The Importance of Birth Plans...

Birth Plans are a great idea for any pregnant person to have ready! We all know birth is unpredictable and having a "plan" in place is no guarantee that anything will go in any particular way. However, the great thing about putting together a Birth Plan is that it makes you think about how you'd want things to go ideally…and it helps prepare you for the alternatives.

There are so many interventions that you may wish to avoid (or elect to have) during your birth experience, and preparing your Birth Plan is a great way to discover what all these interventions are and what they mean for you and your baby. I found that for my pregnancy, the easiest thing for me to do was find a template for a birth plan (BabyCenter has a good one HERE) and then researched the options in each section to determine what best fit my preferences.

You can start putting together your preferences as early as your first trimester, although the recommendation is to have some sort of idea ready by your 5th month of pregnancy. It's important to know as early as possible what is important to you (for example, perhaps you absolutely DO NOT wish to have continuous monitoring so you can move freely during labor, or maybe you absolutely NEED to eat and drink during labor) so that you can discuss these things with your care provider. The reason it's best to do this early is because it gives you the best chance of finding a doctor or midwife you LOVE, should you decide your current care provider is not the best match for the type of birth experience you have in mind. *By the way, remember you can ALWAYS change doctors…even at the very VERY last minute!

If you and your care provider agree that your plan is feasible and safe, and you are SURE your provider is giving you the best possible care and not just considering what is most convenient for THEM, then a good idea is to have the doctor sign your birth plan. It's not in any way a binding contract or anything, but the idea is that if you go into labor and arrive at the hospital or birth center before your care provider does, you can have something to show the nurses and support staff that shows that your care provider is on board with your preferences. It's also important to have several copies on the day of the birth for the nurses, your doula, etc. Every one that comes in contact with you during your labor should see your birth plan, to avoid miscommunications or misunderstandings.

You can include things in your birth plan regarding pain management, what you wish to happen to the baby immediately after birth (like immediate skin to skin and waiting to do newborn exams for an hour so you have a chance to bond, for example), and your plans for feeding your baby (bottle or exclusively breast feeding?).

It's definitely important to be flexible and be ready to forgive yourself if things don't go exactly as you'd hoped…The most important thing is to be educated about all of your options so that if things DO need to go in a different direction, you are equipped to make the best choices for you and your baby. Remember, even if your Birth Plan doesn't come to fruition, preparing one is always beneficial because it familiarizes you with your options (and their risks and benefits), and the policies of your care center and provider.

What advice would you give a first time mother about preparing a birth plan? What is something you think every plan should include?

I can’t believe some people are DEFENDING this.

Fifteen out of 105 of ob-gyns the Sentinel surveyed have set weight limits for patients, which usually start around 200 pounds or are based on BMI levels.

Most of the doctors said that their equipment and examining tables couldn’t hold larger woman (which smells oddly like bullshit), but some said that obesity comes with more complications that the doctors would rather avoid.

“People don’t realize the risk we’re taking by taking care of these patients,” Dr. Albert Triana, who practices in South Miami, tells the paper. “There’s more risk of something going wrong and more risk of getting sued. Everything is more complicated with an obese patient in GYN surgeries and in [pregnancies].”

Unsurprisingly, many of the doctors who have enacted the weight cut-off also have a history of being sued for malpractice or cover high malpractice insurance premiums.

While doctors can not turn down patients based on race, gender, or sexual orientation they are free to turn away patients based on weight. Though not everyone agrees with the policy.

“This completely goes against the principles of being a doctor,” James Zervios, a spokesman for the Obesity Action Commission said to the paper. “Health care professionals are there to help individuals improve their quality of health, not stigmatize them according to their weight.”
Source: Miami New Times Blog


I weighed about 280 when I conceived. I am having absolutely NO complications. I’m expected to have a perfectly healthy pregnancy and birth. To have turned me away simply due to weight would be discrimination, plain and simple, because weight has nothing to do with health or possible complications. Not all thin people are healthy and not all fat people are lazy diseased slobs.

