Shit Happening To My Pregnant Ass: Week 35

[contents: medical, TMI, menstruation, fat hate]

Lately I have found great enjoyment from putting my hands on my belly, looking at The Man, and intoning "SOON" as creepily as possible.

Because SOON.

Nesting has returned in full force. Last Friday I was all kinds of anxious and cranky, and I decided to wash a load of baby clothes, and it made me feel SO MUCH BETTER ABOUT MY LIFE. I haven't folded them yet - that is kind of waiting for me to make the drawer organizers for the dresser - but they're CLEAN.

I also started packing my hospital bag, which also made me feel better about my life. And started packing the diaper bag with things to bring to the hospital for The Kid. Thoughts I have had include "oh, hey, this neato microfiber car seat cover, that's a good thing to stick in the bag", and "oh hey, all of these new gigantic cloth pads you just bought, those should go in your hospital bag", and "OMG YOU NEED TO REPLACE ALL OF YOUR UNDERWEAR AND BUY SPECIAL HOSPITAL UNDERWEAR". That last one I talked myself out of.

Okay yeah, theoretically the hospital provides underwear for you for postpartum. I have read so many blogs extolling the virtues of the "mesh granny panties" from the hospital. Yeah, so, I had some right after my surgery in December, and, no. No, the standard size is not sized for fat folk like me. So while maybe the hospital I'll be delivering at has bigger ones (and I plan on asking during the hospital tour), I'm assuming hahahaha nope they won't and bringing some of my own underwear with me. All of the blogs assure me this is a TERRIBLE idea, because there will be BLOOD and LEAKING and BODILY FLUIDS all over, but uh, you know, mesh panties that don't fit me aren't going to stop it either, so maybe let's wear knickers that actually fit and use pads that are actually comfortable and fit instead of the giant monstrosities that are hospital pads (seriously. They're like a giant pillow in your crotch, except made of scratchy paper and somehow STILL not in the right place, even though they are LITERALLY AS LONG AS MY FOREARM). You know.

So I've put in some cheapie knit underwear I have but never wear, and some underwear I bought on sale at Christmas but managed to get the wrong size and then I exchanged them but managed to get the wrong cut but you know if they get ruined I won't cry, and we're going to go from there.

I've also got a pair of slippers I picked up for a mere $7 post-Christmas, since the hospital is VERY ADAMANT that I be wearing socks and/or slippers at all times "for safety and hygiene purposes". And a giant fuzzy blue robe that I got for like $20, so that when my in-laws inevitably visit us all in the hospital I can look something approaching put together. And since they weren't super expensive, if all the blogs are right and everything is going to be leaked on and ruined, it's not the end of my world.

I'm also trying not to obsess over the "coming home" outfit for The Kid. I have no idea how big they will be, and no idea if I should just bring something easy like one of those snap-up footie pajama outfits, or something more elaborate, and if I do bring something omg WHAT SIZE, and should I bring a couple sizes, and what if I'm WRONG and oh my GODS. And logically I know that it doesn't have to be the MOST PRECIOUS OUTFIT IN THE WORLD (we can save that for pictures for the baby announcements), it just has to be cute, and I can put like two different sizes in there and if, for some reason, neither of them works, OUR HOUSE IS NOT THAT FAR AWAY I CAN SEND THE MAN HOME WITH INSTRUCTIONS.

BUT WHAT SHOULD I PICK AAAAAAHHHHHHH.

The Man and I have also been attending baby-havin' classes. The hospital calls the course "Prepared Childbirth", but whatever, baby-havin' classes. Thankfully these are better than the infant care class we took a few weeks ago that was omfg awful (and yes, I did just mail a letter to the department enumerating the many problems with that shit... and hinting that I'd like my goddamn $55 back THANK YOU VERY MUCH). Our instructor is a little spacey sometimes, and mispronounces "centimeters", but generally pretty good. (Her pronunciation is like a mash-up of "sonogram" and "centimeters", so it sounds like "sonometers", which... yeah I don't know.) I do find it difficult sometimes to not pipe up when she's answering a question with what I've found out in the research, but mostly I bite my tongue. I don't want to be that asshole, you know?  BUT I KNOW THINGS OKAY YES I KNOW THE ANSWER TO THIS OKAY LOOK SERIOUSLY NO THAT CONDITION IS NOT LINKED TO THE WEIGHT OF THE BABY.

Ahem.

It is kind of nice to be around other pregnant people and talk about that shit though. And there's someone in class due on the exact same day as me, so that's fun. There's also one other kind-of fat pregnant person in the class - although I have no idea how they'd describe themselves - which is pretty awesome too. They were also the one to speak up last week when everyone was describing unmedicated vaginal birth as "natural" and call out how bullshit and stigmatizing that was, so HI FRIEND LET'S BE FRIENDS.

Shit I am Not Worried About includes labor and delivery, and how to take care of The Kid afterwards. Which damn BLANKET to bring to the hospital? MOMENTOUS ANXIETY. Labor? Wev. Delivery? Meh. Basic baby care? Yeah it's cool. Even knowing that I might have a 10-pound baby? Yeah it's fine, I know people who've birthed big babies vaginally and unmedicated, I am not concerned. This is... not the common attitude in our baby-havin' class.

Meanwhile my MIL is holding a baby shower for us in like a week and a half and she's REALLY EXCITED OKAY. She also asked "OH SO SHOULD WE HAVE YOUR MOM AND DAD SKYPE IN" and I made an executive decision NO on that one. I get that she's trying to be nice and make this wonderful, since this will be the only in-person baby shower I'm having. And that really is lovely of her. But um, it's going to be the only in-person shower because HI I HATE BABY SHOWERS, AND NO I DO NOT LIKE THEM ANY BETTER WHEN THEY'RE FOR ME. I WOULDN'T EVEN HAVE CONSENTED TO THIS ONE IF I DIDN'T KNOW FOR A FACT THAT YOU WERE SUPER-SAD THAT I DIDN'T HAVE A BRIDAL SHOWER. I AM AWARE THAT I HAVE SOME INTERESTING EMOTIONAL HANG-UPS, THANKS. Also having my folks dialed in is not going to make anything better or less awkward for me. So like I said, executive decision, NOPE.

I am not looking forward to the baby shower.

