Plus size pregnancy. It’s something that is typically not discussed, not seen in media, some people even think it’s impossible for plus size folks to get pregnant. There is so much misinformation out there when it comes to plus size pregnancy!
Pre-Conceived Notions around Plus Size Pregnancy
When my spouse and I had decided we wanted to have children, I made an appointment with my OBGYN to see what I should do proactively before we even started trying. She told me to stop taking my birth control and wait about three months for my body to re-regulate itself before we started trying to conceive.
She explained that once my body was able to regulate its hormones off of birth control, the average couple takes anywhere from 6 months to 1 year to conceive. If it took us over a year, then she would have recommendations of fertility specialists to look into if either of wanted testing at that point.
Ovulation
I had the hardest time being able to figure out when I was ovulating. I tried to track my ovulation with an ovulation kit but no matter when I tested myself, it never showed positive for ovulation.
I have since learned that ovulation predictor kits (OPKs) might not work as well for folks who have a higher body mass index (BMI). According to Nicola Salmon (@fatpositivefertility), “Recent research has found that LH levels, which are super important for predicting ovulation, can be lower in people with a higher BMI. A study from 2017 (PMID: [29234665]) found that “women with higher BMI may have lower LH levels, and hypothetically, a positive test may be less frequent.” Basically, if you have a higher BMI, it could be harder to detect a positive LH surge, which could make it tougher to pinpoint ovulation.
Another study from 2020 (PMID: [32410606]) found similar results, with LH levels being lower in folks with a higher BMI. The study didn’t find a big difference in pregnancy rates between people with different BMIs, so it’s important to remember that if your LH is lower, it doesn’t mean that getting pregnant will be harder.”
We’re Having a Baby!
It was Easter morning and my period was a few days late. So I took a pregnancy test and it was positive! I had all the emotions- happiness, hopefulness, fear, uncertainty. All of them flooded in at once and I walked down the stairs, set down in the middle of the steps and told my spouse that I had a positive test.
He ran out to the store immediately to grab a few more tests- just to be sure! And they were all positive!
My OB
I got so lucky with my OBGYN. He was amazing throughout my pregnancy and only mentioned my weight once, in passing. He had a medical student following him for one of my first few appointments and told the student that “with women who are a higher weight, they may not gain much weight in the first trimester, and some even lose weight because of morning sickness but to not be surprised if that happens.”
If you are worried about finding a doctor that will treat YOU and not focus on weight, you can read more here about how to find a fat positive doctor.
Not Rounding Out
I’ve had a B belly since I can remember. If you aren’t sure what that is, read more here. But I always thought that when I got pregnant, it would round out and look like a typical pregnant belly. I was wrong. Mine never fully rounded out into a D shape. It stayed a B shape, just a larger B. The important thing to remember is that pregnancy doesn’t look one certain way. It looks different for everyone and that’s beautiful!
Reactions from the Crowd
I remember two specific instances when I was pregnant that I realized that the average person has NO IDEA what plus size pregnancy looks like. The first one, I was probably about 5 months along at this point. I was working in a pretty big office and was semi-familiar with a lot of the people who worked on my floor.
I was in line in the women’s bathroom, because our floor was mostly women so it was typically pretty crowded. Another girl walked in, who was also pregnant, but a few months father along than me. Everyone made comments about how she could go in front of them, she needed to get in there faster than anyone else, she must have to go so bad, etc. No one noticed I was also pregnant and therefore I stayed in my spot in line.
The second time, I was verrrrrry pregnant. My C-section was scheduled for about a week or two out and I was talking to a co-worker about maternity leave and how HR has been making the process really difficult. Another co-worker walked over and said “oh my gosh! You’re pregnant?! I had no idea!!!” I have no idea whether she thought this was a compliment or something? But I just looked her dumbfounded and wondering to myself “does she think I only gained weight in my belly?”
Maternity Photos- TAKE THEM!