I argued this point on my facebook earlier. You know what I was met with? A MAN I don’t know defending the article saying, and I quote, “if you care so much about your baby, why are you not in the healthiest condition you could be?”

My response?

“ideally I would have weighed less when I conceived, but it was unplanned. Seeing as losing 150 pounds overnight by sheer will and love for my child is impossible, suggesting I don’t care about my baby by not being “at my healthiest” (which actually, I am in spite of me weight) is remarkably fucked up and ignorant. My two cents.”

I saw the article earlier and was already pissed off, so to see a couple of MEN argue that fat women don’t love their kids simply because they’re fat kind of REALLY set me off. WTF do men know about being a woman, about being pregnant, about losing or gaining weight as a woman (because men and woman metabolize differently, in case I needed to point that out)? Answer: NOTHING.

Everyone is entitled to their opinion, but if the topic is over your head and is something you could never and will never understand, you will only sound ignorant and/or like an asshole by sharing your opinion. Not to mention that owning up to discrimination of any type isn’t exactly an attractive quality.

 I’ve always been considered overweight, obese, or even morbidly obese. I’ve NEVER had a problem with BP, cholesterol, etc whereas several of my thinner friends who don’t take care of themselves have had such problems. I’m not saying I’m the picture of health despite my weight, but I AM of the very strong opinion that simply LOOKING at me shouldn’t be enough to decide I’m not healthy. ssumptions are dangerous, regardless of what they’re based on. Turning someone away based simply on weight is no different then turning them away simply because they’re black, catholic, or gay. NONE of these things mean anything definitely about someone’s health, even if statistics might suggest differently. 

The point I am maki ng is that obesity in and of itself should NOT be reason enough to turn anyone away for treatment. And in this particular case, the insurance companies are applying pressure to doctors that based on their own histories of malpractice, are high-risk doctors, not necessarily because they deal with high-risk patients. 

 I’m willing to repeat my stance til my fingers fall off. Living an unhealthy lifestyle and being overweight are not synonymous. I haven’t had a problem with a doctor, thankyouverymuch but I don’t think anyone else in my position should.  


:EDIT: I juts want to add that just today, I went to the endocrinologist, a specialist that I am supposed to see every 6 weeks throughout my pregnancy simply due to my weight and nothing else…he looked over my blood work and was impressed with how good everything looked. “Beyond perfection!”, he said. He also told me he wished he could give me some suggestions or pointers, but, and I quote “You can’t argue with success!”

So there. 





NOTE: This post was originally dated May 17, 2011...this is the post from my pregnancy blog that lead to the NBC feature on Sizism in OB/GYN offices in Miami. I thought it'd be fun to post it here to show what my perspective on fat-shaming and being a plus size preggo was while I was actually pregnant ;)

Plus Size Preggo repost: "One Big RACKET"

On Thursday, we had several appointments…one of which was with a Gestational Diabetes specialist. My endocrinologist has been subjecting me to random glucose tolerance tests (BLECH!) and having me monitor my blood sugar pretty much since the beginning of the second trimester, simply due to the fact that I’m obese and the obstetrician insisted I be monitored closely since I’m “more likely” to develop GD. Throughout the pregnancy, my results have bounced from borderline pre-diabetes to completely normal and back, but never conclusively YOU HAVE GD.
 
One of the OBs in the practice (whom I really never liked because she has a really shitty attitude about everything) decided to give me yet ANOTHER glucose tolerance test because she didn’t believe I hadn’t developed GD (nice, right?)…so I went to the lab SHE wanted me to, took yet another test, and it came back positive for pre-diabetes (again, not full blown GD, just that I COULD develop it, which obviously we’ve known from the get-go). Well, based on that, she decided that rather than retest to see why that test came back high when none of the others had, she’d rather just send me to a diabetes specialist despite what my endocrinologist said.

