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Fourth midwife visit.
I went to the midwife today for my 23-week appointment. (I know that's a weird number, but they start visits at 8 weeks and then want you to come in every 5 weeks.)
Everything looks just great. The baby's heartbeat is strong and regular. My blood pressure is 108/62, which is fine, I don't have any swelling in my hands and feet, and I don't seem to be spilling any sugar or protein. She tested for anemia because of my problems with dizziness and shortness of breath, and my hemoglobin came back 13.6 - which is excellent. (Normal for a woman who isn't pregnant is 12.1-15.1, and normal for a pregnant woman is 11-12.) I guess all the red meat I've been eating has really paid off.
She thinks the shortness of breath is normal pregnancy stuff, and the dizziness is probably related to low blood sugar. She recommended that I have three snacks a day, avoid too much sugar at once, and eat protein at every meal and snack - so now I have to think of lots of easy high-protein snacks. It's too bad I'm trying to avoid deli meats (because of listeria) - otherwise that would be a great option. There's only so much cheese you can eat.
I am still two pounds under my pre-pregnancy weight, which has me a little worried. The midwife says I'm just slow getting started with my weight gain, and predicted that sometime in the next month I will start being ravenously hungry all the time and my weight will take care of itself. She's not at all concerned.
We spent some time talking about post-partum depression. I'm probably at higher risk, because I've had two mild depressive episodes before and because my sister had real trouble with it. Both of those things are predisposing factors. I wanted to know if there's anything I can do to reduce my chances of developing PPD after the baby is born. She said that the most important thing is to make sure I have a strong support system in place - including help with the baby, having someone else to do the cooking and housework, making sure I have opportunities to leave the house without the baby, and possibly joining a new mother's group. She also said that I might want to consider using formula for one night feeding, even though otherwise I'll be exclusively breastfeeding, because PPD is strongly linked to sleep deprivation. Finally, she gave me the name of a psychiatrist who regularly works with their practice and suggested that I might want to meet him before the baby is born, so that if problems arise I will already know who to go to for help. She tried to impress upon me the importance of being willing to take antidepressants if necessary, even if I'm nursing - I told her that, as a psychologist, I know enough about the potential developmental impact of having a depressed mother that I will be perfectly willing to take whatever medications are necessary.
Some of this seems like it might be more than is necessary, but I feel better knowing that all the bases will be covered.
I go back at 28 weeks - the beginning of my third trimester. (Isn't that a terrifying concept?) That's also about the time I get more labwork done, including a glucose tolerance test (for gestational diabetes) and a Rhogam shot (because the baby and I are probably Rh-incompatible). They're also going to test for thyroid problems because there's a family history and because it can cause complications - but she said that's just a precaution, because if I were *very* hypothyroid then I probably wouldn't have been able to get or stay pregnant.
I continue to be very, very impressed with my midwife practice. This visit was 45 minutes long, and I had all the time in the world to ask questions and get them answered. We've now met all three of the midwives, and although I still have a favorite, I will be perfectly happy to have any of them attend our birth.
And of course, I am also very impressed with the Li'l Critter and her stellar health and behavior. What a fine baby we're going to have!
Everything looks just great. The baby's heartbeat is strong and regular. My blood pressure is 108/62, which is fine, I don't have any swelling in my hands and feet, and I don't seem to be spilling any sugar or protein. She tested for anemia because of my problems with dizziness and shortness of breath, and my hemoglobin came back 13.6 - which is excellent. (Normal for a woman who isn't pregnant is 12.1-15.1, and normal for a pregnant woman is 11-12.) I guess all the red meat I've been eating has really paid off.
She thinks the shortness of breath is normal pregnancy stuff, and the dizziness is probably related to low blood sugar. She recommended that I have three snacks a day, avoid too much sugar at once, and eat protein at every meal and snack - so now I have to think of lots of easy high-protein snacks. It's too bad I'm trying to avoid deli meats (because of listeria) - otherwise that would be a great option. There's only so much cheese you can eat.
