Thursday, August 26, 2010

"Overdue" and thoughts about nutrition

I'm now some 10 days past my "official" due date, but a week or two ago I knew, I could just feel that I'm not really at my "due date" and not ready to go into labor yet. There are a few physical and psychological signs I felt towards the end of my last pregnancy, and that I feel now, the most prominent of which is restlessness and emotional readiness to go into labor, as opposed to anxiety about what's to come and wishing it didn't have to happen just yet.

I stopped going to my prenatal visits because I know that at this point, all I'll get is pressure to artificially induce labor and perhaps a few invasive and useless cervical examinations. I've been saying for a long time I have a feeling the baby will probably be born around end of August and not mid-August as was suggested. Every stage in this pregnancy simply felt "delayed" as compared to the previous one, from the onset of morning sickness to feeling my baby move for the first time, and many other symptoms – but most health care providers are interested in fixed dates and numbers, not in complicated stuff like the intuition of pregnant women and the alchemy of hormones that will decide, if left unhindered, when you will go into labor.

In the meantime I've been reading up and building a post-partum nutritional plan for myself. I am ashamed to say that last time around, I didn't watch my nutrition very carefully. I am naturally thin and have had to struggle to keep my weight on while nursing. I know some of you might say you'd love to trade with me, but being extremely thin is not healthy for a nursing mother or indeed for any woman during the reproductive period (obviously thinness is a relative term, but you'd better keep an eye on your constitution to ensure healthy weight). The result was that I began my second pregnancy weighing about as much as I did in ninth grade. Now eating well is much easier to keep up with because I have a toddler who has fixed meal times and eats grown-up food so we usually eat together.  

For many years, I hadn't touched meat or fish, though my diet contained liberal amounts of animal protein in the form of eggs and dairy products. After reading Nourishing Traditions, I realized that what helped me avoid various deficiencies (even though I never took any supplements before pregnancy) was probably also the presence of animal fats in my diet. The dairy products I consumed were never low-fat, in fact, I grew up in a home where sour cream is liberally added to soups (a practice that is unfamiliar for most Israelis). I was a healthy vegetarian. 

Anyway I, a person who could not bring herself to eat fish for 12 years, found myself munching on fish during my first pregnancy, following an irresistible craving. I especially wanted salmon. Again, reading Nourishing Traditions and learning how highly valued fish and other seafoods (and fish – not all kinds of fish, mind you - are just about the only kosher seafood) were for women in the reproductive stage, helped me put things in perspective a bit. I've been eating fish ever since but I still find myself unable to eat meat and I do not believe it's strictly necessary if I eat liberal amounts of protein and fat from animal sources anyway.

I think it's very important to listen to your body and your cravings during pregnancy, using discernment of course. Obviously if you crave a bag of Doritos, it doesn't mean your body needs Doritos. But if you find yourself wanting real food, even if it's something you don't normally like or consume at all, perhaps it's worthwhile to give it a try (unless you know you're allergic to it of course).

However all conventional diets for pregnant and nursing mothers are PC, meaning that they are relatively low-fat, and especially low in animal fats. I find this illogical, for example, how first people are told omega-3 is good for them, and then they are encouraged to eat lean fish. Obviously, omega-3 will be found in fish oil – the fatty fraction of fish. I read recommendations to new mothers "not to consume less than 1,500 calories daily" – considering how nursing alone will burn about one third of that amount, I find this recommendation dangerously low. I'm also appalled to find nutrition experts write out menus where a "recommended" night time snack is ice-cream or some chocolate. Obviously most people indulge in ice-cream or chocolate from time to time, but including it in a daily menu makes it seem as though this is ideal, which it isn't. 

This time around, I plan to be much more responsible about my nutrition. Nourishing, high-value foods for a nursing mother aren't indulgence, they are a must!      


Anonymous said...

good for you, for deciding not to go to your appointments.

i hope you have a wonderful, natural delivery.

Tonia said...