So, I went…in the waiting room, I met a woman who DID have GD, and she told me she could tell just by looking at me that I was fine, and started pointing out all the physical manifestations of diabetes that she possessed that I clearly did not. I felt good about just letting whatever the specialist said roll off my back, until I got in there and she insisted that I was endangering my baby just by being me. At least, that’s what I took away from the conversation, since my blood work was perfect, so if I was endangering my child, it’s not due to my sugars.

I got REALLY pissed and kind of took it out on the lady, who kept trying to win me over after I went off on her, but I let her know not to bother, she’d lost any hope of me liking her and she should just say what she had to say. Long story short, I was given a booklet on diabetes management and given a VERY strict diet to go on immediately. I was given more testing supplies and told that I was to send her my blood work results once a week for the next 3 weeks to make sure my pre-diabetes could be controlled simply by diet and that insulin wasn’t necessary. I KNOW insulin isn’t necessary because I’M NOT SICK, so I decided to make the best of it….ok, a diet and testing 4 times a day…big whoop. I can stand to eat better and testing isn’t SUCH a drag…if it’ll shut these guys up in only 3 weeks, fine. I’ll play along.

THEN I got a call on Saturday from the specialists office, letting me know that I needed to meet with a nurse AT HOME, and have her give me more supplies, including ketostix (sounds like they’re doing more than monitoring my diet)…and SHOCKER! My insurance won’t pay for all of it, just 70%, so I need to pay $200 co-pay in order to be put on this program that I’m positive I don’t even need. If I thought for a SECOND that I was truly endangering my son, I absolutely would be on board, but since I’ve started the program, my blood sugar levels have been IDEAL. Not just good for a fat woman or good for a pregnant woman, but SIMPLY PERFECT. This is just one big racket to get the scared fat girl to pay for crap she doesn’t need and to squeeze more out of the insurance. How about I just buy some ketostix at Walgreens for $15 and we call it fair that I didn’t just send the whole pile of people involved to hell?

So yeah. The diet doesn’t SUCK (in fact, it’s a LOT of food), it just involves a LOT of planning because it’s not easy to count exchanges for pre-packaged food, so I’ve been eating nothing but home cooked food SIX times a day for the past 5 days, and will be for at least the next couple of weeks. The baby’s movements have been more subtle since I’ve started the diet, hubs thinks it might be because he’s not hopped up on fruit juice anymore LOL
End of rant.

Weird Pregnancy Behaviors...

the things no one talks about.

originally dated 2/25/11
Since I’ve been pregnant, I’ve been having thoughts and urges that scare even me.

Namely, the urge to lick things.

I’ll wait for you to laugh. I find it hilarious, myself.

I’ve asked my mom if she ever had a similar urge, and she only giggled. I’ve googled it and found nothing. Even my husband can only smirk when I get a certain look on my face because he knows I’m actively holding myself back from licking something in my vicinity.

Now before you get any ideas, I only have had urges to lick food, and stranger still, the television when there’s an image on food on it. I haven’t ACTUALLY licked the TV (yet LOL), but this anxious NEED to lick the screen comes over me whenever something tasty appears! LMAO

My theory is that I’m having too many cravings to actually fit all these foods in my tummy at once, and lately I can only eat about half what I used to, but get hungrier much more often…so I guess maybe I want to lick things just so I can taste them without actually ingesting them? IDK…it’s the only thing that makes sense to me. Also, I’ve much more aware of textures in my food lately, so maybe I get the urge to lick things because I’m not interested in chewing them…(?) Any ideas/theories would be appreciated (and probably laughed at).

I’ve heard of women eating chalk and dirt while they’re pregnant, so me wanting to lick a chicken wing or a tamal isn’t THAT strange…is it? ;)

This was something I wrote on my blog back when I was about 7 weeks pregnant with my son. Have you experienced weird or unexpected inclinations during your pregnancies? I'd love to hear from other mommas so I know I'm not the only weirdo! hahaha ;)

Guest Post - "Wrapping Your Pregnant Belly"

You can use your shortie woven wraps before baby is ever born, for comfort and relief for tired bodies. Here I'll briefly outline two techniques for helping to support your pregnant body as you grow! For both of these, I'm photographed with a size 2. A size 2 or 3 woven is recommended, or a longer rebozo, 9 feet or more.