I’ve heard so many plus size women regret not taking maternity photos. I totally get it. People don’t recognize that you’re pregnant. Your body is rapidly changing. Your body feels weird and different. It feels like there isn’t even enough room in your body for your organs! I completely understand not wanting to document it when you feel less than fabulous.
But do it! I was hesitant as well to take pictures. But looking back, they are absolutely some of my favorite pictures of myself!
To ECV or Not to ECV
My son was breech. I knew this around my 34-week ultrasound. He found a comfy spot and just wouldn’t move. I was scared to have a C-section so I really wanted the doctor to try external cephalic version to turn him in order for me to be able to deliver him naturally.
If I had to do it over again, I would absolutely NOT ask for the ECV. I forgot to breathe the first time they tried and hyperventilated because it was so painful. Some people describe it as uncomfortable, as they try to flip the baby from the outside, but I found it incredibly painful. My spouse said they were pushing so hard on my belly that he could see the outline of the baby through my stomach.
They tried a total of 3 times and I got to a point where I asked them to stop. They would get him about 50% of the way and then he would slide right back to where he sat the entire pregnancy. So I ended up with a C-section anyway.
The Dreaded C-Section
I was pleasantly surprised by how easy my C-section was. The anesthesiologist told me that my back was made for the spinal block. I couldn’t feel anything from the neck down, which did make it a tiny bit hard to remember to breathe. It’s hard to tell your body to use your lungs when you can’t feel anything! They also had to tilt me on my side for a few minutes because my blood pressure started to dip.
But after that, it was smooth sailing! The meds they give you are phenomenal, I didn’t have a care in the world and asked if I could take a nap. My surgeon happened to be a woman and I appreciated that she hid my scar under my belly apron, but just above the fold of my skin. I know this is a concern for a lot of larger women- that the surgical wound will be hard to keep clean and dry and free of infection. I think the placement of my incision plus the aftercare instructions they gave me helped me have no wound complications afterwards.
An Unexpected Diagnosis
Insufficient glandular tissue (IGT). Have you heard of that? I hadn’t before I did some online research and eventually was diagnosed with it.
IGT is a disorder where the milk-making tissue of breasts doesn’t develop as it should. This can happen in utero, during puberty, or during pregnancy. There are different theories behind what can cause IGT such as PCOS, thyroid issues, and more. But the truth is, the numbers you’ve probably heard about 99% of women being able to successfully breastfeed are inaccurate.
I knew something was wrong when my son wasn’t sleeping more than 20 minutes at a time and always screaming. I tried to reach out to other moms since I was a first-time mom and everyone assured me that babies are just hard sometimes and it was normal. It wasn’t.
At one of my son’s follow-up appointments about a week after birth, we found out he was losing weight and they were starting to get concerned. Our pediatrician asked me to pump instead of breastfeed to determine how much milk he was getting. I only pumped a few milliliters. My son was unknowingly starving.
I started supplementing with formula, power pumping, taking supplements, eating foods that were supposed to help boost supply, saw 3 different lactation consultants. I didn’t understand why nothing I did seemed to work. That was until I read about IGT. Once I brought it up to my lactation consultant, she knew at that point that I had done everything she asked and more and told me it was a solid possibility. My OBGYN later confirmed the diagnosis.
A year postpartum, I had an unrelated mammogram that made me feel so validated. The tech told me she could see everything in my breasts because I had the opposite of dense breasts- there was only a tiny bit of glandular tissue. Which she commented is great for mammograms but terrible for breastfeeding!
What I Learned
Getting a doctor that cares about YOU and not your weight during pregnancy is so important! There is no other time where you go in expecting your weight to increase over time. This is when you want a provider who treats you like a pregnant human being and not a number on a scale.
Do your own research and ask your providers the hard questions! I can’t emphasize this enough. I wouldn’t have known that I had IGT had I not sought out the information myself and brought it to my medical team for discussion.
Appreciate the moments during pregnancy even when they’re hard. Whether it’s questioning whether to take pictures of your changing body, or comments from co-workers, there will be amazing things too! Like the first time you feel your child kick or the first time you see them on an ultrasound. You got this mama!!!