Physically, turns out that I was right about how tired I was a week ago - that was probably my thyroid deciding to be an asshole for a week. THANKS AUTOIMMUNE DISEASE. My hips are also doing marginally better this week, although it is still the world's biggest production to move around in bed. I also added a waterproof, absorbs-up-to-five-cups-of-fluid pad to my side of the bed under the sheets. Just in case. Except that it totally has a plastic back, so that shit does not breathe, and it moves around with and under the sheets, which is also less fun. So when I wake up, inevitably in four hours or less, my hip and leg I'm laying on are not only sore, but slightly sticky from laying on something with a plastic back. So far, I am convinced this is a better plan than my water breaking in bed and ruining our memory foam topper and mattress. We'll see how long that lasts.

My belly is still getting bigger. OMG SO MUCH BELLY. My bellybutton has not popped, as I was told that NO REALLY EVERYONE'S DOES, but it has gotten... flatter. Like, it's normally pretty deep, and in kind of a crease in my belly, and as that crease has flattened out so has my belly button. It's weird and feels weird when I touch it.

The Kid also seems to be doing fine. There are few kicks, and more... burbling. Like, there's movement, and my belly moves, and ugh super weird, but it's... not as violent. JUST EXTREMELY CREEPY. Like as I was typing this paragraph I looked down and was watching The Kid move my belly. SO WEIRD. SO. INCREDIBLY. WEIRD. Also there is still a foot wedged up under my ribs and OW.

Today's midwife appointment also went well, I gained 2 more pounds so I am a whopping FOUR POUNDS over my starting weight now YEAHHHHHH. I am happier about this than any of my care providers. So if that's going to be the case, I might find a new practice for next time. But no swelling, blood pressure looks great, blah blah blah oh shit you mean the fat lady is still having a pretty uncomplicated pregnancy at this point THE HELL YOU SAY.

No but seriously BELLY EVERWHERE.

Shit Happening To My Pregnant Ass: Week 33

[Contents: medical, TMI, weight discussion, fat hate]

Wait, 33? Is it really 33 weeks?

This whole time I have had no trouble knowing exactly how many weeks and days along I am, and now I'm just like SEVEN AND A HALF MONTHS PREGNANT RARRR LEAVE ME ALONE I DON'T KNOW ANYMORE.

But I can tell you that in just under three weeks, I get to stop the progesterone. I picked up my last refill of that the other day. And in just under four weeks I get the cerclage taken out. At my OB appointment this week I definitely had my doctor WAY UP IN MY BITS THANK YOU to check on cervical position and cerclage status. Apparently everything feels good and we should have no trouble just taking the cerclage out in the office at 37 weeks.

After that comes out, who knows what'll happen. When she put it in, my MFM specialist warned me that some people get it taken out and basically proceed directly to hospital for baby-birthin' time without passing go, some people go home and don't start labor until like 41 weeks. Like many things with pregnancy, IT IS A MYSTERY.

I'm getting kind of ready to be done though.

I mean, I don't want the kid showing up until April. PLEASE, DARK LORD, NO. But while I certainly chose to get pregnant, and I do not in any way regret this choice, fucking a this shit is getting old. I'm kind of over the tireds. I'm kind of over the painful hips. I'm kind of over the nausea OH YES IT'S BACK, I'm way over nothing in the way of food or drink sounding or tasting particularly good, I'm so far fucking over the hormonal bullshit, I'm getting over the times that The Kid makes me even MORE nauseated as they burble around in there, I cannot wait to be able to stop taking the prenatal vitamins that make me gag more often than not STILL, I'm JUST ABOUT DONE.

Conveniently, I am just about done, but, you know.

 Also about halfway through writing this I had to stop and eat dinner, and it dawned on me "HEY MAYBE THIS IS YOUR THYROID" and it actually probably is. While unrelenting tired, appetite problems, and mood swings are all pregnancy symptoms and are the short summary of this past week, cold spots on my thighs and ass are not - those are definitely my thyroid. So is the brain fog. YAY AUTOIMMUNE DISEASE yes I have emailed my doctor and I have lab orders to check shit already.

Meanwhile, I have gained weight (although now that I know my thyroid swung a bit I wonder how much is that HA HA GOOD TIMES) and am FINALLY above my starting weight. Barely. If I am doing the math right, I did gain more than the "recommended" pound per week, and I'm sure if my blood pressure weren't fucking terrific my doctors would be freaking out, but that shit is the lowest it's been at any point during this pregnancy for the past two weeks. Instead I got "oh your weight looks okay" - not "we're happy with your weight" any more, I NOTE.

Plus I have literally no swelling. Seriously, none. I'm trying really hard to not get a bad case of the smugs about it. At my appointment this week my OB complimented me "Oh how smart you got a pretty chain to put [your wedding ring] on", because the necklace I was wearing has a pretty silver circular pendant with a small diamond in it. So I held up my left hand with my wedding ring on it and waggled it and said "Oh no, I'm still wearing it". She was surprised. The damn thing is LOOSE on me. Like it spins gleefully around my finger all damn day when I wear it. Trying and mostly failing to not have the smugs.

Also at my appointment this week, I brought up "hey by the way I have thyroid disease and while I do plan on trying to breastfeed, there's not a lot of good information out there about it, do y'all have anything?" and apparently they have a lactation consultant on staff who may have some stuff. So my OB is giving her a heads up so she can do some additional research and I have an appointment with her later this month.

I'm sure my insurance will try to charge me a co-pay for that visit, even though according to the ACA they're not allowed to any more. They definitely charged me a co-pay for when I got tested for a UTI, so I get to fight with them about that. My insurance company also does not have my plan's summary of benefits and coverage available on their subscriber portal - those are required to be available to me by law. They also charged me a whole fuckton of money for my cerclage, for each of the ultrasounds I got, keep trying to charge me co-pays for pre-natal visits... basically, they are terrible and I am super-sick of having to fight them on everything. I can't even get an answer from them about whether I'm supposed to "pre-certify" for my hospital baby delivery, which I need to know for the hospital paperwork that I really need to send in ASAP. So that's fun.