Belly Lift:

1. Starting at your middle marker, wrap and tighten around the lower portion of your belly.

2. Reaching around behind you, cross the tails over one another and bring over your shoulder. You can gather or spread these passes.

3. In your front, pull downward on the tails, to cause a lift in the belly and relieve tired muscles and pelvis.

4. If you want to use this for an extended period of time, use a longer wrap and tie tightly between the shoulder blades.

Hip Squeeze

1. Starting at your middle marker, gather and place low and evenly across your hip bones.

2. Tie in the back very tightly, at the tailbone.

3. Leave here for knot 1 variation

4. For knot two variation, you can use the tails to twist up and around your knot, forming a large knot. Lean against a wall, sit back, or use your palm to apply pressure down and in, relieving a sore tailbone while squeezing your hips.

   Both of these techniques have a place in difficult or uncomfortable labors as well. Find a doula or other care provider who is familiar with rebozo techniques to discuss when it may be appropriate to use them in labor.

Cortney Baca is a Birth Doula and Certified Babywearing Consultant through the Center for Babywearing Studies. Mama to a sweet 3 year old boy and due with baby #2 in early Spring 2014, if she's not working, she's cooking, reading, gaming, or enjoying the outdoors through exploring and geocaching. You can follow her through her website: www.motherstrong.com, or find her as MotherStrong on facebook, twitter, or pinterest.

Superfoods and Supplements - Coconut Oil

 If you can't see the video above, please check it out on YouTube HERE.

This is the first post of...well, many...about superfoods and supplements. As promised, I'm going to detail different things we give our son to fill holes in his nutrition that his diet might leave to be desired. There's also benefits to mommas including most of these in their own diets as well!

This post is dedicated to COCONUT OIL.

Coconut oil has been demonized in the past because it contains saturated fat. In fact, coconut oil is one of the richest sources of saturated fat known to man, with almost 90% of the fatty acids in it being saturated. It contains so-called Medium Chain Triglycerides (MCTs) – which are fatty acids of a medium length (duh LOL). Most of the fatty acids in our diets are so-called long-chain fatty acids, but the medium-chain fatty acids in coconut oil are metabolized differently. They go straight to the liver from the digestive tract, where they are used as a quick source energy or turned into so-called ketone bodies, which can have therapeutic effects on brain disorders like epilepsy, autism and Alzheimer’s.

Also of interest is the fact that another great source of Medium Chain Fatty Acids is… breast milk!
Breast milk is rich in Lauric acid, the same fatty acid found in coconut oil...and it’s there because, in addition to easily digestible nourishment, it provides immunity against infection. the Medium Chain Fatty Acids in coconut oil are believed to help with the body’s absorption of vitamins and minerals from other foods.

According to the research, when a lactating woman adds foods rich in lauric acid to her diet, the amount of lauric acid available in her breast milk increases substantially to levels three times the original level and nearly double the amount of capric acid. A single meal of coconut oil can significantly affect the breast milk fatty acid compositions for 1 to 3 days with the maximum increase occurring during the first 10 hours. This data supports the hypothesis that diet directly affects the quality of human milk and possibly the womb environment.

Also, coconut oil can be used to ease dry skin, diaper rash, cradle cap, even to moisturize nipples after breastfeeding or pumping!

This is my favorite way to use coconut oil, because it stays liquid even when cold or blended into smoothies...although Costco sells HUGE tubs of organic coconut oil for about $15...much cheaper than I've found organic coconut oil anywhere, even Trader Joe's. It's important to try to get organic or at least cold-pressed or virgin, because the cheaper stuff is usually extracted with chemicals.



