The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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Gestational diabetes mellitus (GDM), or high blood sugar during pregnancy, used to be relatively rare, occurring in about 3 percent to 4 percent of pregnancies. But in recent years, the rate has doubled— now, up to 6 percent to 8 percent of moms-to-be are diagnosed with this prenatal complication. And new recommendations lowering the cutoff point for diagnosis may lead to an even more dramatic increase.
From traditional meals with family to laid-back gatherings with friends, this time of year is a minefield of social activities centered around food and drink. “Most people hang up their diet hat during the holidays because they feel they can get back on the program later,” says Elisa Zied, M.S., R.D., an American Dietetic Association spokeswoman and author of Nutrition at Your Fingertips. But when you’re pregnant, you don’t have the luxury of giving up a healthy eating plan—even for a few weeks.
How much weight to gain during pregnancy is a tricky issue. Guidelines exist, but health experts are reviewing them because so many women of child-bearing age are now overweight.
If you want your baby to develop healthy eating patterns, don’t load up on cheeseburgers and milkshakes while you’re pregnant. Research on rats found that a high-fat prenatal diet produces permanent changes in the offspring’s brain that ultimately lead to overeating and obesity. Study author Sarah F. Leibowitz, Ph.D., says that triglycerides, unhealthy fats that are elevated in the blood after high-fat meals, stimulate brain chemicals that cause us to eat more. In her study, she fed pregnant rats a high-fat diet, then replaced it with a normal diet just before they gave birth.
In increasing number of American women who want to get pregnant soon might want to reconsider their timing: They’re overweight. A study that looked at 53,000 pregnant women’s weight at their first prenatal visit found that the average had increased by 20 percent from 1980 to 1999. That’s bad news for them and their babies.
Erika Stehl stood in front of her full-length mirror, fighting back tears. Barely nine weeks pregnant, her favorite jeans were already way too snug. “After a lifetime of trying to stay slim, I’m in a panic just thinking about piling on 25 to 35 pounds—or maybe even much more,” says Stehl, a freelance social worker in Port Washington, N.Y.
From the outset, I had no trouble accepting two immutable laws of nature: 1) Pregnant women get big. 2) Over time, they get bigger. In fact, I greatly enjoyed this process, as evidenced by my avid waddling. I waddled before I was even showing — maybe as early as conception. I waddled excessively in my second trimester. I went whole hog in my third.
At first, I was one of those “you-can’t-even-tell-you’re-pregnant-from-the-back” people. (As if pregnancy ought to be a period of clever camouflage: “You’re six months? You look three at the most!”)
If you’ve worked long and hard to be fit and trim, you may not take kindly to the idea of pregnancy’s portliness. While you might envy a friend who slipped back into her old jeans a week after delivery, gaining weight is now part of the program.
Kelly O’Dea Landes, 35, a clinical social worker from Marion, Mass., struggled with eating disorders in her early 20s but, at 5 feet 1 inch, had leveled out at 98 pounds when she got pregnant at age 33. “I was running about 30 miles a week, and my obstetrician, who was conservative, told me to stop exercising, cold turkey,” she says. “He also told me to expect to gain more weight than the average woman because I was underweight. I thought, OK, so he’s telling me I’m going to be short and fat.”
If you’re confused about pregnancy weight gain, it’s no wonder: In one recent study, 49 percent of doctors gave their pregnant patients the wrong advice, and 27 percent gave no advice at all. And up to half of normal-weight women, and nearly two-thirds of overweight ones, gain too much during pregnancy. What’s more, it’s no longer enough to worry about how much to gain: When you put on “baby fat” affects how much you’ll hang onto afterward.
When she got pregnant with her first daughter, now 5 years old, Christy McDonald weighed 160 pounds, which was 15 pounds over her longtime weight of 145. She never imagined that being slightly overweight then would lead to a struggle with 65 unwanted pounds after her second daughter was born. “I’d hoped to get back to 145 before conceiving again,” says the 5-foot-7-inch graphic designer from Berkeley, Calif., “but I started my next pregnancy 10 pounds heavier than I started the first.” During the year after her second delivery, her weight hovered around 210 pounds.
Before Jennifer Griola, then 30, of West Orange, N.J., became pregnant, she weighed just under 300 pounds. Griola lost 30 pounds, but at 5 feet 10 inches tall, she was still considered obese when she found out she was expecting. During her pregnancy, Griola gained back the 30 pounds and developed borderline hypertension and gestational diabetes. At week 34 she went into labor and delivered her daughter, Sarah, via emergency Cesarean section because her placenta ruptured. Sarah was in the neonatal intensive care unit (NICU) for 10 days, a harrowing time for Griola and her husband.