In more annoying shit The Man and I started taking childbirth classes this week, starting with "Infant Care". If you look at the outline on the website, this class is supposed to be 2.5 hours all about "oh shit now I have the kid home WHAT DO I DO". So covering feeding, bathing, clothes, car seats, sleeping, etc. and so on. I know this shit, because I've literally been through it with a sister who is nearly 13 years younger than me, with all of the babies I've cared for over the years, etc. and so on, so I was like wev about it. But The Man has literally zero childcare experience, so we thought it would be a good idea to learn some of this from a neutral, non-hormonal third party.

HAHAHAHAHAHAHAHAH which, that was a good plan, if that were what the class had actually been. I ranted about this on Twitter for a while on Sunday, but basically, our instructor was terrible and kept talking about shit the nurses do in the hospital, there was less than half an hour of hands-on practice (which only covered bathing and changing a diaper), she covered approximately none of the stuff in the packets we were given (which was all of the stuff we were led to believe the class would be about), talked way too fast, went fifteen minutes over, did not give us evaluations to fill out, and the class was in a room that you HAD TO USE STAIRS TO GET IN TO. So I'm writing a very long letter to the department overseeing this about all of THAT. It was a waste of our $55 and a waste of our Sunday afternoon.

This Sunday starts our actual "SO YOU'RE GOING TO HAVE A BABY" classes, that cover birthing techniques, the hospital tour, all that happy crap. Hopefully it's significantly better.

Finally, do y'all even see my belly? I mean holy shit. Also it is definitely starting to move lower. And while it's not clear in the picture, my waist has been getting... flatter. Like, I used to have a really deep crease right through my belly button dividing my belly, and that's flattening out. Also The Kid has pretty consistently been head-down these past few weeks. I have a foot wedged up under my rib cage on my right side. SO PLEASANT, THANK YOU CHILD.

Shit Happening To My Pregnant Ass: Week 30

[Contents: medical, weight discussion/fat bias, TMI]

Uhhhhh y'all I am so not ready to have a baby.

I mean, with any luck, it's going to be a solid 10 weeks before I do but uhhhh that's like two and a half months? Aaaaand that is not much time.

Also oh my fucking gods I am so fucking tired. SO FUCKING TIRED. I'm at the point where I am waking up every 2-4 hours at night, either because I have to pee, my hip hurts, or both. So while I am sleeping, it's broken sleep. Which I mean hey, good practice for when The Kid arrives but OH MY GOD JUST LET ME SLEEP FOR REAL.

Then some days I feel really pretty good, and energetic and shit! And I want to do all the things! And I have to keep reminding myself NO, DO NOT DO ALL THE THINGS, THAT ONLY LEADS TO SORROW AND PAIN, STOP. So I'm not getting things done as quickly as I'd like, and my hormones are like YOU WILL NEVER GET YOUR HOUSE CLEAN AND EVERYTHING READY IN TIME YOU ARE DOOOOOMED and the rest of my brain is like, uh, the house is pretty clean, yo, like, you're fine. Baby clothes are small that's only going to be like one load of laundry, chill. DOOOOOOOMED.

Not doomed. I mean, hey, I cleaned up my half of the bedroom the other night and it took like an hour, because I kept sitting back down and taking breaks. So now the bassinet can get set up in a couple weeks. And after my prenatal appointment today, I was all adulty and shit and ran errands, including buying a giant thing of motherfuckin' Mod Podge, so all those shoeboxes I'm no longer using can get some of my cute fabric from my giant honking fabric stash applied and BE TRANSFORMED in to drawer organizers mwahahahahah. And I also bought some cute baby clothes because LOOK THEY WERE ON CLEARANCE AND THEY WERE ADORABLE AND SUPER CHEAP AND OMG. One of them might turn out to be the "YAY HERE IS YOUR FIRST REAL CLOTHES" outfit for leaving the hospital. We'll see.

The prenatal appointment went really well. The midwives are sooooo happy with my weight... which, I lost another pound, so uh hey! Great. I'm not trying, I wish I weren't losing weight, and I know full well that if I were gaining the pound a week that all of the pregnancy books and shit say that I should be at this point, they'd probably be counseling me ohhhh, be careful you don't gain too much. Especially since my uterus is still measuring a little over a week ahead of typical for this point. But I also know from previous ultrasounds that The Kid is likely going to be taaallllll. You know, that and plus genetics and shit. So whatever. Kid is still extremely active, we have reached the "alien chestburster" phase, heartbeat was right where it should be still and everything is fine. So I'm not worried, but again, I know, I KNOW, that if I were gaining like many people do, they'd be on me about my weight.  Bleah.

My hips are definitely complaining after all of the in and out of the car and walking around I did today. So definitely doing PT exercises tonight. And tomorrow Fuckwinter is supposed to be back in force, so my plan is to sleep as much as I can, go upstairs and do some sewing, come down to eat and pee, then go back upstairs. I'm making a dress for a friend of mine that needs to be done by the end of the month. I also maaaaay have bought some fabric to make a baby quilt or something along those lines MAYBE. (Okay definitely... hey I had a coupon.)

I'm still not getting a ton of Braxton-Hicks; it's still only after I have WAY overdone shit, or if I get pretty dehydrated. But oh my fuck god, I have to drink all the water. ALL THE WATER. GIVE IT TO ME. NO, MORE. YES. WATER. Ugh. Some days, or if I move the wrong way, I also get ligament or muscle pain. I figure that's what it is because while it is sharply painful, it's super-localized, transient, and goes away if I stop doing whatever move started it. I've also occasionally bent down to get something and I swear to Maude SORRY KID FOR CATCHING ONE OF YOUR LIMBS IN THE FOLD. It's freaky-feeling.

Things I was told would happen in the third trimester were "right so food aversions and nausea, welcome those back" and YUP. I've been having raspberry frosted Pop Tarts for breakfast with a glass of milk for like a WEEK. Yesterday, I made them, and took a few bites, and was pretty sure I was totally going to puke. GREAT. THANKS BODY. Pork still doesn't sound great, and neither does cooked broccoli (but only COOKED broccoli; raw sounds fine). Guacamole and queso are the best things in the world and if you disagree we will fight.

I was also told OH HA HA YEAH YOUR ANKLES AND FINGERS WILL SWELL and nope. My rings are still super loose, and even after a long day like today my ankles aren't swelling.  I'm not complaining; sudden or extreme swelling can be a sign of pre-eclampsia, and you do NOT want to fuck around with that shit. But it's perpetually interesting to me to compare what I'm told should happen and when, with what IS happening and when.