Sources: 1, 2

Guest Post: "Baby After Bypass"

So I was fat. I still am fat (not that there's anything wrong with that!), but I was REALLY fat when I was little. I was born and raised in Jersey and I have a stubborn German for a father and a pile of moosh n' love for a mother. I heard a lot of crap from my dad about being heavy. "Put the food down." "You'll die big you know." "Try to lose weight so you can play with your friends..." I don't ever think he meant anything bad by it, but it really took a toll. And as for my mom: "lets go get ice cream so you won't be sad anymore.." (you can see how this snowballs, right?)

When I entered high school I had already had years of bullying. As if being big wasn't enough, I had pimples, I wore glasses, and I had super short hair. I was a target for sure. But as I went to doctors for check ups, we realized one thing: weighing 380 pounds when you were 15 years old was pretty darn unhealthy. It was literally killing me and I was scared.

Around this time gastric bypass was pretty knew, but something drastic needed done. I had all the visits and analyzing one could ever want, and I was in. I was going to get the Roux-En-Y gastric bypass procedure on December 13th, 2002. I went under the knife and came out alive. AND SUPER GASSY! In one week I lost 36 pounds. In one month I lost 90. In 6 months I lost 200 pounds. I could finally walk up the stairs and not be in pain and out of breath. My life had changed for the better.
I did have some complications but they were minor. I still have skin, 10 years later, that I'd like gone, but I'm married now and my husband loves me for what I am and he thinks I'm sexy. (I met my husband on match.com and said hello because I thought his beard was AWESOME. It was love at first beard )

My husband and I said we wanted a family and we started TTC in january of 2012. Frustrated 3 months later we were told to relax and grab some champagne. We did...and voila! Pregnant! I had some concerns having had the surgery and being pregnant. Also, trying to conceive wasnt difficult and it was fun my husband is big too so our positions are limited but our energy never is! We wanted a baby so bad so we tried all the time. The surgery had no impact on our ability to conceive.

 I asked all the doctors if I was safe and how to get my calories in. NOTHING that went in my mouth could be crap calories. Everything I ate had to be good for me and for baby. So that's what I did.
Everything I had was high in protein and I ate many small meals through the day. I drank protein too, tried to cut back on coffee (so hard!), and tried not to head to fast food too often. I did have my fair share of ice cream and pickles for sure, but I did crave healthy things too which helped a lot. I had a complication free pregnancy: no gestational diabetes, no problems whatsoever. I kept myself in check and made sure to do things right. This baby was too important to my husband and I.

In February I gave birth to a chubby 7 pound 13 ounce boy: Edward Remy. I was in labor for 2 hours before fully dilated, and pushed for 18 minutes until he came into this world. He truly is the most amazing thing. My husband and I can't wait to have another!

The gastric bypass was harder to deal with when it was initially done. I was young and didn't follow "the rules" like I should have, but I managed to keep the weight down (although I gained back a little bit). Once I got pregnant I didn't want anything to damage my tummy or my baby, so I kept in close contact with the gastric doctors and they helped me a lot. I would do BOTH of these things again if given the chance. I've never looked back!

This story was shared by Molly, momma of one from Levittown, PA. Molly is the owner of MollyCakes Bakery, find out more about her awesome cakes here.

Disney While Pregnant

I'm a bit obsessed with Disney World and try to go often, since I'm in relatively close proximity. Earlier this year, we took our then-19 month old son for his first time, along with my then VERY pregnant sister. Not just pregnant, but pregnant with twins! I put together this video with some tips based on what she did while on the trip to keep comfortable and have the best possible time.

If anyone has any other tips, I'd love to hear them!

In case you can't see the video above, you can see it directly on YouTube here.

Gestational Diabetes - Now What? (3/3)

So you've been told you have Gestational Diabetes...now what happens?

Usually, the first line of treatment is a diet/meal plan. There is an example of one here. The thing about GD meal plans is that they make a great structure for what your diet should be like in pregnancy anyway! I am not saying "diet" as in "plan to lose weight", I mean "diet" as in "the food you take in". You're building a whole new body within your own, so it can't hurt to eat plenty of fruits and vegetables, whole grains and lean proteins. These will be the building blocks of someone else's (your baby's) entire organism! Just that thought was enough for me personally to start eating more whole foods and less processed junk.