I absolutely agree that we should listen to our cravings at times and wanted to add that often if you have uncontrollable cravings for sugar, what your body actually needs is protein. Meat, nuts, peanut butter, etc. can often give you the energy your body is looking for. This seemed counterintuitive when I first heard it, but I have found that keeping up with my protein intake actually does help reduce my sweet cravings.

Miss Tatiana said...

I'm so happy to read of a lady who is doing her own research and listening to her body over what doctors are swearing up and down must be done to have a healthy baby. Excuse me, but I think a woman knows best.

The 1500 calories daily shocked me! I'm a taller lady (about 6 foot) but my calorie intake needs to be AT LEAST 1700 calories daily (that's with doing no exercise or movement). I'm guessing I'll have to consume at least around 2000 or 2200 calories if I'm breastfeeding too.

Linda Albert said...

Dear Anna,
Trout, mackerel, sardines and herring (my favorite)as well as tuna and salmon are rich sources of Omega-3 fatty acids, though I would avoid eating mackerel and albacore tuna unless it was Pacific tuna because of the mercury and methylmercury levels found in those species. Like you I find it so very strange that the official dietary guidelines call for low or no fat foods especially for pregnant and nursing mothers and young children when we know now that cholesterol is absolutely vital to proper growth and functioning of nerve cells and babies produce the majority of their brain cells and nerve connections in gestation and the first year of their lives. Maybe the low/no fat diet fallacy is responsible for the prevalence of behavior disorders like autism, ADD and ADHD that might indicate a more subtle kind of brain cell or neural dysfunction.
Beans, winter squashes, nuts, flaxseeds, and olive oil are also good sources of omega-3 and other EFAs. Full fat dairy products and eggs, most especially is they come from pastured cows, not dry feed, are very good sources of linoleic and conjugated linoleic acids. There is a brand of butter from Ireland, Kerrygold, that is from 100% pastured cows.
It is the presence of refined carbohydrates in the diet and food industry refined polyunsaturated oils that has led to obesity and heart and artery disease not the unprocessed fats found in fish and pastured animal products.
I pray all goes well with this delivery and you are soon home with a precious new baby.

Leah Brand-Burks said...

Very good, Anna! Love this post all around. We think a lot alike.

Karen said...

1500?? Wow...I guess it depends on how much muscle you have and how active you are, but I lost weight on 2000 calories when I was nursing. Unfortunately I had to stop because my baby was losing weight too! She was 1/2 lb underweight and the Dr tried to convince me to switch to formula. But I knew it was the dieting!! Sure enough, as soon as I stopped dieting she piled on a healthy amount of weight.

You aren't really "overdue" till 2 weeks past your due date. Really it should be due Month! But personally I worry a little about the placenta losing it's nutritional value for the baby, so I would definitely try some walking to try to get labor started. I don't think I would try any other form of "natural" induction though...those only caused my water to break! Then I had to worry they would not let me go past a certain amount of hours of labor without an induction due to the risk of infection (which would be much less if they'd just stopped poking at me!)

If you are not seeing your doctor, are you considering doing some home prenatal care? Just to make sure the baby is continuing to do well...wouldn't hurt.

Mrs. Anna T said...

Karen, I think no calorie counting at all should be done while nursing - just focus on wholesome nutritious foods.

While 42 weeks are considered the "upper limit" for normal gestation, it's important to remember that this is not necessarily true if they didn't get your gestational age correctly. I know in my case estimated due date based on LMP is worth nothing. I did several ultrasound scans which all showed my gestational age is less, but even scans can't really tell when I ovulated.

I am trying to be as active as possible, although walking a lot is difficult since my pelvic bones have "shifted" slightly which causes pain when I try to walk more than a bit. There are other harmless forms of natural induction, though - which do *not* involve nasty things like Castor oil.

But you know what, I believe that if any kind of physical activity causes you to go into labor, it means it would have happened soon anyway - otherwise, your body just isn't ready.