I also got all the paperwork for the hospital - shit like consent forms, registration forms, the form for the birth certificate, the form for the birth plan, all that. Oh my maude, that shit is a shitshow. Why is is so difficult for institutions to make functional, easy-to-use-and-understand forms? WHYYY. So I definitely made a pain in the ass of myself at my appointment today with "so by the way this is a hot mess and here's why, also your instruction sheet is no better thanks" hahah WELP. I am definitely that patient. But seriously... if you're going to say that I can refuse to, say, allow you to use any tissue or body parts of mine you remove during birth for research purposes, it behooves you to give me a space to clearly mark whether I consent or not. Like, come the fuck on.

But basically at this point it's EAT ENOUGH FOODS, DAMMIT and DRINK ALL THE WATER and TAKE IT EASY OH MY GOD YOUR HIPS CANNOT HANDLE SHIT... and trying to go full-term. WOOOOOOOOO.

"Have You Thought About How You're Going to Feed the Baby?"

[Contents: medical, gender essentialism, fat hate]

That was one of the questions I got asked yesterday in my prenatal appointment with the midwife.

She's not new to the practice, but I hadn't seen her before, and we actually had a good discussion on the framing of that question. She talked about how she had used to say "So are you planning on breastfeeding?" and after some feedback and looking in to things, realized that could be incredibly stigmatizing towards people who could not or chose not to breastfeed. So, good for her. Especially since so much of the pro-breastfeeding rhetoric that's out there is stigmatizing, shaming, and guilt-tripping bullshit.

I tweeted about this the other day, but I ran across an article entitled "Is breastfeeding the key to mother-baby bonding?" And the answer is NOPE NEXT QUESTION, again, as I tweeted. But if that article is intended to get more people to breastfeed their babies, that's not going to do it. Because what that title is really saying is "fyi, if you don't breastfeed your baby, you're a BAD MOM and you WON'T BOND with your kid." Which is false false falsity false... but when you hear that message often enough, it starts sinking in.

I also mentioned, both to the midwife and to Twitter, that I planned on breastfeeding, in spite of a lot of the pro-breastfeeding stuff that was out there. And that's really the case for me. Honestly, The Man being pro-breastfeeding did way more to convince me to try it than anything I've ever read or heard on the subject. I was formula-fed, as were my siblings, and really, I don't have a problem with formula feeding. (I have problems with formula manufacturers, but not formula in and of itself.)

The thing of it is, I don't know that breastfeeding is going to work, for a couple of reasons.

One, supposedly breastfeeding requires you to consume an extra 500 calories a day, above and beyond what you ate during pregnancy. Okay, I haven't read any good studies on it, but on its face, that passes the sniff test, if you will. It makes sense that you're going to need some extra fuel in order to produce food for an entire other being. You're also supposed to drink plenty of water - again, makes sense. But here's my problem: I apparently can't eat enough to even gain weight during pregnancy. I lost three pounds this past month, as I transitioned in to my third trimester, where "typical" weight gain is a pound a week. Instead I lost almost a pound a week. Let's not even get in to my fucked up issues with food from my past - I really have been pretty damn good about fooding myself on the regular once I got over the constant fucking nausea. But even with that, it seems I cannot eat enough.

I also know that I don't often drink enough water. When I get really dehydrated, I start getting Braxton-Hicks contractions. That's considered typical (although apparently I started getting those much earlier than most people, WHOOPS sorry care providers; I've always been precocious), but jeezy muffin creezy I'm supposed to drink EVEN MORE WATER? Oh fuck.

I just don't know that I'll be able to keep up with eating and drinking enough to actually do this.

Secondly, that's all complicated by the fact that I am hypothyroid, and most likely have Hashimoto's disease. I haven't been officially diagnosed with Hashi's... but I meet every criteria, including the presence of TPO antibodies above and beyond what's considered "normal" in a woman my age. It's also the most common cause of hypothyroidism, so HAHA WELP. There isn't a ton of research in to hypothyroidism of any stripe and breastfeeding, but what's out there suggests that breastfeeding is more difficult with hypothyroidism. The TPO antibodies, so far as we know, are not secreted in breastmilk (which is good), but people with hypothyroidism are more likely to have significant supply issues.

Plus, we just started regulating my thyroid, and fixing all of the problems that come along with a borked thyroid (which, in case you forgot, include severe iron deficiency, severe vitamin D deficiency, a totally wack metabolism, B12 deficiency, and more) less than a year ago. I'm quite honestly a bit shocked a, that I even got pregnant, and b, that I've been able to stay pregnant while some of this shit is still regulating. (And yes, it still is - I can tell from symptoms, but even without that, it was probably fucked for twenty years. It ain't gonna fix itself in nine months.) Even by the time The Kid is born, it will STILL be less than a year that I'll have been in treatment. And while my iron and D counts are still slowly creeping up, they have slowed down their upward movement in pregnancy. In other words, things are improving, but not as quickly, because pregnancy is an additional stress and draw on those resources.

This is why when I got an email from yesterday's midwife about "oh yeah, your blood work was normal, your iron looks good for this point in pregnancy", I laughed. Lady, my hematocrit and hemoglobin slid down again and are both below normal, and my MCV is still below normal. I'm still fighting for iron and having trouble hanging on to it. "I recommend you continue taking your current vitamins and supplements" also made me laugh. THERE WAS NO CHANCE I WAS STOPPING ANY TIME SOON, THANKS. Especially since that's all being managed by my pcp - who is tracking my ferritin, that is, stored iron, not just the circulating iron. It's the ferritin that was dangerously low and that we're working on bringing up. As of December, it was at 51. After supplementing since July. It should be around 80. Yeah. Got a ways to go on that one.

Which also raises the question, how nutritious is any breastmilk I manage to make going to be? And, if it's like pregnancy, wherein the fetus and placenta basically override my needs for nutrients and steal shit like calcium right out of my damn TEETH if they need it... what cost will I have to pay? How healthy is that going to be for me?

Plus, people with  Hashi's are more likely to have significant thyroid problems in the post-partum period. In other words, it's very likely that shit's going to get wild with my thyroid. So with that, on top of "hey things aren't actually totally regulated yet WHEE", and then trying to breastfeed? Oh yeah shit could get real interesting, real quick.