It is also recommended hat one exercise daily, even a brisk walk after ever meal. Exercising increases the muscle tissue sensitivity to insulin, which helps your body metabolize sugar. Ideally, a woman would be on an exercise program before and during pregnancy not just for overall health (at ANY size), but because this is the more surefire way to help your body metabolize. No amount of exercise will keep you from developing GD (as one cannot control their ethnicity or family history), but it can definitely help in its management.

You may also be asked to monitor your blood glucose levels several times a day, usually fasting first thing in the morning and after every meal. The reason for this is to check for patterns and look for any spikes in blood sugar. This can give care providers a window into how you metabolize sugars regularly, outside of a lab setting. High sugars after eating could signal that a change in diet is needed.

High sugars in the morning, however, may signal that the body is overall not metabolizing sugar, and a doctor may then suggest a regimen of medication. The most common form of medically treating gestational diabetes is with insulin injections, which are self administered, usually directly into the belly. Obviously, one is taught how to do this by professionals so that the baby is never in any harm due to the injections. Another alternative is pills, such as glyburide and metformin.

 I hope this series has helped answer some questions about what Gestational Diabetes is and what it really means. I will be sharing a guest post soon about a readers experience with Gestational Diabetes, and I hope if anyone has any questions or would like to share your own experience, you will please comment or email me. Thank you!

Gestational Diabetes - How is it diagnosed? (2/3)

How is the test administered? A one-hour test screens for (but does not diagnose) gestational diabetes mellitus (GDM). If your blood sugar levels seem high after a one-hour test, you'll have to come back for more gestational diabetes testing.The best method for diagnosing gestational diabetes is taking a glucose test (glucose tolerance test). The test measures how the body reacts to a large amount of glucose (sugar).

According to The US National Library of Medicine: "For this test you will drink a glass of water that contains 50 grams of dissolved sugar. You do not need to fast beforehand. One hour later, blood will be taken from a vein in your arm to determine the blood sugar level. If the value is below 7.5 millimoles per liter (mmol/L, about 135 mg/dL), the results are considered normal and no more testing is done.
If an elevated level is found in the glucose challenge test, it is still not considered a final diagnosis. It only serves to determine which women will be offered a second and final test. This second test, called the oral glucose tolerance test, is more involved. For the test, the pregnant woman must fast beforehand, which means not eating or drinking anything but water for at least eight hours. The first step in this test is taking blood. After this the woman drinks a sugar solution containing 75 grams of glucose. Blood is taken from an arm vein again after one hour and after two hours. If any of the following three blood sugar values is exceeded, gestational diabetes will be diagnosed:

• After fasting: 5.1 mmol/L (92 mg/dL)
• After one hour: 10.0 mmol/L (180 mg/dL)
• After two hours: 8.5 mmol/L (153 mg/dL)" 

Testing for Gestational Diabetes can be done as early as 8 weeks in women that have certain risk factors, and is done routinely on all women at about 28 weeks gestation. Interestingly, however, not all women NEED to be tested for diabetes during pregnancy.
 
According to pregnancy.com:

"One of the most intriguing recommendations is that a woman may not need laboratory testing to screen for GD if she meets all of the following criteria:

• less than 25 years old
• not a member of a racial or ethnic group with a high prevalence of diabetes (eg, Hispanic, African, Native American, South or East Asian, or Pacific Islands ancestry)
• a body mass index (BMI) 25
• no history of abnormal glucose tolerance
• no previous history of adverse pregnancy outcomes usually associated with GDM
• no known diabetes in first-degree relative

Women who are at a higher risk for GDM usually have one of the following risk factors:

• age
• ethnicity
• obesity
• family history of diabetes
• past obstetric history"

 Before testing, you should eat normally for the few days prior. Women used to be told to eat less carbs or sugar in the days before their test, but that could just make your body react more aggressively to the glucose in the drink, giving a false higher result. If you are opposed to drinking loads of sugar water and various other chemicals, you can arrange to eat a specific breakfast and have your blood drawn at an interval following your meal instead. Many doctors frown upon such a request, but it is your right to request it.  
 
