Fat and pregnant: week 13

First — the belly pics!

Week 13 -- belly has definitely "popped", breasts may be larger

Compare with week 10:

10 weeks. Subtle changes, but uterus hasn't yet risen out of pelvis.

Next: I talk technology and the (yes, I recognize the amusing juxtaposition here) invisible pregnant person.

Last weekend, we had our first prenatal visit. Our midwives come to our house, and we basically sit around and chat for an hour1 and it is pretty much The Best Way To Spend My Health Insurance Company’s Money Ever.

Also, we heard the heartbeat.

As a rule, unless indicated, I don’t do imaging ultrasound in pregnancy2, and besides the blood tests I get to monitor my thyroid (and the basic prenatal panel3 because hey, if I’m gonna get poked anyway…), the first Doppler search for the heartbeat is about as high tech as I hope to ever get in pregnancy.

And I gotta say — it was amazing. And awesome, in both colloquial and original meanings. When we tried at 12 weeks with the Boychick, the placenta was anterior and blocked us from getting at him, so we didn’t bother trying again, and didn’t hear his heartbeat until it was late enough we used the good old fashioned fetoscope. But this time, though it took a couple minutes as Child Number 2 kept giving us the slip and Child Number 1 kept trying to “help”, we heard the machine’s reproduction of the oh-so-fast thupathupthupathupthupathup of the little protoperson’s heartbeat.

As is typical for many people in I-would-bet-most pregnancies, I’ve been in something like denial about the reality of this. Or, more accurately, I go through phases where I’m convinced it’s all in my head, or really I have a tumor not a fetus, or the pregnancy died two months ago and my body just hasn’t flushed it yet, or, or, or… So hearing that heartbeat was Really Big, and made those crazy voices that much easier to ignore.

And yet…

Why?

I question a society that, rather than giving me space to voice my fears and let them go as I am able, expects me to use technology to “prove” myself wrong (or right). I question a society that says pregnancy isn’t really-real until the urine stick or the blood test or the ultrasound or the Doppler says it is. I question a society that demands direct access to information about the being I carry, through ultrasound and amniocentesis and even the fetoscope, rather than viewing me as whole and solid, as a person in my own right, and this pregnancy as a function of my body. I question the deification of the “objective” and the derision and dismissal of the “subjective”4.

I’m not questioning prenatal technology per se, nor anyone’s use of it: it, itself, is a tool, and as all tools is neutral, and capable of great benefit. There are times when a near-direct look at an embryo or fetus is exactly what is called for, and I am so grateful we have the technology available for those who need or desire it. Further, I am happy to celebrate with someone who is thrilled about the first ultrasound pictures, or benign amniocentesis results, or, yes, hearing the first Doppler-reproduced heartbeat. No curmudgeon, I, out to tell anyone Yer Doin It Rong.

But there’s an important, if subtle, difference between celebrating with a person, and exalting or idolizing the information. I experienced both, when I told others about hearing the heartbeat, and one felt great, as sharing good news with friends should, and the other felt… jarring. And erasing. What is the difference? Those celebrating with me were happy that I was happy; what my news was barely mattered, only that I found it something worth a grin or ten. The other comments focused on the information and what it “meant”: that — finally! — there was evidence that the pregnancy was healthy, that the fetus was fine, that my body, surprise!, hadn’t fallen down on its job. Because those things can’t be assumed, can’t be trusted based on my experience of nausea and exhaustion and food aversions and tightening waistlines.

Part of it, I know, is that some people have experienced losses, or difficulties conceiving, or risky and traumatic pregnancies, or undesired outcomes. Some people have learned not to trust the pregnant body, to rely on the outside look that technology offers. And I understand and sympathize with and am happy to hear and hold the space for that perspective, because it’s no less valid or worthy than any other experience of pregnancy.

But so many of us have, instead, been taught not to trust pregnant bodies, not to trust our own bodies, not to believe anything unless an MD or a machine says it is so. So many of us have learned not just to embrace the “objective” view, but to reject the “subjective” — and that’s what I have a problem with. That is the function-and-formation of kyriarchy, of a system that devalues women and women’s bodies and the typically-female role in pregnancy, that says my opinion and my experience is meaningless because it hasn’t been and can’t be confirmed or controlled by authority, by expertise, by privilege, by power.

I don’t want to reject technology wholesale. I really don’t wish to go back to a world without the options we have now. But I would give so much to exist in a world where a pregnant person was recognized universally as a person, capable of making the best choices for them given full information and uncoerced options; where the subjective was as valid and accepted as the objective; where technology was a tool available when called for; where we didn’t slice up the pregnant body into Vessel and Object, Uterus and Fetus but honored the breathtaking complexity, intricacy, and interdependence of the pregnant system.