Finally... if you look at the pictures in all of the breastfeeding literature? Fat people don't breastfeed. People with very large breasts like mine don't breastfeed. People like me don't use breastfeeding aids like Boppy or My Brest Friend (NOT KIDDING, THAT'S THE NAME) pillows, because they aren't big enough. If I want to use a pillow to help support The Kid, I either have to make one, or make due with other pillows, because there just aren't purpose-made pillows manufactured to fit someone like me. There aren't a lot of options for nursing bras even in my current size, much less if my breasts get even bigger (which they probably will), or clothing made to make nursing easier. All of those nursing covers? AHAHAHAHAHAHAHHAHAHAHAH nope too small.

I have no idea if any of the lactation consultants will even know how to work with someone shaped like me. You would think they would... and yet doctors and other care providers often don't, so I don't assume they will. Which could mean that for the most part, I'm going to be on my own, without a lot of professional support. Which is also not a guaranteed recipe for disaster - the lactation consultant is, after all, a recent invention - but it's not like breastfeeding was something my family has done recently either, you know? My mom is definitely pro whatever my plans are, but she doesn't have practical experience with them. Even most of the people I know who are pro-breastfeeding, give breastfeeding advice, etc. are not fat folk.

So yeah I'm planning on breastfeeding, and if you want to be all like "WELL YOU ARE GETTING DISCOURAGED BEFORE YOU START YOU ARE BAD", go fuck yourself. I'm also signing up for formula coupons just in case. And preparing for the onslaught of BREAST IS BEST and OH BUT YOU SHOULDN'T SUPPLEMENT and all of the other bullshit, including, I'm sure, guilt from some folks if I switch to formula. Fuck it. Kid's getting fed no matter what. But shit, can we drop most of how we talk about breastfeeding and how we "encourage" people to do it? Because it's really not encouraging at all.

Full Genetic Sequencing for Fetuses and Motherfucking Ethics

[Contents: ableism, eliminationist rhetoric, fat hate]

I briefly mentioned this article on Twitter yesterday: What Fetal Genome Screening Could Mean For Babies And Parents. That's a donotlink link, by the way. The article was published in Scientific American.

I'm not even sure I can adequately express how deeply I'm disturbed and frankly disgusted by the attitudes expressed by the scientists in the article. The first few commenters are even worse.

Basically, some bioethicists at Brigham & Women's Hospital in Boston, MA have published in The New England Journal of Medicine that YUP, parents should be able to get this with appropriate genetic counseling services.

That in and of itself isn't necessarily so bad, although "genetic counseling" leaves open a big door and there's lots of variation as to what it includes and entails. Then you get in to their reasons for arguing this. The big one cited is "Parents may emphasize diet and exercise more for a child at heightened risk of diabetes, for instance."

BECAUSE YES, SINGLING OUT A KID FOR DIFFERENT TREATMENT FROM DAY ONE FOR A DISEASE THEY DON'T HAVE BUT MIGHT GET IS SUCH A GREAT FUCKING IDEA, FOLKS.

I just... look. If you are different as a kid already, that's hard enough. Kids who have illnesses that require treatment, like special diet plans, medication, or other treatments visible in public, are incredibly stigmatized on a routine basis. And while the article makes the point that genetics do not guarantee a disease, this argument for fetal full genome sequencing completely ignores that. It's arguing you should treat your kid differently on the basis that they MIGHT get a disease (a disease we associate with OMG OBESITY, by the way - I don't think THAT'S a mistake), marking them from early childhood on as someone who's less than, someone to be pitied, mocked, someone who's impure.

The rest of the article is from some other scientist all dismissive of "perfect baby quest" concerns, and all "WELL IF PARENTS WANT IT THEY SHOULD GET IT". Which is a shitty, shitty argument. "Well I want it" is no basis for a solid ethical decision. And her reasons for dismissing ethical dilemmas about the potential for parents terminating a pregnancy because they found out they fetus' eyes would be brown instead of blue, for instance, is "well not everyone would get it". Which doesn't eliminate the ethical problems at all! And there's a brief mention of "well fetuses can't consent", but it doesn't even remotely touch on what the ethics are of having your genetics on record before you're even born, much less consent. Can you imagine insurance companies with that information, for starters?

Then you get to the comments, and the first few are so deeply ableist and eliminationist, jesus fucking fuck. They straight up say there are no ethical problems with this, and raising a child with an illness or disability is not loving. "That's the unethical thing", one person says. You'd be a bad parent to not get it is strongly implied, because giving birth to a kid with a disease is abusive.

Yes folks, someone argues that it's unethical for people with disabilities to even be born.

I... holy shit. This person thinks I shouldn't have been born.  This person thinks that my kid shouldn't be born, because I opted for absolutely zero genetic testing or screening. This person thinks that a whole fucking bunch of people I know shouldn't have been born, because they weren't born "perfect".

Holy. Fuckball. Shit.

So yeah, you're damn right I disagree.

I absolutely think there is an ethical debate to be had here.

In some respects, this is a debate many pregnant people and their partners have. The Man and I had a discussion about it, although in our case the discussion was short. While full genetic sequencing was not offered to us, we were offered other testing, including a nuchal translucency scan, a quad scan, chorionic villi sampling, and more. We turned them all down. Part of that, honestly, is because The Kid is at low risk of developing anything those are testing for. The bigger part of it is that even if The Kid did have something that was being tested for, such as trisomy 21 (better known as Down syndrome), we wouldn't do anything about it. We wouldn't terminate the pregnancy. We'd have The Kid, and we'd love them, and raise them the best we could. The Plan would not change.

We did get the "standard" anatomy scan between 18-24 weeks. If that had discovered that The Kid had a condition wherein there was no way they would survive to term or outside my uterus, at that point we would have terminated. If that had discovered Trisomy 18 (also known as Edwards syndrome), where the majority of fetuses die before birth, and approximately 8% of those who are born survive past the first year, that would have prompted more conversation, although we likely would choose to continue the pregnancy anyway, with monitoring.

Those are our decisions. (And shoutout to my midwife and OB who are 100% supportive of them.) And yet this commenter thinks those are unethical. Wow.

