First Pregnancy

[katie1010]

This is my first pregnancy and I have the triple whammy of prediabetes (diagnosed a few weeks before conception) advanced maternal age (39) and high BMI (51). I’m 9 weeks and had an appointment with a nurse practitioner today where I got a lot of information and scheduled the next few months of appointments. My blood pressure was also high today 140/80 and I’ve been doing a lot of reading and I’m just terrified of what can happen in the coming months and feeling like I’ve set my baby up for failure. I don’t really have a point for this post but I guess some reassurance that it’s possible to have a good pregnancy and get to have a healthy little babe at the end. I want to do everything in my power to get to the end, any tips or words of wisdom are appreciated.

 

[atruth]

@katie1010 So sorry you are feeling this way! I would just say try to be as positive as you can and remember that people of any size or age can have pregnancy complications. Just because you have some risk, doesn’t mean anything bad will happen.

In regards to the blood pressure, I would suggest getting a monitor for home and checking it at home regularly. I’m always really nervous at the doctors so my blood pressure is higher.

 

[cruserschocve1975]

@atruth Same issues with me for blood pressure. Have white coat syndrome, BP is always 140/90 or whatever at the clinic, but then less than 120/80 at home. I take my blood pressure at home first thing in the morning everyday and record it so I can show my doctor. It’s worth taking more than one reading too as usually the first reading would be higher.

 

[katie1010]

@atruth I just ordered a monitor, great advice! Thank you

 

[frunziss]

@katie1010 One thing to add is that once you receive your home blood pressure monitor, you should take it with you to one of your doctor’s appointments to see how it’s calibrated against the machines in the office. If it’s just a couple of digits off from the in-office reading then it will be helpful for the doctor to know that. Also, and this is probably obvious, make sure you and your doctor are both using the correct sized cuff. They should be able to measure your upper arm in the office. A cuff that is too small will result in artificially high blood pressure readings.

 

[process2324]

@katie1010 I just had a baby 2 months ago. He’s perfectly healthy and had zero problems. I am 39, pre diabetic since I was in my 20s, well controlled with diet/exercise and metformin. BMI is also in 50s. I’ve never had issues with high BP. Throughout my whole pregnancy everything went very well up until the end of my 3rd trimester my BP started to get elevated and I delivered at 38+1 due to preeclampsia. After 26 hours of labor I ended up having to deliver via c-section because my labor wasn’t progressing. I only delivered 6 days early, since I was going to be induced at 39 weeks anyway due to a high risk pregnancy because of diabetes. Despite that my baby is healthy and thriving. I’m still on the road to recovery trying to get my BP back in order. My doctor is hopeful it will eventually go back. Since I had no history of high BP. Just being patient, if it doesn’t there’s plenty of medication to help and hoping once I am able to be more active again that too will help. I am 2 months PP and things are improving. My one piece of advice that worked well for me was being good about following the carb count for gestational diabetes at each meal especially breakfast. My baby was 7lb 4oz. I am only 7lbs over my pre pregnancy weight. It’s not fun to be on insulin or restrict some carbs but it was worth it for my healthy baby boy. As soon as I had the baby I no longer needed insulin which was great. I’ll keep maintaining as I was before I got pregnant, start taking Metformin again once I’m done breastfeeding. Everyone finds what works best for them. Wish you all the best in your pregnancy and congratulations!!!

 

[katie1010]

@process2324 Thank you and congratulations!!

 

[tripletiger1200]

@katie1010 I just did this with similar metrics and a similar age and am watching my 16 week old coo at his father. Get a med team you trust and lean into the monitoring and treatments for the good of baby. You got this.

 

[katie1010]

@tripletiger1200 Congratulations

 

[karmel]

@katie1010 I had my baby at 35, bmi 50, with existing high blood pressure, and gestational diabetes. I ended up being induced at 37 weeks because he was measuring small on one measure. Had a totally normal induction and vaginal birth. He’s now a perfectly healthy and thriving 9 month old. I did end up with postpartum pre-eclampsia (make sure to keep an eye on your BP for a week after you leave the hospital) but otherwise felt totally fine my whole pregnancy. Also, r/gestationaldiabetes is an amazing sub with all the support and tips for managing GD and diabetes during pregnancy.