For fetal monitoring, I don't go into the doctor's office because our local clinic has no equipment anyway. I go to a women's health center in a nearby town. But overall I'm doing great and feeling lots of movement so I think we're going to be just fine, God willing.

Kate said...

I'm probably going to switch OB's and even hospitals for my next pregnancy. I had premature labor at 33 weeks and they were concerned I'd delivery prematurely. However, as soon as I hit 37 weeks, they pushed induction. Thankfully, I went into labor naturally just days before the planned induction (which I was going to skip anyway). It baffled me that they wanted me to hold on until full term, but then jumped on inducing at 37 weeks! Also, my OB didn't delivery my baby, another one I never met did. He ordered pitocin for me even though I didn't want it and my labor was going perfectly without it. I mean, it was a beautiful labor and delivery...the kind every woman dreams of. Why would they order pitocin!?

Admittedly, I'm glad when they do internal exams when labor is so close because it kind of helps things least for me.

I do like my OB for some things, though, like he really supports eating fatty foods and high cholesterol foods while pregnant because they're good for the baby. So I get to eat eggs, fatty fish, almonds, etc without hearing negativity about it.

Mrs Happy Homemaker said...

My last baby is 4 months old now, and I was SO hoping to have a natural delivery with him, as I had to be induced with my first 2 children. But, sadly, that didn't happen yet again. For some reason, I never ever go into labor on my own. Instead, my water breaks without labor coming. Boo!

I hope that your labor comes much much easier than mine ever does! Blessings your way!

Robin said...

I agree that calorie counting when nursing should not be done. I am nursing my 2nd now. She is over 2, but still nurses at least once a day. I have not dieted at all when pregnant or nursing with either of my children, and have not had any weight issues. I definitely notice that I need more food when nursing, though, especially at first!

Mrs. Anna T said...

Mrs. Happy Homemaker,

How long do they "let" you wait after your water is broken? I know doctors are very keen to induce if water is broken but there are no contractions, because they are afraid of infection. Last time mine broke after I was already 5 cm dilated and was having strong contractions.

Mirka said...

Here in Finland they recommend at least two fish meals per week during pregnancy (rainbow trout, brown trout, vendace, whitefish...) but I didn't find any exact calorie intake figures. Recommendations just say that it depends on how much mother weighs (or more precisely: how much does she have fat in her body), how much she exercises during pregnancy and breastfeeding and is there more than just one baby. I find that 1500 calories too low because nutritional experts don't even recommend that strict weight loss diets in here. If nonpregnant/nursing women aren't recommended to consume that little, why on earth should pregnant/nursing women do?

It is also recommended that weight loss during nursing should be limited. When fat is taken from mother's body instead of consumed food, (environmental) toxins from body fat emanate to breastmilk.

There IS calorie intake recommendation for women with gestational diabetes, though.

I'll pray you have a safe and natural labor!

Anonymous said...

Anna, I think that every doctor is different in how long they will let you wait after your water breaks. Labor can also be different with each pregnancy. My water broke very early on the first time, at the very end the next time and with my third the midwife broke the water about halfway through to speed things up, which it did. However, as my first was a hospital birth, once my water broke I was not allowed up out of bed which did nothing to help labor progress. As to the crazy pregnancy cravings, with my second I craved McDonald's cheeseburgers. This was after serious morning sickness coupled with the flu and a ten pound weight loss. I think my body was just depleted as I normally don't care for such things. Praying that you have a safe and uncomplicated delivery.

MacKenzie said...

A friend of mine delivered a perfect healthy (albeit large) baby at 44 weeks. I'm sure she was ready to be done being pregnant but she knew her baby would let her know when HE was ready...that said, I know there are risks when you go over 42 weeks but I don' think that necessarily means you should be induced. Good luck as you keep fighting for what is best for you and your baby!

Jewels said...