But if you think that if a fetus has a disease, or a potential for a disease down the road - because let's be real, 99% of what fetal genome sequencing would find would be the potential for a disease - then that fetus shouldn't be born, where do you draw the line? Obesity is considered a disease - should fetuses with higher risk of obesity not be born? Ehlers-Danlos? What about my Hashimoto's? What about schizophrenia? Cancer? Does it matter what kind of cancer? Diabetes? Does it make a difference if it's Type 1 or Type 2?

Because here's the thing - we all get sick. Each and every one of us. Every single one of us carries within us the potential for a whole host of things, from heart disease to cancer to fuck all knows what else. And genetics are not a guarantee of disease. We don't even know which genes are tied to which conditions, in most cases, much less how the complex interplay between genetics and environment determines who gets what and when. We just cannot predict, outside of a few things diagnosable in utero, what any fetus will get in their life after they're born.

Moreover, we rank diseases and disabilities. I've already done it a few times in just this piece. I think most if not all of us have that sort of internal ranking. "Well Hashimoto's is bad and an autoimmune disease, but it's not thyroid cancer" is another one I have. I also think that our wider society's rankings of disease and disability go beyond their treatability, the pain and suffering they cause, their risk of death, etc. and gets way in to aesthetics. See also, obesity is considered a disease. As I mentioned earlier, I don't think it's a mistake that "diabetes" was the example given by the bioethicist arguing for fetal genomic sequencing. We perceive Type 2 diabetes as preventable, as well as caused by obesity - which we also consider preventable. It's one of the diseases where society really likes to blame the person for getting it.

And to use that potential of disease or disability as a screener to determine which fetuses should be born or not is so abhorrent. Even if they do have the potential for something that's really scary, that's not a guarantee. Conflating giving birth to a fetus with the genetic potential for something you don't like with abusing that child, or with a death sentence, is mendacious as fucking hell, not to mention unethical.

Finally, the idea of health at every cost comes out here. As if we owe it to ourselves, to society, to our children, to be absolutely healthy. To do everything we can to be healthy. And let's be real, it's a real narrow definition of healthy that's always used here, and it absolutely includes "not fat". It also doesn't include "uses a wheelchair", "has a mental illness", or "has a chronic disease that limits their activity". We're all supposed to be thin, preferably white, happy, active, totally able-bodied people. Anyone outside those parameters need not apply.

Fuck that.

Fuck that narrow definition of health, and fuck anyone who thinks I owe fitting in to that definition to them or to "society". And fuck anyone who thinks that as a presumptive parent, I owe it to anyone for my children to fit that narrow, ableist, racist, hateful mold. Fuck the entire idea that if you and your body and mind are less than "perfectly healthy", that you shouldn't be here. Fuck that fuck that fuck that.

What Is Actually Complicating My Pregnancy

[contents: medical, tmi, fat hate, scare-mongering]

Before I get any further: YES, THE KID (AND I) ARE BOTH FINE.

Okay!

It's a really popular position to assume that all fat folks who get pregnant have high-risk pregnancies, and the resulting babies have tons of problems, and it's just oh my god terrible and WHY WOULD YOU GET PREGNANT IF YOU'RE FAT DON'T YOU KNOW YOU AND YOUR BABY WILL DIE. See also: pretty much any mainstream article about obesity and pregnancy published in the last ten-plus years, or so many entries on My OB Said What?! (seriously, that site needs major trigger warnings).

Except that position is not actually based in reality.

I'm not saying that there are no risks associated with (note: ASSOCIATED WITH) being fat during pregnancy. Fat pregnant folks are at higher risk of gestational diabetes and preeclampsia. The fetuses of fat pregnant people are at higher risk of being born large for gestational age, of having neural tube defects, etc. etc. etc.

What even the American College of Gynecologists doesn't tell you is that while yes, obesity is associated with higher risks (that is, we have no idea about what causes any of these), including things like OH MY GOD A FOUR-TIMES GREATER RISK of things... the actual, numerical risk is not actually that high. Not that you can tell from the ACOG paper, or indeed, many reports, because they don't actually include the baseline risk numbers.

The thing is, when you multiply a very small risk by four, the risk is STILL SMALL. And all of these things? Occur in very small numbers of pregnancies. Are they scary and bad? Absolutely. But even if your risk is elevated for them, that is far, so far, from a guarantee you'll get them. Even if you are "morbidly obese", your risk of any of these complications is less than 10% - in some cases, WAY less than 10%. For example, the CDC says that your risk of gestational diabetes is between 2-10%. (They also say here that it's between 2-5%, and that "some - but not all [people] with gestational diabetes are overweight before getting pregnant". Not even the CDC is telling you the fat causes gestational diabetes, y'all.) Is your risk higher than in folks that aren't fat? In some cases, yeah. Is it ever YOU WILL DIE AND SO WILL YOUR BABY high, as it's often presented? Not. Even. Close. Fact is, the vast majority of fat pregnant folks have perfect fine, healthy pregnancies, and give birth to perfectly fine, healthy babies. But that doesn't sell diets and papers and ads and shit.

These also aren't the only complications of pregnancy though. (And I have my theories about why they're what we hear about... namely, WE CAN LINK THEM TO THE FAT OMG). Last week, I was referred to a maternal-fetal medicine specialist. Not because of my weight, thank fuck, because it really isn't complicating my pregnancy. I mentioned here that there was a finding at my midpoint ultrasound just before Thanksgiving that resulted in a referral. The finding wasn't about The Kid - The Kid looks fine, is measuring spot on for the due date, is extremely active, everything seems to be going well. The finding was that my cervix was a bit on the short side.

(Here is where I spent an hour trying to find how common a short cervix is in pregnancy, and found no good answers. Basically, judging by this study and a few others, at least 95% of all pregnant folks do NOT have a short cervix. It's actually pretty hard to find baseline risk information for any condition. So frustrating.)

Having a short cervix around this point in the pregnancy is associated with a higher risk of delivering early, and the shorter your cervix is, the higher the risk. I'm not in the highest risk category, but my cervix was short enough to up my risk, so I was referred to a specialist to be evaluated and see what, if any, treatment would be necessary. So I got a second ultrasound in a week, which again confirmed that The Kid looks just fine. The ultrasound was pretty entertaining. I'm pretty sure The Kid was napping when it started. Then after a minute or two of wand-on-belly, I started seeing hand-waving and kicking... and was kicked pretty constantly the rest of the day. Thank you for expressing your opinion, Kid. But the ultrasound also confirmed that yeah, my cervix is a little short.

