B-Belly and overshooting recommended pregnancy gains

[geomer12]

Hey all, this is a post about weight - I checked the side bar and think I'm adhering to the rules by not mentioning specifics, asking for medical advice, or solely taking about diet, but mods, please let me know if I have to change anything! Trigger warning that this is generally about weight gain and related health.

I'm looking for some gentle guidance here. I'm normally in generally good cardiovascular shape - summers full of hiking, running (did a half marathon in fall 2020), etc. I'm often in the "overweight" category of BMI but I tend to lean muscular when I'm very active. That being said, core strength has always been a limitation and I've definitely always had at least a little belly (and have not been worried about it!).

Quarantine coupled with depression topped off by a year of assistive reproductive technology has me currently in both the worst cardiovascular shape of my life, and at the highest weight point I've ever been at. Now I am 15 weeks pregnant. My first trimester, I had literally insatiable hunger and I did not hold back. I was also exhausted so that translated to a lot of takeout.

At my 12 week OB appointment, my midwife informed me that given my pre-pregnancy weight as documented by my fertility clinic, I had already gained the low end of the TOTAL, whole pregnancy recommended weight gain. Honestly even that didn't have me too stressed out (my baseline weight is funky because of the hormones I was on for IVF)... until I noticed that my belly is developing a very pronounced "B" shape that I of course googled and it sent me into an anxiety tail spin. It's not so much that I'm worried about how I look, but more that I'm worried about the impact this will have on my baby and my health. My googling seemed to indicate that it's a sign of really poor abdominal musculature and a "fascia limitation" and this belly shape is associated with diabetes, high birth weight, and more.

So far, to try and course correct, I've ramped up my daily exercise (my exhaustion has resolved so thankfully this is now a possibility) by getting in longer and higher intensity walks, and I'm trying to get my calorie consumption both back in check, and higher quality nutrition wise (ex: more greens & whole foods, less empty carbs).

My midwife was pretty harsh at my first appointment so I'm really hesitant to bring this to her. But what can I expect and how much can I push myself? Can I expect this extra belly fat to go away during the pregnancy (and for my belly to become more baby) or do I just need to accept it? If I count calories, how can I figure out an intake goal? I haven't run in nearly two years - I was told that I could continue to do exercise i was doing before but, is the running history too remote to pick that up again at this time?

I want my baby to be healthy and I want myself to be healthy for my baby. This is giving me a LOT of anxiety right now. Any help at all is appreciated.

 

[godservant762003]

@geomer12 Weight gain during pregnancy is not linear and the first trimester can be brutal! Keep eating well and exercising, and trust your body to do what it needs to. As for the high birth weight and diabetes concerns, the belly shape might increase your likelihood but there isn’t anything that completely takes those risks away. Gestational diabetes can happen to anyone and sometimes there’s nothing you can do about it! Hopefully it won’t, but if it happens it happens and you will be able to handle it. Trust your body and trust yourself!

 

[geomer12]

@godservant762003 Thank you, I appreciate the reassurance.

 

[faerin87]

@geomer12 I can only answer one of your questions -- it's fine to resume running during pregnancy if it feels good to you! The advice "continue what you were doing before" doesn't have to literally be what you were doing in the week of conception, it just means not to start any exercise regimes during pregnancy that are extreme or new to you. Personally I used couch25K to get back into running (ok really jogging) at the beginning of my second trimester after a COVID lull . I also posted recently about how I started hiking during pregnancy and got pretty serious, pausing just before I delivered! At 5m pp I started again carrying baby

As for counting calories and maintaining versus losing, unfortunately that's a question for your midwife or OB. If your midwife made you uncomfortable enough that you don't feel you can ask them, I strongly recommend switching to a new midwife who can talk to you compassionately about what is and should be purely an issue about your health and not a matter of shame.

 

[geomer12]

@faerin87 Thanks for the insight on the exercise. I did find that "continue what you're doing" to be really confusing.

Unfortunately I can't switch my practice, my city has wait lists and any new (to me) practice I've called are scheduling out 3 months or more. I know that sounds insane because there must be something available for those who don't call immediately but whatever that is, I haven't figured it out yet.

 

[al3x]

@geomer12 Don't have any specific advice for you, but I've had a B-shaped belly my entire adulthood throughout all my various periods of exercising, dieting, doing both, doing neither, and it has not affected my pregnancy at all. Easily passed the GD test, baby is measuring at the average percentile for almost everything, and have had zero complications. This is just my personal experience but hopefully it gives you some peace of mind!

 

[geomer12]

@al3x This is super reassuring. I didn't even know it was a thing until I was googling images to try and figure out if I was on track as far as belly size for my due date, and I saw an image that looked just like me and it was like, "ALERT, RED FLAGS, NO GOOD" . Stupid Internet.

 

[ipotlove]

@geomer12 I gained more than the guideline weight (although I started at a low BMI) throughout my pregnancy. I did do core work (no crunches) and long walks, hikes throughout (until about wk 32 when I got to uncomfortable). I passed the GD test no problem and baby was not high birth weight.

Honestly, the best advice I got was to start my meals with a vegetable and a whole grain and reduce 'empty' calories by avoiding sugary drinks (including milk). My practice told me to focus on getting GOOD NUTRITION rather than strict 'dieting' by avoiding things.

Hope this mindset helps you.