I am still two pounds under my pre-pregnancy weight, which has me a little worried. The midwife says I'm just slow getting started with my weight gain, and predicted that sometime in the next month I will start being ravenously hungry all the time and my weight will take care of itself. She's not at all concerned.
We spent some time talking about post-partum depression. I'm probably at higher risk, because I've had two mild depressive episodes before and because my sister had real trouble with it. Both of those things are predisposing factors. I wanted to know if there's anything I can do to reduce my chances of developing PPD after the baby is born. She said that the most important thing is to make sure I have a strong support system in place - including help with the baby, having someone else to do the cooking and housework, making sure I have opportunities to leave the house without the baby, and possibly joining a new mother's group. She also said that I might want to consider using formula for one night feeding, even though otherwise I'll be exclusively breastfeeding, because PPD is strongly linked to sleep deprivation. Finally, she gave me the name of a psychiatrist who regularly works with their practice and suggested that I might want to meet him before the baby is born, so that if problems arise I will already know who to go to for help. She tried to impress upon me the importance of being willing to take antidepressants if necessary, even if I'm nursing - I told her that, as a psychologist, I know enough about the potential developmental impact of having a depressed mother that I will be perfectly willing to take whatever medications are necessary.
Some of this seems like it might be more than is necessary, but I feel better knowing that all the bases will be covered.
I go back at 28 weeks - the beginning of my third trimester. (Isn't that a terrifying concept?) That's also about the time I get more labwork done, including a glucose tolerance test (for gestational diabetes) and a Rhogam shot (because the baby and I are probably Rh-incompatible). They're also going to test for thyroid problems because there's a family history and because it can cause complications - but she said that's just a precaution, because if I were *very* hypothyroid then I probably wouldn't have been able to get or stay pregnant.
I continue to be very, very impressed with my midwife practice. This visit was 45 minutes long, and I had all the time in the world to ask questions and get them answered. We've now met all three of the midwives, and although I still have a favorite, I will be perfectly happy to have any of them attend our birth.
And of course, I am also very impressed with the Li'l Critter and her stellar health and behavior. What a fine baby we're going to have!
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Seriously, though, if you have access to any sort of gourmet cheese vendor, this could be a great opportunity to try little bits and pieces of exotic new cheeses!
I've developed wonky blood sugar without even being pregnant, and I find that small quantities of the following nibbles (in addition to cheese) keep things pretty well in check.
* Nuts. It doesn't take many. Unsalted almonds are especially good for you - lots of calcium.
* Nut butter (peanut, cashew, almond) or tahini on whole-meal crackers.
* Hummous, preferably home-made, with crunchy raw vegetable dippers
* Sunflower seeds.
* Edamame.
* Beef jerky.
* Smoked salmon (the nice, hard-smoked PNW sort)
* Other smoked fish. An outfit in Tillamook makes a smoked tuna jerky that's to die for.
* Leftover ham or roast beef (cook it yourself and slice/package/refrigerate promptly so you don't have to worry about the listeria issue).
I'm so glad things are going well for you and your Critter!
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K. [but of course you should eat things you like to eat. Should you want advice on cheeses you can have it, natch]
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Sadly, blue cheeses, soft cheeses like Brie, and raw-milk cheeses are also off the menu. That rules out a lot of tasty options.
Smoked fish is a good idea. I'll have to see what they have at Whole Foods. I'm not eating tuna (except for, possibly, canned light tuna - ick) because of mercury, but smoked trout is a good possibility.
We looked at some hummus at the store, and were surprised to see that the protein content listed on the nutrition label is very, very low. You found that it worked okay to control your blood sugar, though?
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Unlike you, of course, IANA doctor. (-:
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*eyelash batting*
I mean, I'd have to save it until after delivery, but...
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You can still bat your cute li'l eyelashes at me, though. (-: