Thursday 29 September 2016

Baby steps to the battle of the pregnancy bulge

We'd rather take umbrage at Dr Eva's advice that we eat less in pregnancy, says Sarah Caden, than do anything about it

Sarah Caden

Published 02/08/2015 | 02:30

‘It’s not some sort of feminist stance to put your health, and that of your baby, at risk’
‘It’s not some sort of feminist stance to put your health, and that of your baby, at risk’

For once, Dr Eva Orsmond chose her words carefully. Famous for her Finnish bluntness, when the medical doctor and weight-loss consultant spoke last week about weight gain in pregnancy, it seemed like she was being careful not to offend. Not that any amount of care could help her to avoid that. Not when it comes to weight and women.

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Dr Eva's idea of being careful was relative. Which is to say that she didn't repeat earlier suggestions that women are "selfish" for carrying or gaining weight while pregnant. Instead, she trod relatively carefully, and suggested that 200-300 extra calories per day is all any pregnant woman should consume.

"And that is less than a chocolate bar," said Dr Eva, in another careful, but subtly powerful use of words. Because chocolate and its ilk is a lot of where it's at when discussing the whole notion of excess weight and excessive weight gain in pregnant women. It's the treats, the 'I deserve it' indulgences, the notion that to ratchet up your food consumption while carrying a child is in some way being good to yourself. When, in fact, it's quite the opposite.

The greatest good a pregnant woman can do herself is to take care of herself. In fact, the greatest good a woman can do herself at any time is to take care of herself. There are no Irish-mammy medals for putting yourself at the bottom of the pecking order. And that includes making sure your kids are eating well while you clock up the pounds on low-blood sugar chocolate binges and "oh, I finally get to sit down" glasses of wine.

Further, there's no feminist, anti-body-shaming point being made by you gaining four stone in pregnancy and potentially damaging your health. You're not making a stand for ordinary women; you're doing yourself harm. And that's putting aside the fact that maintaining a healthy weight is also better for the baby.

Overweight mothers tend to produce big babies, who have a much higher chance of developing Type 2 diabetes in later life. But having trod that ground earlier this year and thrown "selfish" at such expectant mothers, Dr Eva rowed back and took a different approach last week. She went, gently, for the mothers-to-be.

"You should gain no more than 25 to 35lbs during the nine months," Dr Eva said. "And I'm of the opinion that 25lbs is fine, and you don't really need any more weight than that, to be honest."

Inevitably, Dr Eva got a bashing for being too tough on women, crushing us with pressure to maintain a perfect body, loading us with yet more modern-mother guilt.

This is the easy response to anyone who suggests that women should get a grip, be it with regard to our drinking, our eating, our mothering, our professional performance. Anyone who suggests we might be getting it wrong, or as Dr Eva might put it, that we need to cop on, is rounded on for trying to make us feel worse about ourselves.

However, the problem with playing the women's-guilt card in the weight context is that it is based on a pretence. A pretence that Irish women do not have a weight problem. We do. Not just in pregnancy, but all the time.

And we dodge dealing with it by slapping down any discussion of it with the notion that we're being made to feel worse about ourselves, that we are being body-shamed, that unrealistic thinness is being expected of us. Worst of all, when a woman says that we need to address our national weight problem, there's always a suggestion that she's being unsisterly.

But what's more unsisterly? To say that we should all fire ahead and crack out the chocolates and load on the pounds in pregnancy that we then struggle to shift afterwards? Or to say that the most empowering, important thing a woman should do is to take care of herself. Not to take care that she stays thin, or gets thin, or starves herself to thin. But that she stays healthy. That's all anyone, Dr Eva included, is talking about. Healthy.

But partly to suit the resistance to reasonable eating habits and, let's face it, a bit of restraint, we have confused healthiness and thinness. Someone says that we shouldn't put on more than two stone when pregnant and the backlash is all about the pressure on women caused by celebrities who "snap back to their pre-baby body" two weeks after childbirth and other such rubbish.

Who knows why or how these women achieve such results, whether it's starvation during pregnancy or spandex knickers afterwards, but it doesn't matter. So you can't be Mila Kunis or whoever. So what?

Is that really an excuse to claim a craving for cream buns and gain four stone in a 40-week gestation? It won't make any difference to Mila Kunis, or those 'snap back' headlines, and it's not some sort of feminist stance to put your health, and that of your baby, at risk.

What Dr Eva pointed out last week, however, is that Irish women aren't just gaining too much weight in pregnancy. The bigger problem is that we're going in to pregnancy overweight. We have a general overweight problem and a problem with unhealthy eating and lack of exercise. Which only gets worse in pregnancy and, as any woman will testify, weight gained in pregnancy is harder to shift than any weight you've ever had before.

Interestingly, in fact, a UK study last week suggested that overeating and weight gain in pregnancy can alter the working of a woman's digestive system, and that is what makes pregnancy weight so hard to shift. It should be said that the study is at the fruit-fly stage. Maybe we should take umbrage at that.

However, experts other than Dr Eva have issued similar warnings in the recent past. Earlier this year, Dr Mary McCaffrey, a consultant obstetrician/gynaecologist at Kerry General Hospital said that they were recording a "significant increase in the number of women with a high BMI in pregnancy; of over 30".

Which is to say that it's not so much that we've a problem with weight in pregnancy, but that in pregnancy, we're making our weight problem even worse. And, potentially, passing it on to our children. There's nothing empowered about that.

Sunday Independent

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