I hide away in that world with my midwives for an hour once a month, but then I step out into the rest of humanity, barely-pregnant belly just beginning to jut before me, and I am reminded that what should be a fundamental right for all, regardless of desired place or mode of birth, is, in my society, the rarest of privileges.

  1. And then they take my blood pressure, whilst I’m sitting comfy in my favorite recliner. Anyone surprised it’s ten points lower than when perched on the exam table five minutes after defending my right to decline having my weight taken to my fatphobic primary care provider? Anyone? No?
  2. Just because this is me and I have to, I’m going to take this moment to bust the myth that Doppler technology is somehow “less” intense than imaging sonography, for those concerned about ultrasonic radiation. Rather, Doppler uses continuous waves, compared to imaging ultrasound’s split-second waves. Although I couldn’t tell you which creates a more irritating uterine environment, the pulse or the constant, in purely number-of-waves terms, there’s probably about as much exposure in a minute of Doppler use as in a 20-30 minute imaging ultrasound. There are other reasons to avoid imaging sonography, not least because the American College of Radiology discourages its routine use in pregnancy without specific medical indication, but I gotta say I have to try not to roll my eyes when people avoid it over concerns about the long-term effects but happily use Doppler to hear the heartbeat at every appointment.
  3. Not the tripple/quad screen or aught, just the “Do you have HIV?” stuff.
  4. Both in scare-quotes here as every experience — including the act of observing — is inherently subjective to some extent. Though the subject/object duality is a sometimes useful shorthand, I reject the notion that there is any such state as “purely objective”.
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20 Responses to Fat and pregnant: week 13

  1. Yay, baby! Boo kyriarchy. And doctors who adhere to dogma and not patient individuality & rights.

  2. I’m going to leave one of those irritating “yeah! what you said” comments.

    Yeah! What you said! :D

    I do have some tests, and I don’t have others. The information is useful to me, but, except in a highly personal “go body, lookit you growing a healthy baby there!” kinda way, it doesn’t validate me as a mother to have the tests, nor does it make me a bad one to refuse some of them.

    I do both a combined screening ultrasound at 12w and an anatomy scan at 18-20, and I will probably have the GBS test, but not the GTT. Screening at birth for metabolic disorders, yes – VitK and HepB for a low risk baby born at home, no. Arbitrary? Maybe, but they’re all decisions based on reading and personal risk assessments as to what’s good for *me* and then the baby, not just me-as-incubator-and-the-precious-precious-cargo (too many dashes there, sorry).

    Doppler’s not just “at every appointment” anymore. I do flinch at those who buy home doppler kits and use them every day. :/

  3. All I can do is nod my head and say “Yeah! What you said!” and maybe even throw in a “Sing it, sistah!” Which is, I suppose, kind of a boring comment. Sorry.

    PS STOP TALKING TO ME! ;)

  4. On this one I have to say yes, but not for me. I like to think it’s a personality thing — I’m an information seeker, and if it’s available I can’t not have it. And I’ve had enough complications along the way to be glad to be living in “modern times”.

    But it shouldn’t be imposed from outside.

  5. I guess I agree about not imposing. I mean there is no guess about it, I don’t want things forced on people.

    I, for one, do not trust birth, pregnancy, or my body. I myself would have bled to death after my first (very fast but otherwise absolutely normal) delivery. I also suffered a miscarriage before that. There is no trust in a physiological process (for me). Either it works (and you are the one who lucked out and wins) or it doesn’t (and without help you’d of been the one who died). I think pregnancy and birth deserve the respect, and the veil of danger it carries, of the complex thing that it is.

  6. Hey! I think we are both having a baby at the same time! I am 12 weeks along. And I have 1 biologically mine (we have 2 older adopted children) boy child already also. Anyway, I just wanted to say thank you for making me think about the use of the heartbeat machine more than I would have otherwise and that you are incredibly lucky that your health insurance pays for midwives that will come to your home. I am forced into another hospital birth due to finances and health insurance issues this time, despite my strong desire to go to a birthing center this time. Anyway, I also love when you review books for your older child! That’s the original reason I subscribed to this blog and I haven’t regretted it since.

  7. On subjective/objective in medical contexts. (Pregnancy is many things, the medical is only a tiny important part.)

    The distinction is one of viewpoint – inside vs outside. Different information available. The ‘objective’ view ‘only the facts maam’ omits much valuable insight. The subjective view has privileged access to the inside of just the one subject, information nobody else has except by second hand report. Only the gestator knows what being pregnant feels like!

    Good medical people use SOAP Subjective, Objective, Assessment, Plan to organize the small part of the information that goes on record.

