The goal of this is to ensure that I am neither going to hurt myself, the baby, or both of us. It's a standard exam given a few times throughout pregnancy (12 weeks, 26 weeks, and then again a few weeks postpartum), but I have to take it every time I visit the office because there's a hospitalization due to attempted suicide in my medical records.
I'm not sure if I've ever mentioned that here, or to what depth I've discussed it, but at the moment, the past isn't what I aim to explain. The point of bringing it up now is, this past Monday I had an appointment, and apparently my survey score was in a range that merited an extra discussion to clarify what I'm feeling.
I was asked how I was feeling, and above all else, if I had any urge to hurt myself. I insisted that, no, I don't - as depressed as I am lately, my top priority is making sure that this baby is safe and protected while inside me. With my midwife, Tracy, I talked a bit more about the answers I'd marked as "some days" and "most days," and I was so grateful for her understanding.
At our first meeting, I was just shy of 12 weeks pregnant. I spent a good hour or so explaining, basically, my entire life story to her: my weight loss, my relationship with Matt, my past experience with depression, and anything else that could even possibly be a concern with this pregnancy. And she understood. The past two checkups I've had, though, were with other midwives due to scheduling errors, and the women I saw then were almost entirely unaware of my weight history, save the ten second interjections I could add between their criticisms and prescriptions.
At the last checkup, when I was handed a piece of prescription paper that said "exercise to avoid obesity in pregnancy," I bawled. As if I'm entirely unaware of what's happening and how to fix it. I'm acutely aware of my weight gain, and as someone who's struggled with eating disorders, I'm very strongly affected by interactions I have with people regarding my size. And this was an action that, frankly, hurt more than it helped.
When the woman told me my weight gain was "probably due to the fact that [I] don't know how many calories are in soda," I almost screamed. I haven't had soda in ages, and even if I had, this woman has absolutely no idea about my background and understanding of nutrition. After telling her my first daily meal is Greek yogurt and fruit, she told me I need to be eating meat with breakfast, and with that, I completely disregarded everything else she said. Most doctors have only completed a few hours of nutritional coursework; it's safe to assume a midwife has even fewer.
I explained to Tracy how I felt after this interaction, and how it shaped a lot of the last month for me. On top of feeling depressed when I look in the mirror, when I lay in bed, when I bathe myself, and when I get dressed in the morning, I now felt self-conscious nearly constantly. I don't always answer my phone and I avoid unnecessary errands, preferring to stay at home in bed. It's not thrilling, but at least there, the criticisms are only coming from myself.
One night, walking home from the bus stop, a stranger in a van drove past me, yelled "Fatty!" out his car window, and threw something that hit me in the stomach. I held my composure for the three block walk home, then shared the experience on Twitter and Facebook, desperate for people to reassure me: it doesn't matter what your body looks like, no one has the right to say or do these things. And I laid in bed with Matt, and he listened while I told him what happened, sobbing and choking on my words.
I hate this. I just want him out of me.
It's not true, entirely. I don't want him to born until the proper time, but still, I'm anxiously awaiting that day. Sharing a body is the absolute hardest thing I've ever done. Not feeling in control over my body is a constant struggle, and I do more than my fair share of crying these days. I mourned the Ragnar, cried over it, got sick over it even. I cried waiting for Matt while he ran a half marathon, getting it out while he was away so I'd be fresh-faced, smiling, and supportive by the time he was done. It's so hard watching people smile and hold hands as they crossed the finish line. I know what that feels like - I used to be an athlete.
I felt so proud at this weight on the way down. It was progress. This time, it feels like failure, and even though the weight is around the beautiful little boy growing inside me, I can't, as always, see the forest through the trees. I can't accept pregnancy and what is happening to my body. It's concerning, both to me and my midwife, who is slightly concerned that I am going to overdo it once the baby is born, cutting calories too low to make up for the previous nine months. She reminded me that during pregnancy, a woman needs an average of 300 more calories daily; while breastfeeding, however, the number is 500-800. I assured her, again, that properly caring for my son is my top priority. But at the same time, I know she's absolutely right to be concerned.
At least two-thirds of my postpartum fantasies are related to my body. I feel terrible, because Matt is concerning himself with planning the bris and conversion, and nearly all I can think about is weight loss. I'm consumed by it. I feel like a bad partner on so many levels. We are rarely intimate, and when we are, I am as clothed as possible because I don't want him to see or touch my naked body. And it's never initiated by me, even if I want to. I worry so much about myself and not the bigger picture - all I'm thinking about is "in three months, I'll finally be more in control of my body" rather than "in three months, we're going to be parents and the rest of our lives will be different from here on out."
Tracy sat me down and told me that, yes, my weight gain is more than the 15 pounds recommended for obese women. But she also told me to keep in mind that she is absolutely 100 percent unconcerned about it. The baby is healthy, and measuring perfectly average (one concern with excess weight gain is that the baby will be too big, which may lead to heart issues for me or needing a C-section for delivery). My blood pressure is excellent and my first gestational diabetes screening came back well within a normal range (I also did a second screening that day, and am anticipating results, which she expects to also be normal). I lost the weight once with diet and exercise, she knows I should be able to do it again.
The concern is, though, is that "should" and all it implies. The concern is that I won't be healthy about it this time around, that I'm so fixated on numbers this time that I'll overdo it and get hurt. That I'll fall into disordered eating habits. And above all, that I won't be properly nourished, thus hurting myself and possibly my child, and not just in terms of physical nourishment. Putting it in that perspective was important for me. I'm quite concerned that I'll pass my disordered eating habits on to my son, and with children, Tracy said, actions speak louder than words. I need to find balance again, to be self-confident, to have faith in myself and all I am capable of accomplishing. The scale showing my weight will take care of itself, she assured me. The priority right now is the scale measuring my depressed thoughts, and how to manage and take care of those.
We talked a lot, and I left the office feeling much better than the last time. Tracy's confidence in me (and utter shock and disgust at the other midwife's assessment) was reassuring. I left with her personal cell phone number in case I ever had any questions or needed any help, as well as the numbers for counselors at the clinic who specialize in both weight issues and pregnancy-related depression. Though it's only been a few days, I have felt better since then - certainly much less consumed by worries about my weight. Still, I know for the next few months, it will get harder before it gets any easier, and I'm working on a few plans to stay positive and focused on things that truly matter, both right now and long-term.