Dr. Gitanjali Srivastava is the medical director of obesity medicine at Florida Hospital Celebration Health. She is a physician, a pioneer in the field of obesity medicine, and a first-time mother. Here, she chronicles her experience with pregnancy, childbirth and postpartum challenges.
January 2012. Boston, MA. Life is a journey and everyone succumbs to their own path, some predestined, while others pre-contemplated. Three years ago I met my husband; one year ago we got married; six months ago we moved, bought a house, and I started my fellowship training in Obesity Medicine at Harvard. This year we found out we are having our first baby.
First Trimester. Excitement. News quite hasn’t sunk in. Very quickly thoughts came to mind: first trimester embryology and fetal organ development. I tried to eat fruits, salads and yogurt. I felt nervous with my first visit at the obstetrician, but the waiting room and the staff were so welcoming and I felt at ease as a patient. I had not gained any weight during the first trimester.
Second Trimester. Appetite returns. My husband thought it weird that I could eat a whole plate of pasta, a sandwich and ice cream and still be hungry. I justified this insatiable hunger by telling him, “Well the baby is growing!” (And so was I). Typical healthy pregnancy weight gain for a woman of normal weight before pregnancy should not exceed 25-35 pounds. This is based largely on David Barker’s work: maternal nutrition affects fetal development which persists into adulthood. Barker was a scientist who linked adult diseases like obesity, diabetes and heart disease to mom’s nutrition when the baby was still developing. There are genes, activated by mom’s in utero environment, which affect the baby later in life.
Third Trimester. Weight gain continues. Glucose high. Swelling. Snoring during nighttime!? I resorted to eating steamed vegetables and nonfat Greek yogurt for lunch for several weeks. This seemed to stabilize the weight gain (sort of). I had gained well over 45 pounds. I tried walking as much as I could (without huffing).
Shock of Delivery. October 24, 2012. My husband went white when the nurse turned around and asked him, “Which leg would you like to hold?” I was in labor for several hours as the baby’s head seemed to be stuck. So, when the labor and ward team decided to step out momentarily and wait, that’s when the baby surprisingly popped out. Within a few seconds, a crew barged in, including the pediatric and neonatal ICU team. The baby was not breathing.
2-6 Weeks Post-Partum. We were at the pediatrician’s office. I had problems with breastfeeding. The baby would not latch on properly and he was jaundiced. As a pediatrician, I was worried about kernicterus due to high bilirubin levels. I was so exhausted and sleep deprived. There was too much work at home. My meals were not all that great either. As an internist, I knew this was not helpful for the anemia after delivery. I could not even find time to exercise, much less walk without hurting. As a new mother, I felt vulnerable. I started crying when I saw the pediatrician.
12 Weeks Post-Partum. Going back to work. Extreme separation anxiety from baby. I still had not lost my pregnancy weight. At my last check up, my doctor had told me that I may never return back to my pre-pregnancy weight. I wondered why I was not scheduled a follow up in several months time for a weight recheck.
15 Months Post-Partum. Enormous changes occur in infant and maternal nutrition during the first year of life, which may be inadequately addressed by the medical community. Type of delivery, multiple gestation, stressors, sleep deprivation, breastfeeding, changes in circadian rhythm, hormonal shifts, pregnancy physiology, genetic potential – these all affect a woman’s body. Understanding these factors is critical to targeting an effective strategy for pregnancy-induced weight gain. Treatment strategies need to be individualized for expectant and new mothers, keeping these physiological changes in perspective. As an obesity expert, I am excited to implement the Mommy-Me program at Florida Hospital Celebration Health, designed specifically for women and their little ones before, during and after pregnancy to address obesity, weight gain during pregnancy, and postpartum weight retention.
To this day, I have not regained all of my muscle tone, but I was able to reach my pre-pregnancy weight. My 15 month old, the new love of my life, still keeps me awake most nights.
For more information or to make an appointment with Dr. Srivastava, “Dr. S.,” visit ObesityMedicineandSurgery.com or call 407-303-4986.