the same time as a bunch of studies and articles about the dangers of obesity in pregnancy– there are increased risks for the pregnancy, birth, mom and baby’s future health. It’s an important health concern– everyone from high-risk OBs to the crunchiest midwives out there want you to realize that you (and your baby) are what you eat.

But what I find most distressing about the new crackdown on weight-gain is this– and Ms. Moore points this out in her piece, too–how we eat and stack on pounds during pregnancy is so individual. Some women find they eat constantly and gain a mere 25 pounds. Others watch their portions and get gestational diabetes or gain weight rapidly.

Sure, in general the more you eat and the more sedentary your life is, the more you gain. But in pregnancy, and certainly during breastfeeding, there seem to be other, highly individual, metabolic forces at work. About half of breastfeeding women lose weight almost instantaneously and need to make a conscious effort to get the extra calories. The other half cling to extra pounds until weaning.

Then there are the idiosyncratic food aversions. (I found it nearly impossible to eat anything that wasn’t a white carb during one of my pregnancies. ) And how about the endless food safety recommendations? A pregnant Australian I met the other day told me there’s concern in her country about pregnant women eating way too many processed foods out of a fear of over-the-counter salads and cold meats. (Australia rivals America when it comes to obesity stats.)

Now getting back to my earlier point of the liberated anorexic finding peace of mind and appetite in pregnancy. There’s the flipside: I know svelte women who found that suddenly, during pregnancy, cravings, exhaustion, an unforgiving metabolism led to immediate and stubborn weight gain. In these situations, menu-reading does not feel freeing at all, but complicated and hostile. There are also women with eating disorders who become even more obsessive during pregnancy, which can be very dangerous.

I suppose my point here– or rather my question– is: Can health recommendations about diet and weight ever convey the nuance such topics deserve?

Maybe not. Maybe public service announcements will always be reductive and unsubtle and play on our worst fears. And that’s necessary.

But maybe there’s a way, as women and mothers and bloggers and care-providers, we can open up our conversation a little and talk about nutrition during pregnancy in a way that emphasizes the differences between women.  Just last week there was news of a study showing that better body image was associated weight loss. It sounds like putting the cart before the horse, but it makes sense to me. Finding a positive way to think about our own particular (hungry, round, ravenous, picky) pregnant bodies, may shape the way we treat them.

What has your experience been when it comes to monitoring and learning about food and pregnancy? Punishing? Or nourishing?

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