My own experience and advice for others that are deemed "borderline" like I was: I demanded a retest and that one came back ok but they were "concerned", so I compromised and told them I'd do my best to follow a GD diet and I'd monitor my sugars for a couple of weeks to "put their minds at ease". I figured I could use healthy eating guidelines anyway (though I did still have my daily vanilla ice cream cone) and when monitoring was all good, they left me alone. They insisted I get urine/ketosis sticks and keep a food log which I was meant to fax to them, but I did neither because EFF THAT, THEY'RE NOT MY MOMMA.

I had a bit of a rebellious streak during my pregnancy as you can tell ;) But honestly, I think it's a fair compromise and it'll give you AND the doctors a chance to see how your sugars are doing in the real world over time, rather than just once during a lab test. And then I think no matter what happens, everyone will have peace of mind that they're making the right decision on how to proceed; whether your sugars really ARE high or not. This was something I did in order to appease my doctors because I had one slightly elevated level on my test but otherwise showed no symptoms, but you can also request to have this several-times-a-day self-monitoring in place of the glucose challenge. Again, your doctor might fight you on this request, but as I mentioned previously, this is the best way to get a REAL WORLD view of your glucose metabolism, which is much more accurate than a one-time lab setting.

In the next last post on GD, I will discuss the various ways that Gestational Diabetes can be treated if you are, in fact, diagnosed with GD after your tests. 

Gestational Diabetes - What is it? (1/3)

This will be one of a three part series I'm doing on gestational diabetes. It seems to a be a topic that has been coming up a lot lately in the forums/groups I belong to, and what I'm finding is that a lot of women are being told they have it or being threatened that they will develop it, but no one is really receiving proper information regarding what it is, how it's diagnosed or how to treat it.

What is Gestational Diabetes?

According to the American Diabetes Association: "Pregnant women who have never had diabetes before but who have high blood glucose (sugar) levels during pregnancy are said to have gestational diabetes. Based on recently announced diagnostic criteria for gestational diabetes, it is estimated that gestational diabetes affects 18% of pregnancies."

Basically, your growing baby needs glucose to grow. Your body errs on the side of "too much" rather than "too little" so the baby doesn't go without. As the placenta grows, the hormones it creates may interfere with your body's processing of all that glucose. This is why testing tends to be done later in the pregnancy (if no other risk factors exist) because the placenta is larger as the pregnancy progresses.

Non-Caucasian women, and women that are overweight pre-pregnancy, are likelier to develop Gestational Diabetes.You are also likelier to develop it if there is a history of diabetes, gestational or otherwise, in your family. Granted, it's not to say you WILL develop GD if you fall into any (or all) of these categories, your chances are simply greater.

Some of the risks of having Gestational Diabetes are macrosomia (baby growing too large), which could mean a broken clavicle or collarbone upon vaginal delivery, among other complications. This is why doctors are quick to induce as early as 39 weeks when the diagnosis for GD is present, or even elective c-section.

AGAIN, let me be clear...the doctor will be quick to suggest (or even insist) upon these interventions, but they may not be necessary. Also, ultrasounds are not, have never been, and are not meant for measuring your baby, and they are usually off by 1-2 pounds either way, so don't be alarmed if the doctor decides your baby weighs 10 pounds solely based on ultrasound...but that's another topic for another post.

Women that have had GD are likelier to develop Type 2 Diabetes later in life, but many of these cases are because the women studied may have had undiagnosed Type 2 Diabetes before pregnancy, and GD may not have been a factor.

Most of the time, GD can be kept under control by diet and exercise, and only in extreme cases will an insulin regimen be needed...so please, do not worry right off the bat that you will need to inject yourself several times a day until you've spoken to a specialist about the severity of your case! Stressing about it will do no one any good, though I know that is easier said than done.