  8. J00 is one hawt mama!

    I trust the empirical evidence of my body, but hearing the baby’s heartbeat is super-reassuring, given my history of losses… all the way up thru labor. Although in labor I took my own advice and didn’t worry about the (telemetry thankyouverymuch) monitors, just did what I needed to do.. and while in labor, and the monitors were not picking up much, a) my nurse was NOT worried (and neither was I) and b) things were going fast enough that even if she had been in distress, it would have been slower to go the surgical route! I mentioned the 3.5 ctx worth of pushing, right?

    We talked about doctor’s office blood pressure readings. :)

    The whole subjective/objective dichotomy BS is why I don’t like anthropology. I love the idea of studying how people live, but the practice? Sucks dead rat through a straw. :D

  9. It’s funny, b/c I am just over 8 weeks pregnant, for the first time, and am recently transplanted to Canada. Where I have not been so much as offered any sort of scanning before the 18-20 wk ultrasound, and I don’t even have an appt with an ob until 20 weeks. And so I am forced to take a rather un-american backseat and simply wait for my body to do its thing, trusting that it will. (I have been offered all of the blood tests on the relevant dates, but the relative lack of concern for constant monitoring of the as-yet-invisible pregnancy is definitely a change of pace…)

  10. Man, I feel I could write a novel on this post singing your praises for writing it, but first, here’s some anecdata:
    I had huge amounts of anxiety and lost a ton of weight due to hyperemesis. At five months, my OB told me I had a molar pregnancy (aka a “tumor that mimics pregnancy symptoms”), because it was just too bloody unlikely that there was a baby in there.
    They scheduled a D/C the next day as well as a doppler, and surprise, surprise, they found a heartbeat. Just like they had found at the 13 week appointment, hmm.. From then on, I took two busses (one way!) twice a week to get stress tests done, in addition to all of the other crap (dopplers, ultrasounds, glucose tests). I had to quit my job.
    At eight months, I still wasn’t gaining enough weight, and I was told that my womb was a “hostile environment, and it would be better if your child was born prematurely. We can schedule an induction immediately…” They were not pleased when I refused.
    At nine months, my doctor stripped my membranes without my permission or knowledge (I asked her what the hell she was doing to make it hurt so much) in an effort to induce labor. It worked, but I finally wised up and fired her medically negligent ass.
    Pregnant women maintaining personhood? Preposterous!
    I will totally do it better next time, but it’s posts like these that remind me that it’s not my fault per se; it’s a societal construct that doesn’t trust women that I have to watch out for. Thank you.

  11. P.S. What a beautiful belly! Thank you for sharing!

  12. Wonderful post, as always. And beautiful belly. :)

    Technology for me was…a wake-up call? Grounding? Affirming that this was real? I don’t know the word I want to use. My son was conceived as the result of a sexual assault by a stranger. When I found out I was pregnant, I wanted to deny, ignore. Everyone who knew asked me when – never if – I was getting the abortion, even before I had made my decision. I was disconnected from what had happened and was currently happening to my body, alternately ignoring the very real evidence that I was pregnant (sore, enlarged breasts, nausea, expanding waist line) and desperately wishing for it not to be so. Hearing the heartbeat, seeing that little alien-shaped blob on the screen brought it home for me that this was real so I better start dealing with it.

    While I absolutely love my little person, I mourn my pregnancy and birth experience. It was so fraught with uncertainty and emotional pain and trauma that I never really got to the point where I was able to sit back and say, “I trust and celebrate my body.” My body was taken from me from the moment my child was conceived and I never really feel like I got it back.

  13. Right to the superficial here: beautiful! I love your skin, your rolls, everything about these pictures. I love the throws you used, too. Makes me want to whip out the old charcoal pencils from my life-drawing days. I’m looking forward to more pictures as the life inside you grows!

    Having had pregnancies of only the un-medicalized variety, I can say that for me I never really questioned the viability of my pregnancy. I chose to ignore scare tactics and let things be as they may. I just never felt scared when I listened to my own intuition. I didn’t do any of the procedures I hear so much about: glucose test, cervical checks, um… other stuff? One pee test at the end of my first pregnancy. I became a bit of a hermit towards the end of both pregnancies knowing that criticisms would make me question myself in ways that I didn’t need to, being hormonally sensitive with all the prolactin coursing through me. I often just laid in the bath or in bed feeling movements, determining the position of my baby with my hands, just feeling pregnant, happily. I know my way isn’t for everyone, but I’d say it’s a lot nicer for the average.

  14. Personally, I loved being able to “see” what was going on inside, and not just feel it, but I’m a totally visual person. Seeing the little pulse of his heart was more affecting for me, and hearing it was for my husband (a musician). But we did it because we wanted to, not because anyone else wanted us to.

