Monday, February 02, 2009

Belly shot: 27 weeks pregnant

27.2 weeks from LMP and feeling good. I'm starting to get aching hips at night, even with a thick, deep memory foam mattress topper. That was probably the least fun thing about pregnancy last time around. I felt like an eternal pancake at night, always flipping from one side to the other.

I recently re-tested my hemoglobin and although the level itself is good, it hasn't dropped from my 18 week level. If you've read Anne Frye's textbooks, you'll know that she is a stickler for wanting to see a falling Hg level between 12 and 28 weeks, since it indicates adequate blood volume expansion. I didn't have a chance to check my Hg earlier than 18 weeks, so it's possible it was a bit higher at 12 weeks. Anyway, I'm working on increasing my protein intake, as well as ensuring I'm getting enough colorful fruits and veggies and calories overall. I feel like I am already maxed out with how much I can eat--there's only so much room in my stomach!--but I am doing what I can. I'm still only 10 lbs above my pre-pregnancy weight, whereas last pregnancy I was close to +20 at this point. (I started out the same weight each time.) It's bizarre that I am so much bigger this time, yet have gained less weight. Where is it all (not) going???


  1. forgive me for sounding dumb, but can you explain the hemoglobin thing a bit more? Or direct me to more info? This is the first I've heard of this! thanks! :)

  2. You look absolutely gorgeous! Thank you for keeping us updated on how your pregnancy is going. I'm excited to see how everything turns out for you. Also, have there been any developments on a midwife that will help you with your birthing of your second child? -- If you don't mind sharing, that is.

  3. Here's a really short piece from Anne Frye about the significance of Hg levels as the earliest clinical sign of pre-e. I still don't know how it would be physically possible to eat 150-200 grams of protein, and 3,000-4,000 calories, per day, as she suggests for women whose Hg levels are stable or rising at this point. I am really maxing it out at 80-100 g, and part of that is with a protein shake in the evening.

    She has a much more detailed explanation of this in her textbooks.

    I'll update on the midwife soon...just lots of other things to do first.

  4. LOL. its weird thing pregnancy! Youre loking great.

  5. I have a friend who is experiencing the same thing - lower weight gain and she's SO MUCH BIGGER this time around!!!

    Have you tried a Snoogle pillow? It was the only thing that made sleeping even remotely comfortable for me.

  6. Oh, I ached to be able to sleep properly during my pregnancies, but rarely could. I found the only way I had a chance was to wrap myself around a body pillow, and hope I didn't have to wake up too often to go to the bathroom. I think it's a dirty trick our bodies play on us. Here we know that we won't be getting uninterrupted sleep AFTER the baby is born, but our bodies make us practice for 9 months beforehand!

    You look great, by the way.

  7. any chance its twins? maybe that's why your intuition is telling you to seek a midwife??

  8. Blood volume expansion does not occur equally, at the same time, with all blood components. Plasma expands faster than red blood cells, peaking at about 28 weeks. Thus healthy blood volume expansion will be reflected in a hemoglobin drop of about 2 points from the initial baseline HGb value from early pregnancy to the one taken at the 28 week visit. Because the red blood cells continue to expand after 28 weeks, so the hemoglobin should rise slightly during the third trimester.

    It is definitely possible to get in 150 or more grams of protein a day, but it takes planning. It is easier to make specific suggestions when you know what someone is eating to begin with, so all our clients do at least 3 days of diet sheets (writing down everything they eat) early in pregnancy, and more as needed as we work with them to make sure they are getting what they need. Generally: Make sure that every meal and snack (you should be planning on 2-3 snacks a day as well as your 3 main meals) includes a good protein food. Look for foods that you can replace with higher-protein versions: for instance, hemp bread or a high-protein roll-up for your sandwich instead of regular bread. Start with your protein and "fill in the edges" with your veggies, leave the carbs for last.

    Sample 150 gram day:
    breakfast: 1 slices hemp bread and 2 scrambled eggs (22 gms)
    snack: 3/4 cup plain yogurt mixed with 1 scoop vanilla protein powder and frozen blueberries (28 gms)
    lunch: green salad with chicken breast strips (30 gms)
    snack: protein shake, 1 oz almonds (30 gms)
    supper: steamed broccoli, quinoa, and salmon (40 gms)

    In addition to increasing protein, we have our mamas do wheatgrass juice and an omega-3 supplement to ensure they are getting all the nutritional components necessary to support their liver function, placenta, and healthy blood volume expansion.

  9. I bought some vanilla whey protein powder and seriously I can hardly get it down; there's something about the taste of it that just makes my stomach I gulp one shake down really fast but I don't think I could eat it more than 1x/day! I've tried putting it in a fruit smoothie and ugh, couldn't stand the taste of the smoothie.

