Help! Unexplained Weight Gain!

QUESTION

Dear Midwife,
I would really appreciate a response, as I am worried about the following issue: I am 25 weeks pregnant with my 3rd child. I was 174 pounds and 5' 7.5" tall prior to becoming pregnant. I expected to be larger than in previous pregnancies and I expected to show sooner. I wasn't prepared for what I currently face, however.

I had complained to my ob/gyn that I was having trouble breathing, similar to the breathing problems experienced near full-term. My uterus was found to be 35 centimeters when I was 24 weeks pregnant. Previous ultrasound had indicated that I am carrying a singleton. I am not excreting protein into my urine. My doctor sent me for an ultrasound immediately. The amniotic fluid volume is fine, no fibroids have been detected via a level II ultrasound, the baby has no physical anomalies except for a small choroid plexus cyst in the left ventricle, my triple screen came back normal and the baby was found to be in the 93rd percentile for her gestational age (my four year old is in the 95th percentile for height and weight, so this didn't surprise anyone).

I am concerned because I was only five centimeters from full term size at 24 weeks. I have noticeably grown in the past week and a half. I was this big at delivery with both of my sons (one born 8lbs. 6 ounces at 41 weeks, one born 7lbs. 6 oz. at 36.5 weeks). Do you know what is going on? My ob/gyn has no explanation. I am also gaining weight quite rapidly, especially now. My blood pressure is fine (110/70), but I am retaining a lot of water. By gaining rapidly, I mean I gain about 10 pounds a month, mostly in the waist. I am watching what I am eating; eating not much more than my 4 year old, but it doesn't seem to matter.

I am also exercising (30 minutes of aerobics for pregnancy 3 days a week). Nothing is slowing the weight gain. Any suggestions? I am quite miserable and am finding it hard to move around. At 25.5 weeks, I have gained approximately 34 pounds, all but three pounds of which were gained during this second trimester. With each of my sons, I gained 50 and 45 pounds, losing all the weight within 3-4 months. I am really worried. Any suggestions? I don't see how I can make it another 14.5 weeks! At this rate, I will gain far above what I did with them. Thanking you ahead of time.

Additional information: I am 32 years old and normally very, very active, as I normally play many sports. I had a blood test to look at thyroid function and everything was normal. HELP. Thank you.

ANSWER

Boy, this sounds like a challenge. The first thing I would check is your tolerance to glucose (sugar), both with a 1-hour glucose test and maybe a hemoglobin A1c for good measure. I would wonder about early onset gestational diabetes. But if that is ruled out, then I would just say that you have larger than average babies because you are taller than average yourself, and that you are carrying this baby higher than you usually do. And that it likes to stretch! For the water retention, I'd measure to make sure you're drinking at least 3 quarts/day, and also make sure that you have at least three servings of protein and 3 glasses of milk each day. And maybe take a bath or two, which will also help to relieve water retention. I'm sorry this is turning out to be so difficult, but I wish you the very best -- good luck!

-- Cynthia, CNM

Comments

Me too!

I have so many things in common with you. I am experiencing the unexplained weight gain and I too am going through my third pregnancy. I am also 5'7 and both of my previous children were were well over 8 pounds. I am also very very very active when I am not pregnant. I weight lift and normally do the equivalent of 4-6 hours of exercise a week and but have reduced that during the course of my pregnancy to 3 times a week for 20-40 minutes and I continue to lift light weights. I have also been told that my child is measuring large for the gestational age, but my husband is 6'4 and they just assume he is taking after this father (and I am not exactly short). I too gained most of my weight during the 2nd trimester. I have another 12 weeks to go and I absolutely do not know how I am going to make it. I know people who are having twins that are smaller than me (their first pregnancies though) and I am larger than I was when I was about to give birth to my oldest child.

I thought I was going crazy and had lost all control of my body. It helps me just to know that someone out there is experiencing the same thing.

The one thing that my be different between us is that I have been diagnosed with PCOS and I have had my thyroid removed and I am taking a thyroid supplement. My endocrinologist thinks that the PCOS and insulin resistance may be contributing to my unexplained weight gain. I also think its shear math: if you are used to being very active and then all of a sudden stop the level of activity your body is used too I think the weight comes back on as your muscles start to atrophy: I think it's an exaggerated version on what happens when someone ages and they lose muscle mass -- they tend to gain weight.

The only thing that makes me think it is something more is that both you and I are experiencing unbelievable swelling. So much so for me that I look like a totally different person!

Good luck to you. I really hope things have gotten or will get better for you (and me). I hope you have a healthy baby and that we are able to put this pregnancy behind us quickly.

Naomi

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.