    If you’re bothered by other people’s hangups about biomedical proof of your pregnancy, why are you telling them? You don’t have to share everything with everybody. People are who they are; they react how they react; it has nothing to do with you.

  15. So many thoughts here. I agree that all these technological tools should be optional and/or used only as medically necessary. Unfortunately I am one of the people you mentioned whose body betrayed me. Before my second loss, I thought everything was going fine – I was constantly hungry, nauseous, had all the “right symptoms” to indicate a healthy pregnancy. Then I found out that I had been carrying a dead baby for about a month – that my body had been lying to me, leading me on. Even the day after I got the news, my body had the audacity to be nauseous again. So this time around I agreed to come in every 2 weeks to confirm that this one is still alive. After experiencing multiple losses and a mistrust of my body, I have too anxious of a personality to leave anything to intuition or subjectivity.

  16. I *want* to trust. And in some ways, I do…moreso than my doctors. They only believe what they can see, and they always assume they haven’t seen everything.

    We’re holding space for the world’s most boring “high-risk” pregancy ever in the history of the world…and planning for the alternatives, because we live with those alternatives every day. I remember being excited in my first pregnancy to see fingers and toes on the ultrasound…and while that was equally amazing this time, there were so many more things I was looking for. 3 weeks from now we’ll peek in there again, this time to check baby’s heart – to make sure there are no holes – and to check the placenta for blood flow.

    Clearly, baby is growing, even if I’m losing weight still (I have lost enough that I should be able to fit in pants a size smaller, but I’ve given up on regular pants in favor of maternity…so we just hope that baby will continue to grow.

  17. Wow, this post was wonderful, thank you for giving me so much to think about :)

  18. Thanks for this post! Incredible, as usual.
    I so appreciate a criticism of technology that emphasizes the experience, and not the “risks/benefits” per se…

    I too was in a state of disbelief in early pregnancy, and chose to hear the heart beat at around 13 weeks, and it was so sweet, don’t get me wrong, but after all was said and done, I was like, “Well, I already knew that, though.” It’s as though the availability of the technology caused me to doubt, or at least exacerbated my doubt of my body and pregnancy.

    I also consented to a visual ultrasound at around 20 weeks, and this won’t be happening in future pregnancies, unless something weird is going on. Besides the fact that it was just a generally shitty experience, I found it so frustrating how fucking excited everyone else got about it, like they could finally get a piece of me, of my pregnancy. I had health concerns about it, yes, but mostly, I was wary of how the ultrasound is touted as some kind of bonding experience, one that is necessarily mediated, by professionals, as though we can’t experience our own bodies and pregnancies and babies without them. I have no problem with people who are stoked on their ultrasounds, but let’s be real, I certainly am not stoked about it being talked about so widely as THE way to bond with your fetus. I can’t help but wonder if relying on this technology actually makes us LESS able to tune in, know our bodies, experience our own pregnancies in a way that is satisfying and reassuring to us. And how the hell do we get to even find out when everyone and their dog is talking about how precious that gd computer screen is?

    Don’t even get me started on non medical 3D ultrasound….

  19. Excellent post.
    Women stop being viewed as women once a fertilised egg attaches itself to the uterine wall.
    This very act of conception apparently strips our ability to make any sort of choices concerning our own bodies, how they are viewed and what we are and are not permittted to do with them once they in the fertilised state. It becomes a case of every body else knows best. Pregnancy is not treated as natural, it’s a ‘condition’ that must be micromanaged by every one you come in contact with who will have their own opinion on what you should and should not be doing and who will more than likely decide that boundaries and personal space are no longer priviledges you can enjoy. (And it’s all for your own good or just offering friendly advice.)

    I love your pictures. You have a beautiful body. It’s incredibly feminine, the kind I call absolute femaleness.

  20. Like pretty much every pregnant person EVER, I constantly had doubts as to the reality of my condition. I’m not sure I see this as a huge problem, to be honest. Even now, with two children walking around my house, I think of pregnancy as pretty surreal. Implausible, even. Add in the kind of fuzzy amnesia effect of hormones, and it seems even more so. It’s very dream-like, in my recollection, not entirely substantial.

    On top of that, things can go wrong in pregnancy entirely outside of my body’s function. A fetus is a separate biological entity, to a fair extent, and can suffer calamity even if my body does its very best. And so the desire to verify its health is not necessarily symptomatic of a lack of confidence in my body, in my mind.

    That said, I do agree fundamentally that pregnancy, and birth, and maybe even just LIFE are often turned into technological events. I also agree that there is a fundamental distrust of nature, and of people to make decisions for themselves. Even so, there are many nuances and shades of grey in the whole thing. And so, I opt for some tests, and not others, and make my own best choices. And I am grateful for access to caregivers who respect that. I wish everyone had that.

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