Photo by Bas Silderhuis

Whenever I see articles talking about the importance of nutrition in pregnancy I get a little tense.  When recent articles came out about research findings that moms that eat a diverse diet of healthy foods during pregnancy expose their babies to flavors that can help them to be less picky and eat a wide range of healthy foods later, I had a momentary twinge of guilt.  With articles like that I find myself thinking “I guess I screwed up” and then “actually, they eat pretty darn well, thank you.  They turned out fine.”

I eat like crap when I’m pregnant.

An article like this one about how physical activity during pregnancy gives babies a “head start on heart health” cause me to want to curl up in the fetal position and cry that it must be my fault that Smunchie was born with a heart defect and I’ve probably taken years off her life because I didn’t exercise much during pregnancy.  In fact, I hardly got off the couch.

It’s not easy to hear that what we have done as parents may actually give our children a disadvantage or worse, hurt them.  In fact, it can be darn near crippling or lead us to defensive responses of anger.

Those articles all hit a sore spot for me, the vulnerable spot of the reality of my pregnancies.  With every one of my pregnancies so far I have battled hyperemesis gravidarum.  Due to extreme nausea and vomiting I lose tremendous amounts of weight and usually don’t even get back to my prepregnant weight by birth.  With my worst pregnancy I was down to 83 pounds at 5 months pregnant.  Instead of a diverse diet of healthy foods, I can’t even keep down prenatal vitamins and pick what I will attempt to eat based on how it will come back up.  (FYI, ginger burns like hell and saltines rip up your throat and make it bleed.)  Regular IVs, PICC lines and an impressive drug cocktail closer to a cancer patient’s regime than anything pregnancy related get me through my pregnancies sometimes along with TPN and NG tubes.  Usually with multiple hospitalizations.  Kidney failure, liver problems, gall bladder problems, and permanent heart damage from severe dehydration have all come with having my babies.

This article just about broke my heart and the possibility that my children may experience long term health and behavioral issues as a result of my pregnancies is a tough reality to face.  I hate it.  It makes me angry.  I may even get defensive.

Sometimes all I want is someone to tell me it’s ok, that nutrition really isn’t that important and all that matters is that the baby is growing.  Not to dismiss the suffering of HG but to somehow alleviate my fears that artificial nutrition is really not that bad and that poor diet in pregnancy isn’t going to ruin my children for life.  After all, I want to say, Lactated Ringer’s and TPN (total parenteral nutrition) are specially formulated to be just as good as real food, right?

No, no they’re not and they come with some very real risks.  I really don’t want people to lie to me and more importantly, I don’t want to lie to myself.  It’s not even close to “just as good.”  But it is as good as I can get.

I’ve tried it all.  Eating the “right” foods, avoiding the “wrong” foods, detoxing, homeopathy, gut healing, a variety of testing, cleanses, herbs, chiropractic, acupuncture, positive thinking (can’t convince me I’m not puking though), prayer, supposed miracle drugs and so much more.  Nothing has worked.  Some have made it a little less awful.  Every time I’ve been afraid of what the medications will do to my baby but more afraid of what not being on them would mean for both of us.  It is not what I would choose and I grieve the loss of the pregnancy experience I had hoped to have.  And, I have to admit, sometimes when I hear that someone else has the perfect pregnancy with no problems and never even took a Tylenol I not only get a little jealous (or a lot, as in completely green… again) I may even get defensive even though what they’ve said really has nothing to do with me.

Do those articles set out to make me feel guilty that I barely eat during my pregnancies?  No, they are just sharing information and sometimes aim to encourage and inspire moms.  Do the moms celebrating their beautiful pregnancy experience do so to punch me in the gut and knock me down?  I’m pretty sure they are just excited about their own experience.  Does the fact that I have very little physical activity during the prenatal stage of my mothering make me a bad mom?  I don’t think so but it doesn’t mean I don’t wonder from time to time or that it doesn’t hurt a little when I’m faced with the reality that it really isn’t a good thing and could be putting my children at risk.  Blaming the information though doesn’t help me or make my reality better.  Hiding it, or worse denying it, doesn’t help anyone else either.