No one is really sure why some cervixes are short. Theories include natural variation, inflammation, previous cervical trauma, and more. (Nobody links it to OMG THE FAT, SORRY HATERS.) There's also a difference between just a short cervix and what is called an incompetent cervix (and isn't that just a lovely health term). Some people will tell you that any cervix sufficiently short is incompetent, while others will say no, there has to be early dilation. Like many health topics, it can get somewhat confusing, but long story short, HAH, my cervix is just short, not incompetent.

I also mentioned earlier this week that I'd been all over Cochrane, checking to see what the actual risk was and what the treatment plans were. Cochrane kindly confirmed my assessment (higher than usual, but not panic time), and that of the two treatments (cervical cerclage, which is literally stitching the cervix closed, and progesterone supplementation), for people like me, who just have a short cervix, no signs of pre-term labor, and no history of pre-term delivery, progesterone is the way to go. It's associated with better outcomes all around, including reducing the rates of pre-term birth and neonatal complications. As I mentioned previously, the specialist I saw was on the same page as me - thank FUCK for doctors that read and understand research. And thank FUCK for doctors that love when their patients read the research. And a final, super-hearty thank FUCK for doctors who don't engage in fat shaming - my weight came up exactly ZERO times in this appointment, which is exactly how it should have been.

So I am now on supplemental progesterone. I go back in about a week for another special ultrasound to check my cervix, and so long as it hasn't gotten worse, then I get to go back in a month or so. Is it considered a complication? Yes (but technically, so is my well-controlled hypothyroidism ALSO NOT CAUSED BY FAT, THANKS HATERS). Is it a big one? No, and I'm thankful for it. I just have to take some additional meds and see another doctor once in a while, and that's okay for me.

Shit Fat Pregnant People Get Told: The What (Not) To Eat Edition

[contents: diet talk, disordered eating, medical, food restrictions, fat hate]

Everyone and their mother has advice on what to eat when you're pregnant. It's in every book, every provider I've seen so far (and I've been rotating among people in the practice, so that's three so far) has told me what (not) to eat. Random strangers give you advice. Seriously. EVERYONE.

Some of this advice falls under "what to do for morning sickness", which... is another topic entirely and so annoying. I'll probably cover that at some other point. What I wanted to talk about is the recommendations you get for your "pregnancy diet".

A lot of the books and sites you read are.. yeah, okay. The "YAY YOU'RE PREGNANT HERE'S THE INFORMATION ABOUT THE HOSPITAL" book I got at my first midwife appointment has this type of recommendation. Eat a variety of foods, heavier on the fruits and veg, try to get some stuff with calcium and protein, etc. and so on. Fairly reasonable so far as it goes, even if it does completely ignore people who have varied needs or dietary restrictions, and completely ignores folks for whom regular food is not a thing.

In fact, all of these recommendations are like that, whether the generalized ones you read in the books, or the ones most doctors and midwives will tell you to your face. On food stamps? No room for that here. Limited income? Food desert? No time to cook (or no energy to cook)? WHATEVER. These recommendations don't give a shit about your "problems". In fact, my care providers have never tried to see if I'm food insecure, beyond a single question on the intake questionnaire (which was FIVE PAGES LONG and had NO ROOM TO ACTUALLY ANSWER QUESTIONS) about if I were worried in any way about "money". Not actually about food or housing, just "money".  And with one line to try to cram an answer in. An answer you're giving to someone you haven't met yet and aren't sure you can trust. Super.

So yeah. Then you get to the stuff that's said to you in specific. In theory, these should be better! They're coming, usually, from people who know you, some of whom know your medical history in detail! HAHAHAHAH WHAT A FUNNY JOKE. These examples are all drawn from what I've been told so far. Please share your own in comments!

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Try to get some protein and a fruit or vegetable together at every meal.

On the scale of 1 to "are you trying to kill me", this is like a three, at least for me. The explanation was that fruits and veg are good for you, and having some protein with it would make sure that your blood sugar was more even and you stayed full longer. Which... the staying full longer is, yes, straight-up diet language. On the other hand, when you get nauseated as hell when you start getting hungry, not getting hungry after twenty minutes is a definite feature.

The blood sugar thing, I'm not entirely sure if that was "you're fat so you'll get the diabeetus", or just general good advice. I do know from past experience that if my blood sugar drops, bad things happen. If you've ever heard the term "hangry", yeah. THAT. So things that can help me not get to hangry are always appreciated. (Interestingly, this happens approximately not at all now that my thyroid is being treated. So many interesting things that I just took as my normal seem to be turning to be "nope your thyroid was fucked".) But there is some research showing that you'll probably be in a better mood, and overall feel better, if you're not riding a blood sugar roller coaster. So... yeah okay.

Fruits and veg, I'm one of the people for whom those sorts of things are really good. I know people for whom fruits and veg in general, or extra fruit and veg, would be absolutely detrimental to their health. From fucking up your potassium levels, to aggravating things like ulcerative colitis, fruits and vegetables are not actually good for everyone! Sure, many people benefit from the whole "five a day" thing that has been a feature of US public health campaigns for years (recently replaced with "More Matters")... but not even CLOSE to everyone. Turns out people are individuals! SHOCKING I KNOW.

But what makes this really less annoying for me was the "try to". Because it signals to me that this recommendation is coming from someone who understands that eating "perfectly", whatever that even is, is really not an attainable or reasonable goal. And that if I reported that I hadn't done this more often than I did, the follow up would more likely be a gentle reminder along the lines of "well keep trying", rather than straight-up fat shame. It's really the only recommendation I've gotten that has even a hint of awareness that everyone is different.

Eat a small meal every two hours.

You hear this in dieting, you hear this sometimes in HAES, and WOOOO I heard it in pregnancy. Some of the thinking behind this one is the same as the previous recommendation - try not to ride a blood sugar roller coaster. Some of this is to hopefully prevent nausea - which is less useful when both eating and not eating make you nauseated as hell, as happened to me the first, oh, three months or so, but it's a nice thought.