    Here's a sample of what I ate yesterday (and it can be hard to estimate grams of protein because I make everything myself):

    B (about 13-15g?): homemade granola + 1c milk (granola has old fashioned oats, walnuts & pecans, sesame seeds, wheat germ, coconut, toasted quinoa, honey, vanilla, & spices).
    S (11g): 1 c plain yogurt w/ raw sugar, cashews & dark chocolate
    L (15-20g?): leftover Italian white bean & sausage dish, green salad with sprouts, 1/2 banana
    S (10g): homemade protein bar (protein powder, dark chocolate, peanut butter)
    D (20-30g?): haddock fillet topped with whole wheat & nut herb crumble, 1 slice wheat bread, 1 grapefruit
    S (27g): 1/2 c milk, protein shake

  10. If you by unflavored protein powder you can easily put it in soups. we do that occasionally and can't tell a difference.

    my first pregnancy i lost 10 lbs, then gained weight.

    my second pregnancy i didn't gain any weight and by 5 months was still in my same jeans. then suddenly BOOM and i had a belly and started gaining weight. =)

    i've always heard that it's not what you're gaining (not gaining) but what you're eating.
    and obviously you're eating beautiful food options!
    and look at that belly! gorgeous!

  11. Try a pillow between your legs to help your hips- that's the only thing that helped me.

  12. Instead of wondering if you could be developing a complication of pregnancy and acting on that fear, why not seek medical care and find out what, if anything, is going on???

  13. Re: difficulty finding a comfortable way to sleep -- have you looked into pubic symphysis disorder? I've blogged about it here, with an exercise from a chiropractor that can help, as well as a link to a site that goes into it much more in-depth.


  14. "Instead of wondering if you could be developing a complication of pregnancy and acting on that fear, why not seek medical care and find out what, if anything, is going on???"

    Sarah--I'm not quite sure what you're reading into or assuming is going on.
    A) I'm not worried that I am developing a complication; I just take my Hg levels to be an indication that increased attention to nutrition might be warranted.
    B) I don't see how "medical care" (whatever that means) would tell me anything more than I already know. If I were having conventional obstetric care, I'd actually know far *less* about what's going on in my body than I do now. I don't think most physicians check Hg at those two points in time, nor do they place much emphasis on nutrition in pregnancy.
    C) I suppose one could argue that I am having "medical care" since I'm seeing a CNM right now. Through her I have access to any labs or tests that I want, and I'm the one who requested the Hg checks. I check my own prenatal stats once a week (weight, BP, fundal height, FHTs), because I love keeping charts of things. Yeah, my inner nerd is coming out here. The midwife checks these at our monthly prenatal visits as well, but it's never new information to me. The midwife isn't overly concerned about the Hg; she just recommended focusing on good nutrition, getting enough protein, calories, and colorful produce in particular--exactly what I would do anyway.

  15. Kathy--luckily I haven't had any troubles with my SP joint at all. It's not my pelvic joints that hurt, more the sides of my hip/butt after lying down on it for a while. Nothing terrible, but just a bit achey during the night. I've slept with pillows and without and am still not sure which I like better. I roll over or get up to pee enough that it feels like a big production to rearrange the pillow(s) every time I move. The memory foam topper has made a huge difference compared to last pregnancy, though. Much fewer uncomfortable pressure points.

  16. Ok. I thought that you were trying to consume a very large amount of protein based on the thought that your hg had not fallen, in light of some research indicating that this could be an early sign of p-e. I just think it makes sense to get these things checked out if you're worried, so I'm glad you have a CNM to do that if it is indicated.

    Just my thoughts...

    Sarah RN

  17. The sleep trouble is torture. I'm 32 weeks gestation and I get up 2x a night to pee, and wake up at least 3 or 4 more times just to flip over. Mother nature has a way of preparing us for a newborn, I guess.

  18. As someone who's done a twin UC, of course I'm fascinated with twins and obsess about it for others! If you've been doing your own care you know what your fundal height is every week. (Of course taking fundal height with a grain of salt). Mine jumped by 2 or 3 cm a week between weeks 24 and 28 and I looked fullterm by 30. Just saying...

    I tried the recommended 150+g protein and never got more than 125 a day. The only sugar I allowed myself was fullfat icecream... to get that nasty protein powder down!

  19. Ahhh twins...I really don't think so based on fundal height, where I'm hearing heart tones and feeling movement, etc. My fundal height is pretty much spot-on for the weeks of pregnancy, although it went from 27-29.5 this past week (but the baby was also in a really wacky position when I measured yesterday, all scrunched up on one side and really sticking out). Time will tell I suppose, but I would be very surprised if I had two babies inside me!

  20. The 28 week mark...try a few more times. The blood expansion that lead to the drop in hemoglobin for me was 29 weeks.

    Protien, can you just munch on almonds and cheese,etc more often? Just try to sneak in almonds, 'round the clock. Bean dip?
    (this from a mama who gained 45-65 pounds FIVE times) maybe this is why ;)

  21. and as you know, you dont have Pubis Symphasis Disorder, : ) trust me you'd know it.

    and and

    You are extremely correct in that not only would the "medical care provider" most liley not take your bloddf at 28 weeks but they would give you attitude for asking about it. Again, trust me it happened.

    Mysterious weight gain versus looking bigger? I dont know. Maybe the combination of gaining LESS weight and being a second baby is givng you a quicker-to-pop out uterus with a smaller body fat gain and the effect is that your tummy looks bigger than with Zari?

    ps you look SUPER cute : D

    are you 100% sure about your hemoglobin testing supplies? Just another idea.

  22. The Hg tests are quite accurate--I actually had both done via a blood draw & lab analysis both times, because the midwife I'm seeing doesn't have a finger-stick hemoglobinometer.

    Anyway I am not worried about the big belly/lower weight gain--just bemused and surprised!


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