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  #1   ^
Old Wed, Nov-03-10, 13:32
mfish mfish is offline
Senior Member
Posts: 510
 
Plan: general LC
Stats: 191/140/133 Female 5'3"
BF:
Progress: 88%
Location: USA
Default My MW's worrying me about my WOE!!!

So I am still happily LC'ing through this pregnancy and beginning my 3rd trimester. Out of my hands, I've ended up at a new provider's office. I have to see all the midwives there, seen 2 so far. Like the 2 providers before, they are against my WOE . Kinda funny too since they are considering my pre-pregnancy weight as putting me in the obese category and have said I should only gain 10-15 pounds all total.

It's always about the ketones in my urine. I've tried to throw off the strip test, even went and bought some myself so I could practice the timing of how long it takes for me to burn glucose... ate 2 donuts last night, thought I'd be good, was this morning, but oh no, that little square was nearly purple again this afternoon (pregnancy sure does speed up the metabolism!!) Today I got to hear about how harmful the ketones are to the fetus' brain since they pass through the placenta.

Which has caused me to revisit this thread which I love:

http://forum.lowcarber.org/showthread.php?t=315682

I've never peed on strips before, but I'm sure if I had it would have been showing purple this whole pregnancy. Like I don't have a million other things to worry about, I've been cycling due to adding carbs in and out, worried that may not even be healthy. I was keto-adapted for at least 6 months prior to pregnancy.

I guess I am just frustrated... Going into this pregnancy I'd researched as much as possible and decided to keep to my LC WOE, deciding it would be the healthiest. I don't mind that my providers don't accept how I eat, but it scares me hearing things like I am harming my unborn child because of how I eat . I think it may be a struggle to stay out of ketosis if I chose to do so, as I don't consume much dairy or any grain or sugar (save the occasional "cheat"). That leaves me with starchy tubers and sugary fruits, just as bad as a donut, IMHO.

And this bit about harming the fetal brain with ketones... can anyone confirm, is that from studies/observations made from diabetics experiencing ketoacidosis during pregnancy? Thanks
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  #2   ^
Old Wed, Nov-03-10, 14:15
jschwab jschwab is offline
Senior Member
Posts: 6,378
 
Plan: Atkins72/Paleo/NoGrain/IF
Stats: 285/220/200 Female 5 feet 5.5 inches
BF:
Progress: 76%
Default

I studied this alot because I was in heavy ketosis my whole pregnancy (due to starvation, not a ketogenic diet). The doc was not worried in the least. The midwives were, but not because the ketones can harm that baby (that is simply not true) but because if you are burning fat, potentially you are releasing toxins stored in your fat into the blood stream and introducing them to the baby. Later I decided even that concern is really just theoretical, since the placenta provides good filtering. Don't worry, find a paper that says ketosis is fine in pregnancy (most practitioners say it's so) and stand your ground. It's your body.
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  #3   ^
Old Wed, Nov-03-10, 14:34
mfish mfish is offline
Senior Member
Posts: 510
 
Plan: general LC
Stats: 191/140/133 Female 5'3"
BF:
Progress: 88%
Location: USA
Default

Thanks for the reply, I am starting to feel a little better about this now... Everything I have been finding in reference to harming the baby with relation to ketones is not a result of the ketones themselves, but comes from the state of dehydration and/or malnourishment that creates the ketones, neither of which I am experiencing.

I will look for a good write up and put it into my chart next time I go, hopefully it will be read and considered with open mindedness. It's funny because I had already considered doing this, I was just holding out in hopes that they would trust me trusting myself with my WOE for the health of baby and my own body. The first MW I met with noted that I declined nutritional counseling not once, but twice both times she offered (recommended) it.

*sigh* I have the feeling my WOE will be a negative focal point with each I meet with, but I am crossing my fingers it will get better.

Last edited by mfish : Wed, Nov-03-10 at 14:43.
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  #4   ^
Old Wed, Nov-03-10, 20:11
jschwab jschwab is offline
Senior Member
Posts: 6,378
 
Plan: Atkins72/Paleo/NoGrain/IF
Stats: 285/220/200 Female 5 feet 5.5 inches
BF:
Progress: 76%
Default

Are you having a homebirth or are these nurse midwives? That's all very annoying.
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  #5   ^
Old Thu, Nov-04-10, 15:29
mfish mfish is offline
Senior Member
Posts: 510
 
Plan: general LC
Stats: 191/140/133 Female 5'3"
BF:
Progress: 88%
Location: USA
Default

This is our first pregnancy, so I decided to use a birthing center, not quite comfortable enough for homebirth. I went through quite a harrowing ordeal a few weeks ago at the hospital, so I want to avoid a hospital birth if it is at all possible. These are all nurse midwives, and I can't help but wonder if I am their first LC pregnancy with the reaction I've encountered so far.