 

[thespiritmolecule]

@geomer12 I’m sorry to hear you’ve had such a stressful start to your pregnancy. I understand how it feels to be very stressed about food and weight gain with your first pregnancy. I’m now on my second pregnancy (22.5 weeks) and will share that with my first, I had gained the upper limit of my total in the first trimester. I ended up gaining more than 3x that was recommended but I did have an “average” BMI to start. Thankfully I didn’t have GD. I made sure that I ate healthy foods and kept as active as I could, thought with all of the weight gain that mostly meant walking. It did mean for me that I had a lot of weight to lose (almost a full person’s worth!) before getting pregnant again but I did it. This go around I’ve been super careful and exercising 7 days a week almost 45 mins per day and I’ve still put on a fair amount of weight, though not as much as last time.

My advice to you is to make healthy choices whenever you can, even when ordering takeout. You don’t have to starve yourself and you can still eat really healthy. Those small choices now will make it easier to continue once you’re PP and need the nutrients for healing. It sounds like you’re also doing what you can to be active which will help with your mental health and overall happiness. Take it easy and trust that you’ll get back to your fit self in due time. For me that was starting exercise again 6 months PP, and gentle walks starting 2 months PP.

 

[pajatip]

@geomer12 Really good on you for taking charge of your health the way you are, but I really think your concerns here are more of the medical persuasion and are more appropriate for your OB than Reddit

 

[pajatip]

@geomer12 Oh man that is super disappointing... I'm so sorry to hear that

Maybe there's someone you can hire third party as a pregnancy nutritionist? I know they exist, if that helps at all

 

[peruss]

@geomer12 Take a deep breath!! TONS of people gain more weight than they want to during pregnancy, esp in the first trimester when all you can handle is carbs. The vast majority of these people go on to have perfectly healthy babies. I know your midwife was harsh but honestly that seems like a failure on her part, not yours!!

Please don’t worry too much about course correcting. Yes, go on walks and eat veggies, but don’t calorie count and don’t try to run if you haven’t done it in a few years. It’s just not worth it. You and your baby are going to be fine, and you can lose the weight later if you so desire

 

[katrina2017]

@peruss I just want to second all of this. If you haven't run in a few years it could be hard on your pelvic floor to start now and then make recovery long and harder. The weight gain guidance is so bogus for the first trimester, and weirdly rigid and harmful for women. So many women feel so sick and the only thing that feels good is to eat. My midwife said "it if feels good, eat it". I agree stick to your good habits and you and baby will be healthy.

 

[allen]

@geomer12

My midwife was pretty harsh at my first appointment

FWIW, I think you need to have someone who you trust on your team. If you're hesitant to bring this kind of stuff up to her (because of her own shitty reactions in the past) then...maybe try to look into finding someone new?

Can I expect this extra belly fat to go away during the pregnancy (and for my belly to become more baby) or do I just need to accept it?

I'm no expert, but I think the answer is no. You gained some weight pre-pregnancy, gained weight again during the first trimester, and now you're here. Baby will grow as it needs to, but it won't eat up your extra fat unless you eat less than you should (MAYBE), which obviously you should not do.

For the record, DR happens to about half of women, whether they're active or not. People of all sizes and weights have poor abdominal musculature (and vice versa) -- and while I can understand that it might be associated with other things like diabetes etc, there's no evidence that it causes it either. You can fix some of that with targeted core work and better form overall in your workouts, but obviously that's harder to address while pregnant.

In other words, the abdominal musculature issue and the extra weight could be two completely separate things, and it makes sense to address them that way. If your muscles "suck" (not saying yours do), losing weight won't change that -- strengthening the muscles will. Much in the same way that focusing on getting stronger doesn't necessarily mean you'll lose weight in the process.

If I count calories, how can I figure out an intake goal?

You should only be doing this with the help of your midwife and/or a registered dietician. Undereating poses a real risk of adverse effects for you and your baby too. Eating enough is always better.

I was told that I could continue to do exercise i was doing before but, is the running history too remote to pick that up again at this time?

If your midwife or doctor cleared you for it then go ahead. Just remember to listen to your body and to stop if things hurt or are uncomfortable.

I want my baby to be healthy and I want myself to be healthy for my baby.

Focus on the stuff you're already doing: eating good nutrient-dense foods, maintaining movement, and following satiety cues. For the record, having a baby can feel like an out of control experience...some people end up spending some of that time stressing out about how their bodies are changing and all the fitness stuff they didn't pursue pre-pregnancy. Personally, I don't think there's much you can do about that now other than what you're already doing. Trust that it's enough. Your body will still be there waiting for you on the other side, and you have the rest of your life to revisit or restart your fitness journey.

For now, take care of yourself your priority should be taking care of yourself and your baby via movement that feels comfortable and yummy nutritious foods

 

[nilton65]

@geomer12 I wouldn't put much stock in Dr. Google. Belly shapes vary wildly both from person to person and within the same pregnancy!

Agree with others here about professional guidance on your concerns, and I just wanted to add that if your midwife is unsupportive, you could check to see if you can see a registered dietician. RDs, for those who don't know, are licensed and trained in dietetics and often see people for outpatient visits to counsel them on meal planning. (People often call themselves "nutritionists" without being qualified in the same way RDs are, hence the distinction.) While there is a lot of criticism in the RD field about lack of diversity and cultural awareness, an RD may be able to provide more detailed recommendations about eating well (and/or resuming exercise) during the rest of pregnancy. Good luck!

 

[onelove22]

@geomer12 Does your country have national nutrition guides for pregnancy and GD pregnancy? The fact that I do remember from the stuff I read was that in case of gd and overweight starting point you are allowed to eat little less than with normal weight. The guides also have good samples of meals