But this ignores the fact that sometimes you're really just legitimately not hungry, and that is okay too! When trying to unlearn disordered eating patterns, it can be incredibly helpful to present food to yourself on a schedule. And even then, it's okay if you're not actually hungry at that time. Eating well isn't about adhering to a strict schedule, or limiting food intake, or restricting in any way, it's about meeting your body's actual needs. Eating a meal every two hours, no ifs ands or buts, is not actually a way to do that.

At this point though, this has become extremely practical for me, because I just cannot fit much food in my stomach. I can be super fucking hungry! And then I take like SIX BITES AND I'M FULL. It's intensely frustrating. If you follow me on Twitter you'll occasionally see me post things like "and for second dinner", because I eat... and then I need to eat again two hours later. It is so frustrating for me right now.

But again, that's me... it's common in pregnancy, especially later on after the uterus has grown significantly, for the pressure this exerts on one's internal organs to make it more difficult to eat. Not guaranteed though. And eating every two hours isn't always the best plan for everyone. Even for me, where this does work pretty well, it varies day by day, as well as by time of day (I tend to be way hungrier in the evening). So again, shocker, PEOPLE ARE INDIVIDUALS. Not that this is reflected in most advice.

Avoid white foods.

This shit alternately makes me laugh and seethe. This was from the same midwife who told me to "only gain 10 pounds". When she said this to me, I nearly blurted out "so... white meat chicken, pork, navy beans, apples, cauliflower... right?" I then thought "so... are you telling me I should be eating the things that in the US we stereotypically associate with Black people? Or I should be eating only Indian food? What?"

I mean it's just a bullshit recommendation on its face.

Usually when you see this what it means is "eat whole wheat bread, not white bread, eat brown rice instead of white rice, avoid potatoes and starchy things" etc. and so on. The rationale is usually OH REFINED FLOUR HAS NO NUTRITIONAL VALUE AND WHOLE GRAINS HAVE FIBER AND MICRONUTRIENTS.

Look.

There is literally no food that has zero nutritional value. I will repeat that. THERE IS LITERALLY NO FOOD THAT HAS NO NUTRITIONAL VALUE.

Literally none.

I mean, did you know you can get 10% of your RDA of iron from a serving of potato chips? And that anemia is ridiculously common in pregnancy, so it's important to get plenty of iron? Seriously. Potato chips have iron in them. Lots of things do. Every single food you could possibly eat has some nutritional value, both in terms of calories (which, you need calories, they are literally units of fuel), and vitamins/minerals. Every. Single. Food.

Additionally, a non-specific recommendation like this to NOT eat foods, to avoid an entire category of foods (even a category as loosely defined as "white foods") can be incredibly dangerous. I've talked about eating disorders and disordered eating before - blanket recommendations to avoid foods can be incredibly triggering for folks in those situations. Additionally, when a recommendation is based not on nutritional needs, but, as I have to figure in this case, the fear of the FAT and the DIABETES, it's not actually helpful, and can in fact be very harmful. Furthermore, the entire idea behind this is based in the notion that some foods are not "real" foods or are "OMG POISON" which... ugh, I don't even have the words for the contempt I have for those ideas. They're straight up diet culture and fat hate. And usually some racism and classism mixed in for good measure.

**********


So yeah. That's what I've heard so far. Mostly a bunch of one-size-fits-all, based-in-diet-culture-and-fat-hate, utter crap.

In the mean time, I'm working on eating when I'm hungry, and satisfying what I'm hungry for. Because I need to eat.

Perfect Pregnant Bellies

[contents: body image, fat hate, racism, ableism, trans hate]

So when I say the words "perfect pregnant belly", what do you think of?

Is it something like this?

Chances are, it is. The epitome of "perfect pregnant belly" belongs to a white woman, relatively small-framed, who looks like she has a basketball for a belly. It has smooth, firm skin, no stretch marks in sight, certainly no extra fat anywhere to be seen. And that's what's in that picture.

When you google "perfect pregnant belly", images like that one are an AWFUL lot of what comes up. There's more variety than I was expecting - some people showing their C-section scars, some with stretch marks, some with henna. I had to scroll some to find someone with dark skin though, and there was only one. All the rest were light skinned. 90% or thereabouts were headless pictures.

What I didn't see were any pregnant bellies that looked like mine.

Sure, I'm a (very pale-skinned, although it's funny how not being "how are you alive" anemic has changed that) white woman. So I saw lots of skin tones like mine, which is typical for media. White and light-skinned folks are way, way over-represented, thanks racism. But I didn't see any fat pregnant bellies in that search. I didn't see any bellies on people who have big thighs like me, and arm fat that hangs below their triceps like me, who had stretch marks on their bellies and breasts long before they were pregnant, like me.

I didn't see any pictures of people who have dark body hair on their arms and legs and lower abdomens like me. I didn't see any pictures of people whose breasts were never "perky" or "firm", but pretty much always looked like a cantaloupe in a sock, like me. I didn't see pictures of pregnant bellies on people who have what their mothers call, not unkindly, "junk in the trunk" like me, with dimpled flesh and back fat and jiggliness all over, like me.

And that's just like me. There's way more things that aren't represented in that "perfect pregnant belly" imagery we get.

That's deliberate.

People will try to tell you that the kind of bodies you see most often represented aren't the result of deliberate choice, that it's all just "how these things work" and nobody is really at fault and it just happens, like the world is a fucking vacuum and culture has no influence on this sort of thing. They're full of shit. The fact that "perfect" is attached to thin white cis able-bodied people with no visible "flaws" is not an accident. It's not an accident in modeling, it's not an accident on tv, it's not an accident in pregnancy. It's not an accident ANYWHERE.

Racism is not an accident. Fat hate is not an accident. Trans hate is not an accident. Ableism is not an accident. What society tells you is "perfect" is not a fucking accident.

And fuck all of that.

Because you know what? My fat pregnant belly IS perfect. It's MINE. There's A FETUS GROWING IN THERE. All of a sudden two weeks ago I saw myself in profile in the mirror and went HOLY SHIT, I LOOK PREGNANT. This is a very wanted pregnancy for me, and that was EXCITING. No, I don't have that "smuggling a basketball look", and I almost certainly never will. But what I DO have, is MY pregnant belly. And MY pregnant belly is fucking perfect.

You know what? If you are pregnant and want to be, and you have a pregnant belly? YOUR PREGNANT BELLY IS PERFECT TOO.