But maybe I have an acceptable reason that gets me off the hook?  Maybe because I had no choice and couldn’t move off the couch or do a prenatal work out with my IV I “shouldn’t feel guilty.”  (I thought this blog post from Analytical Armadillo about telling others they shouldn’t feel guilty was interesting.)  Some may say that but just as soon as some try to make me feel better about the reality of my situation, others will tell me I “should’ve tried harder.”  In fact, when I was pregnant with Lolie I had multiple psych evaluations and was told that if I just wanted my baby and if I would make up my mind to stop throwing up I would be able to eat.  If only that had worked.  It was in moments like those that I felt like nobody really heard me and my suffering and that maybe I was a really bad mom and didn’t deserve my children.  Where is that line?  When is the problem real “enough” that it  doesn’t deserve criticism?  And who gets to decide that?

What if I had just decided to be that way though?  What if I didn’t have HG and just had a normal pregnancy with normal pregnancy fatigue and nausea and I didn’t eat well or get off the couch?  I’m sure the harsh criticism would have been significantly more and maybe even deserved.  But what if there were other factors that others couldn’t see?  What if my husband wasn’t supportive of my pregnancy and I struggled with wanting my baby but having no support?  What if depression was already an issue for me and pregnancy changes led to more of a mental and emotional health battle?  What if no longer feeling in control of my body brought flashbacks of my sexual abuse history?  What if I was totally terrified at becoming a mother, giving birth or that if I moved wrong I’d hurt my baby?  What if I didn’t tell anybody what was really going on and instead I let people think I was selfish and lazy?

Harsh criticism only goes so far.  Occasionally it will inspire people to change but usually it inspires people to become defensive.  It’s hard to listen from a defensive position.  Dialogue, information sharing and genuine care, on the other hand, help people explore their own situations and choices honestly.  It is important to remember that the tone with which we share information can make a difference, making it personal towards someone else’s choices rarely is effective.  At the same time, when reading and receiving information readers bring their own baggage and filters to the message.  Remaining objective is incredibly challenging particularly when we live in a world where much of what we see and read is intended to rile us up and get a reaction.  A form of entertainment.  Even fairly objective peer reviewed studies can be reported in the news with headlines that immediately spark controversy and raise emotions that really have nothing to do with the study.  One I linked above reads as though women who love their babies will be doing prenatal work outs, leaving unsaid but certainly implied that not working out indicates a woman does not love her baby.  With tones like that the actual message can be a bit hard to accept.

Yet these caveats should not preclude us from sharing information.  In fact, we have a responsibility to share it.  My training as a midwife required me to learn a lot about prenatal nutrition and the impact it has on pregnancy, child birth and the health of the baby.  It took a while but I got over the urge to write in every margin on prenatal nutrition “but not always…”  Because ultimately that response was about me, not the standard, normal, healthy, low risk pregnancy these texts were talking about.  Over time I even developed sympathy for women dealing with normal nausea and vomiting in pregnancy, able to offer up suggestions that could help with their discomfort that never touched mine.  These days I can also legitimately celebrate with those that have healthy, normal pregnancies, gain weight without problem and enjoy food and I don’t take it personally or feel the need to remind them “not everyone can, you know.”  They’re not making a personal indictment against me and even if they were too, life is too short for me to dwell on that and let it get to me.  I know they legitimately don’t understand.  Frankly, I’m glad they can’t, I wouldn’t wish my pregnancies on anyone.  But I risk isolating myself, winding up in a dark, lonely hole of guilt and anger if I remain defensive towards the information and the people sharing it.

Whether we’re talking pregnancy health, birth choices, breastfeeding, formula feeding, or just about any other subject related to the choices we as parents have to make, sensitivity and recognizing our own filters in the conversation go a long way.  We should still share information, we should still read information and we hopefully do this in a safe community where processing the information can happen through trusting and supportive dialogue.  I hope that by keeping in mind the fact that we do not know everything there is to a person’s back story and why they make the choices they do we can remember to be more sensitive in how we share information.  I hope that by keeping in mind the fact that we all bring our own baggage to any topic we can remember to try not to take information sharing as personal jabs.  It is through these steps that we can support one another and make a difference for others.