Although I'm not allowing any of this to interfere with how I am enjoying my pregnancy, I can certainly understand how this type of situation can serve as part of motivation to deliver with a lay midwife at home or even have an unassisted birth. My only other option would be a hospital birth which I won't consider and could still end up with the same "mindset" regarding my WOE.

I agree it is all very annoying! I've had a super easy pregnancy so far and am praying for a smooth uncomplicated delivery. If that in addition to good health of mom/baby won't be enough to at least encourage a little more open-mindedness to the LC WOE, then I will definitely be finding an LC friendly practitioner long before the next little one comes along!
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  #6   ^
Old Thu, Nov-04-10, 16:01
katoman's Avatar
katoman katoman is offline
Counterweight
Posts: 1,664
 
Plan: VLC/Moderate Protein
Stats: 291/251.4/150 Female 63.25"
BF:72%/62.5%/26%
Progress: 28%
Location: NW Louisiana
Default

How can ketones be harmful to the baby's brain when it's ketones that the brain prefers as a food source?
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  #7   ^
Old Thu, Nov-04-10, 19:28
Nancy LC's Avatar
Nancy LC Nancy LC is offline
Experimenter
Posts: 25,843
 
Plan: DDF
Stats: 202/185.4/179 Female 67
BF:
Progress: 72%
Location: San Diego, CA
Default

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  #8   ^
Old Thu, Nov-04-10, 19:47
jschwab jschwab is offline
Senior Member
Posts: 6,378
 
Plan: Atkins72/Paleo/NoGrain/IF
Stats: 285/220/200 Female 5 feet 5.5 inches
BF:
Progress: 76%
Default

If you don't mind me asking, which birth center is it?

Remember, it is never too late to go with a homebirth if you get increasingly more uncomfortable. I know of people who switched, literally, the day before they gave birth. A homebirth midwife might have the same concerns, but they are more likely to respect your decisions.
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  #9   ^
Old Thu, Nov-04-10, 20:00
mfish mfish is offline
Senior Member
Posts: 510
 
Plan: general LC
Stats: 191/140/133 Female 5'3"
BF:
Progress: 88%
Location: USA
Default


yup yup... I recall coming across that last week and then read it over again earlier. The link to Jay Wortman's blog contained within also provides for some interesting reading as well, in "American Dietary Guidelines Reviewed:"

http://www.drjaywortman.com/blog/wo...lines-reviewed/

I've been overloading my brain since I've decided to actually get a hard copy of something to put in my file. I think this write up by Robb Wolf is extremely informative regarding the entire issue:

http://robbwolf.com/tag/low-carb-pregnancy/

I'm going to be done stressing about it for today, it isn't worth any further degree of distress. My only major concern with this is that the MW's may be in fear I will have a complicated delivery due to my WOE and find some reason to make me deliver in the hospital, so hopefully they will trust what information I provide to them and be open minded to my and baby's health.
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  #10   ^
Old Thu, Nov-04-10, 20:06
mfish mfish is offline
Senior Member
Posts: 510
 
Plan: general LC
Stats: 191/140/133 Female 5'3"
BF:
Progress: 88%
Location: USA
Default

Quote:
Originally Posted by jschwab
If you don't mind me asking, which birth center is it?

Remember, it is never too late to go with a homebirth if you get increasingly more uncomfortable. I know of people who switched, literally, the day before they gave birth. A homebirth midwife might have the same concerns, but they are more likely to respect your decisions.

It's the Midwife Center in Pitt. The midwife I'd been seeing is permanently moving to another state this month, so I had to switch.

I was surprised to have met with this and everyone else I've talked to has had wonderful experience with this place. I am just hoping they will drop the whole diet issue from the forefront of everything, as it takes away from other things I feel are important issues as well.