 

[katie1010]

@karmel Joining this sub now! Thank you!

 

[frunziss]

@katie1010 I hear you! However, women have been getting pregnant and having healthy pregnancies at many weights for thousands of years. The most important thing is to stay on top of your prenatal appointments and find a provider that you trust. This early in pregnancy, it’s likely that you’re diagnosed with high blood pressure it will be considered pre-existing rather than gestational. You’ll likely have more appointments and may be referred to a maternal fetal medicine doctor. I see one due to advanced maternal age, BMI, and existing hypertension. It’s actually been weirdly nice being more closely monitored, so it’s not all bad.

Something I found reassuring (although your mileage may vary) was actually looking into some of the risks associated with giving birth at a higher BMI, particularly the statistics. I’d spent so long hearing all of these dire warnings of risks to the baby, complications etc that it turned out that my sense of overall risk was out of whack. For example, I feel like I often heard “mothers with higher BMI are twice as likely to develop xyz,” and assumed that meant that the likelihood went from 10% - 20%, whereas in some instances it actually went from 0.5% to 1%, so the overall risk was still quite low.

Has your NP recommended taking a baby aspirin every day? It seems like this is quickly becoming the standard of care for its potential effect of forestalling preeclampsia. It may be worth asking if your provider hasn’t mentioned it.

 

[katie1010]

@frunziss These are great points! And I’ll be starting low dose asprin daily at 12 weeks, I also preferred a BP monitor to see if it’s really an issue or doc anxiety

 

[fanofchristnr1]

@katie1010 Pre-pregnancy I had been pre-diabetic for years. My A1C was either 5.8 or 6.1. Never in between, always one or the other. My first OB appointment my labs came back and my A1C was 5.5! I was shocked. Lol

 

[johanaanderso]

@katie1010 Just take everything one day at a time. Follow your medical team’s advice and dont freak out. I had GD and gestational hypertension and I survived just fine. I ended up having a planned c-section but I was honestly totally fine with it.

 

[wasdax]

@katie1010 Wanting to do everything you can for your baby is the first and most important step

I have had two plus size pregnancies (currently 30 weeks) and I would say listen to your doctors advice. You’ll be going to MFM a lot and they will do a ton of monitoring but may not be very nice to you (commonly expressed opinion, mine included)

Also just focus on clean eating as much as you can and movement, even if it’s just short walks and stretching/yoga. That will help with your overall health and in turn, the babe too!

 

[frunziss]

@wasdax I am so sorry to hear you had a crappy experience with your MFM. I’ve been really lucky and haven’t had to deal with a provider who has treated me poorly. OP, you’re early enough in your pregnancy that if you have a crappy MFM or you don’t gel with you should think about shopping around. We all deserve to feel heard and respected by our healthcare providers.

 

[liane5501]

@katie1010 Just going to add…you might want to talk to a good, fat-positive nutritionist to help you! I had GD and it was tough, but getting some tips and knowing the guidelines helped me. Also, therapy! Pregnancy can be super hard on you mentally, and having support will make the whole process so much easier to process. Congratulations and good luck!

 

[kiranchandra]

@katie1010 I’m sorry you’re feeling anxious. Remember that most people with risk factors have uneventful pregnancies.

I see and hear a lot of people worrying about prediabetes, and I want to note that it’s not a universally accepted condition, and it receives a lot of criticism. Here is one article that summarizes some of this debate:

https://amp.theguardian.com/society...es-patients-out-of-healthy-people-say-critics

You’ll see that it mentions that, “The World Health Organization has rejected pre-diabetes as a diagnosis.”

I am a big believer in medicine and science, but I also keep in mind that there’s a lot of money to be made in telling us we’re not healthy. If the diagnosis is helpful to you, that’s great, but I just want to share this information because enough people and institutions tell us that we’re not healthy, and many times it’s b.s. And of course, even if we do have health problems (I know I do!), we shouldn’t be judged for them. And we have medicine to help!

My best to you and your baby.