Dearest ((Anna)), just a quick note (of far-more-many than you could imagine that have been written in my heart and mind, that have--for various reasons--never actually made it to "paper") to tell you that I am thinking of you and praying for you, often, and, to thank you for the for the priceless gift of your precious friendship. I love you, Anna. Can't wait to hear news of your sweet little(st) one's welcome to your arms and your beautiful family. Thinking of you with very much love. xoxoxo Tenderly, Jewels

Anonymous said...

I personally waited 24 hours, but not sure what you are supposed to do. I ended up having my own contractions by the time we had checked in at the hospital anyways. I'd really like to hear what a doula or midwife has to say about this.

Anonymous said...

Mrs. Anna T,

When "they" induce after your water breaks varies from community to community - which is the same for a lot of obstetric practices. 48 hours is a common standard for the "go no farther" line, other communities of physicians want labor to start within 24 hours. And in general, midwives are more flexible on all of these protocols.

Three of mine went past 20 days overdue - I have great sympathy for overdue mamas! Hang in there - good to have a research project!


Mrs. Parunak said...

As always, I'm SO encouraged to read of your commitment to allowing your body to go into labor naturally at the right time for your baby. You are a very strong and brave woman to simply stop your prenatal visits. I know the medical establishment (at least in the States, and I would think probably anywhere else) would find that appalling and exert all kinds of pressure on you to come in and let them "get things going."

I very much appreciated your thoughts on nutrition as well. I grew up in the fat free craze. I don't think it makes any sense, though. Growing babies need fat, and if you don't eat it, how can you provide it? I always think of Isaiah 7:15 "Butter and honey shall he eat, that he may know to refuse the evil, and choose the good." I don't believe anyone who says that something is bad for you that God calls good.

BellaMama said...

I was "overdue" with my 5th. If you count from my LMP I was pregnant for a year! Had all the symptoms, but when due date came around I was smaller than usual and hubby knew it wasn't time. I went through so much frustration until I KNEW that I had to put it in God's hands and baby girl came (one of my painfree births) healthy & beautiful 8lbs 3oz. after I figured that I couldn't be pregnant forever. There is never a doubt in a woman's mind when it is time!
I've loved every one of my 5 unassisted homebirths with just hubby!! (Wish I could have had it this way with my first 2!) There's just no going to someone else to have them figure me out and tell me when, what, where and how. I am actively and constantly critiquing my nutritional levels while pregnant and nursing, it actually horrifies me that I did so poorly with my first baby & still lived to tell!! You are taking WONDERFUL care of yourself and better with each baby! Enjoy the last bit of time, for, in a blink of an eye, you're going to be holding that sweet new baby!!

Leah Brand-Burks said...

I'm just like happy homemaker; my water broke this time and 8 hours very little (actually only braxton-hicks) contractions. They then administered pitocin, and my son was born 8 hours after that. Standard practice in the US is no more than 24 hours pass from water breaking to baby delivered.

Kathleen said...

Tonia, I find the same thing with sugar cravings. If I eat more protein and a little more fat, my sugar cravings drop.

J in VA said...

Mrs T,

In my hospital, the MDs prefer that one not have brokn water more than 24 hours but it is not a hard and fast rule. Usually, they talk about starting Pitocin within 4-6 hours afterwards--sooner if someone doesn't question and is agreeable.

J in VA

Gombojav Tribe said...

Planning for your post-partum nutrition is so good! I, too, have neglected that in my first few pregnancies. Planning makes all the difference, though!

Eat well and rest!

Luci said...

Praying for you and your family as you prepare to welcome this new blessing from God into your lives! :)


Karen said...

Anna, that is so true! I have one friend who was a week or so over due, so they made her go in for a (very much not natural) induction with pitocin. After 2 or 3 excruciating days - it didn't work! Baby just wasn't coming out of there. Luckily for her they let her go home and rest, and he was born fine and healthy not too long afterwards. In many cases this would've resulted in a c-section and possibly fetal distress from prolonged labor.

If baby isn't ready baby isn't ready!