Ah... even with having a good midwife for homebirth, not knowing how I will handle the birth makes me a little wary too (noise factor) since I live in an apartment building, lol.
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  #11   ^
Old Thu, Nov-04-10, 20:49
jschwab jschwab is offline
Senior Member
Posts: 6,378
 
Plan: Atkins72/Paleo/NoGrain/IF
Stats: 285/220/200 Female 5 feet 5.5 inches
BF:
Progress: 76%
Default

I had all my babies at home in a rowhouse - no problem at all, but I completely understand about the apartment building. I am in PA, too. I don't think they will say you need a hospital birth just due to your diet - they are just harrassing you now.
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  #12   ^
Old Thu, Nov-04-10, 23:11
MstyDragon MstyDragon is offline
Senior Member
Posts: 2,164
 
Plan: atkins pre 1998
Stats: 000/000/000 Female 64 inches
BF:need to calculate
Progress: 27%
Location: Vancouver, WA
Default Low glycemic load diet study

Am J Clin Nutr. 2010 Oct 20. [Epub ahead of print]
Effects of a low-glycemic load diet in overweight and obese pregnant women: a pilot randomized controlled trial.
Rhodes ET, Pawlak DB, Takoudes TC, Ebbeling CB, Feldman HA, Lovesky MM, Cooke EA, Leidig MM, Ludwig DS.

Division of Endocrinology, Children's Hospital Boston, Boston, MA.
Abstract
BACKGROUND: The optimal diet for pregnancy that is complicated by excessive weight is unknown.

OBJECTIVE: We aimed to examine the effects of a low-glycemic load (low-GL) diet in overweight and obese pregnant women.

DESIGN: We randomly assigned 46 overweight or obese pregnant women to receive a low-GL or a low-fat diet. Participants received carbohydrate-rich foods, fats, and snack foods through home delivery or study visits. The primary outcome was birth weight z score. Other endpoints included infant anthropometric measurements, gestational duration, maternal weight gain, and maternal metabolic parameters.

RESULTS: There were no significant differences in birth weight z score or other measures of infant adiposity between groups. However, in the low-GL compared with the low-fat group, gestational duration was longer (mean ± SD: 39.3 ± 1.1 compared with 37.9 ± 3.1 wk; P = 0.05) and fewer deliveries occurred at ≤38.0 wk (13% compared with 48%, P = 0.02; with exclusion of planned cesarean deliveries: 5% compared with 53%; P = 0.002). Adjusted head circumference was greater in the low-GL group (35.0 ± 0.8 compared with 34.2 ± 1.3 cm, P = 0.01). Women in the low-GL group had smaller increases in triglycerides [median (interquartile range): 49 (19, 70) compared with 93 (34, 129) mg/dL; P = 0.03] and total cholesterol [13 (0, 36) compared with 33 (22, 56) mg/dL, P = 0.04] and a greater decrease in C-reactive protein [-2.5 (-5.5, -0.7) compared with -0.4 (-1.4, 1.5) mg/dL, P = 0.007].

CONCLUSIONS: A low-GL diet resulted in longer pregnancy duration, greater infant head circumference, and improved maternal cardiovascular risk factors. Large-scale studies are warranted to evaluate whether dietary intervention during pregnancy aimed at lowering GL may be useful in the prevention of prematurity and other adverse maternal and infant outcomes. This trial is registered at clinicaltrials.gov as NCT00364403.
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  #13   ^
Old Thu, Nov-11-10, 22:45
missaec's Avatar
missaec missaec is offline
Senior Member
Posts: 2,834
 
Plan: modified Atkins
Stats: 252.4/171.2/166 Female 66 in
BF:40.74/27.63/25
Progress: 94%
Location: Norcross, GA
Default

Grrr. I really wish I would have known all this when I was pregnant. It would have saved me a heck of a lot of weight gain.
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  #14   ^
Old Fri, Nov-12-10, 06:50
katoman's Avatar
katoman katoman is offline
Counterweight
Posts: 1,664
 
Plan: VLC/Moderate Protein
Stats: 291/251.4/150 Female 63.25"
BF:72%/62.5%/26%
Progress: 28%
Location: NW Louisiana
Default

missaec, I wish I had known ALL of the information that is available now! It would have saved me not only the massive weight gains during my pregnancies, it would have also saved me YEARS of torture via the military Weight Management Programs.
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  #15   ^
Old Thu, Nov-18-10, 19:51
mfish mfish is offline
Senior Member
Posts: 510
 
Plan: general LC
Stats: 191/140/133 Female 5'3"
BF:
Progress: 88%
Location: USA
Default

Well, I caved today... had all my papers printed out to put into my folder and I didn't do it, only out of worry I'll annoy one of the practitioners that I have yet to meet and possibly worsen the situation where the issue may not have come up at all. The good thing is that my "diet" was not on the discussion list at all today so I am very happy with that. Looking forward to things hopefully being more normal for the rest of my meetings.

I shall still bring with me the articles each time in case something IS mentioned again though
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