On the next post, I will write about information, evidence and resources surrounding testing for Gestational Diabetes and how it is diagnosed. The last post in the series will be about treatment options. I'll also talk about my own borderline GD diagnosis during my pregnancy and what I went through as far as testing and treatment. If anyone would like to share their GD experience, whether just the testing or actual treatment if you were diagnosed, please email or comment. Also, please let me know if you have any specific questions and I will try to answer them in an upcoming post or at least point you to resources that can help.

Cervical Checks and why I'll forever DENY, DENY, DENY.

*DISCLAIMER: This post is made up of both my opinions and research. The research and reading I did while writing this is cited. Do NOT take this post as medical advice as I am not a doctor and don't claim to be. However, I hope that reading this does make you aware that you have options, and that it's best to do your own research into your options and the consequences of each choice. Remember: if you don't know your options, then you have no options.

A conversation in one of the internet forums I belong to recently turned to routine cervical checks and what I think of them. My exact answer was:

"I'd rather go through my Pitocin augmented, pain med free 46 hour labor again rather than EVER getting another cervical check"

I remember being in labor, thinking I was going to die during the cervical checks. Literally. I was making my peace because I was certain the pain of those checks was going to throw me into shock and my heart was going to suddenly stop beating. The labor was nothing compared to those checks.

Needless to say, I'm not really a fan. But I was in labor, I was scared, and I didn't think I had a choice. BUT I DID. I just didn't know it. Now I do know about my choices, and I can assure you my next pregnancy and labor/delivery will go much differently as a result.

Routine cervical checks (when a doctor does an internal measure of how dilated and/or effaced your cervix is) usually start happening at about the 36 week mark in pregnancy, though they may start as early as 34. The reason your OB gives you that fancy gown to change into at your appointments is to make these tests possible. They check you, give you a number, and possibly make judgements or plans surrounding your birth based on what they find.

Now here's the thing....these figures tell the doctor NOTHING. Some women are dilated to 3cm for weeks and it has no bearing whatsoever on when they'll go into labor or how long the labor will take. Other women are completely shut until the moment they're in labor, and have 5 hours between their water breaking and seeing their baby emerge.Cervical checks are absolutely pointless if you are not in labor.

What about during labor? Well, you might want to know. Your doctor might want to know. But again, your "number" at any given point of labor has no effect on, nor can it predict, how much longer it'll be before you can push. In fact, here's three things I learned about cervical checks during my labor (besides how astronomically they hurt me): 

*Firstly, different people have different sized hands and  checking for dilation is not an incredibly scientific process. Two different people might check you within minutes of each other and get two completely different measurements. 
*Secondly, knowing that number may just discourage you. Imagine being at full on transition strength contractions for 6 hours on Pitocin, only to be checked and have a nurse tell you that you opened up another half centimeter in those whole 6 hours. Talk about taking the wind out of your sails.
*Lastly, checks during labor take the laboring mother out of the flow. It's an interruption that takes you out of whatever space you put your mind in to get yourself through the next contraction, or whatever your focus object is, or the anticipation of meeting your child that helps you get through the pain. Whatever your "happy place" is, you have to snap out of it every time anyone even talks to you, let alone tells you to lie down for one of those checks.

Another thing I didn't know? Cervical checks can lead to infection, especially if your water is already broken. If only I had known that, I would have denied each and every one of those checks right off the bat. You live and you learn, right?

So what am I going to do next time instead? Keep my pants on! Unless the prenatal appointment includes the GBS test, there's nothing that's going to happen at that office that can't happen while I stay in my own clothes. As far as during labor, there are other ways that a medical professional can tell how close you are to being ready to push. If anything, I suppose one could opt for minimal checks and perhaps choose to not be told the "progress" so as to not get discouraged. Plus, minimal to no checks mean less chance for a doctor to pull the "failure to progress" card. 

What is your experience with cervical checks? Perhaps they didn't hurt you and I was just lucky ;) perhaps the number encouraged you to keep going when the going got tough...I'd love to hear all opinions and perspectives on this!


Additional Information:
*Stages of Labour and Conclusion
*The Assessment of Progress