Maternity Pants

I’m now 21 weeks, and this past weekend it was time to make the foray into maternity clothes shopping.  At about 18 weeks, I could no longer comfortably button my pants, especially after I’d eaten.  Thankfully, a friend had told me about a band you can buy that goes over the abdomen and top of your pants so that you can keep them unzipped.  Great for the transition period when you’re starting to no longer fit your pants.  I tend to wear dark slacks at work, so buying one in black was great.  I’m sure there are many brands, but here’s a picture of the Bellaband:

Bellaband

The band I bought had a silicone strip along the top of it to help keep it up.  Unfortunately, after the first day of wearing it, I ended up with an itchy horizontal line on my skin.  Good thing is that I could easily turn it upside down and continue to use it without a problem.

The band lasted me for a few weeks, but now it was time to go to the next step and actually buy some maternity pants.  One of my friends had passed along an email with advice from a fashionista friend.  Turns out many of the common brands you’re already familiar with have maternity lines.  Old Navy, Gap, Target, H&M, Ann Taylor LOFT, and J. Crew all have maternity lines.  One friend had told me she liked J. Crew pants a lot for the second trimester.  I think she said they had extra silicone lining inside, which helped keep them up.  Well, given my experience with the silicone in the band and the prices of the J. Crew pants, I decided to check out some more affordable options first.  Plus J. Crew is only available online.

Old Navy and Gap (part of the same company) have select stores where you can try on items.  I had no idea there are several options of maternity pants:

Old Navy

The above is courtesy the Old Navy website (click to enlarge).

I ended up buying one of each between my trips to Old Navy and baby Gap.  Each pair was about $35.  So far I’ve worn each pair once.

The side panel has stretchy elastic just at the sides.  I’m guessing this is probably better for the second trimester, but might not work as well when I’m farther along.  I did find that they tend to sag more easily than I’m used to pre-pregnancy with regular pants.  But this style looks the least like maternity pants, which is nice.  In fact, I was thinking non-pregnant women might like them for comfort, or Thanksgiving meals- think Joey on Friends trying out Rachel’s maternity pants.

The low panel (Gap calls it demi) has a stretchy wide top that goes around the entire waist.  Definitely very comfy, though I did find that when I sat down, particularly after eating, the top of the band would kind of dig in towards my stomach, which was slightly uncomfortable.

The full panel has a stretchy band that pulls all the way up the abdomen.  This is what I’ve seen all of my patients wearing, since they have to bare their bellies for me to listen to the fetal heart tones.  So this was the only option of maternity pants I was aware of till now.  These also sag more easily than pre-pregnancy pants, but otherwise are very comfy.  I tend to get hot easily, and with summer approaching, I do wonder if that’ll be an issue with the extra layer.

For now, it was really just the pants I needed.  For now, looser tops will still work.  Eventually I’ll need to buy tops that will be large enough to go over my pregnant belly.  And I’ll also want to buy dresses and shorts for wearing when I’m outside of work.

Given the popularity of fitness wear as everyday wear like lululemon and the like, I wonder why manufacturers haven’t thought to incorporate these maternity options into regular wear- they would potentially make for very comfy pants.  Or even for men- since men tend to show the waist band of their pants more than women (who can cover up with their top), maybe a variant of the side panel that has a discreet stretchy area of the waist band?

Little Willie

Little Willie

It’s a boy!  So far, we haven’t decided on a name, so we’ve been calling him Little Willie, short for my husband’s last name.  Actually, I’ve been calling him that since before I knew it was a boy.  Above is a pic of Little Willie’s…ahem, little willie (I just crack myself up).  I admit, I scanned myself a couple weeks before the official anatomy ultrasound and found out it was a boy at 17 weeks.  My husband said he was so curious to know the gender that he didn’t mind if he wasn’t there.  So one day at lunch I took the office ultrasound to my own abdomen, and lucky for me he was staying still so I got an easy look.

We had the official ultrasound last week, and got the above confirmatory shot.  My husband very maturely announced to his friend the gender of our baby by saying, “My unborn son’s penis is bigger than yours.”

For whatever reason, I’d had an inclination from the beginning that it would be a boy.  He didn’t want to let out his excitement until it was confirmed, but turns out my husband was really hoping it would be a boy.  For me, not that I’d really care either way, but I think I would’ve just been disappointed if my hunch hadn’t been right.

Expectations

After my last post, I got a comment from someone who may or may not share a household with me.  It included a series of great quotes about expectations.  They are certainly great advice for life in general.  In short, if your reality falls way short of your expectations, you are going to be disappointed.

My expectation that I’d be eating normally in the second trimester turned out to be wrong.  Way wrong.  And a lot of frustration has followed.

But this is the thing- we expectant women have so many (nearly) inescapable expectations placed on us.  Let’s say I expected to be like some of my young, less educated patients who are already obese and unhealthy.  I would then proceed to gain 50 lbs in my pregnancy, eating junk food, fast food and drinking soda regularly.  If that were the case, then I’d say I’m doing quite well right now.

But the reality is that most of us are expected to do better.  We are told to:

  • Avoid alcohol and caffeine
  • Take prenatal vitamins daily, and for good measure, add some fish oil to that
  • Gain 25-35 lbs total (if you started at a normal weight), 0.8-1 lb a week in the 2nd and 3rd trimesters
  • Avoid risky foods like unpasteurized cheeses, deli meats, and bean sprouts
  • Avoid fish high in mercury
  • But eat the safe fish regularly (forget that you may have an aversion to seafood)
  • Eat a variety of foods, and keep a balanced diet
  • Avoid junk food, fast food, sugar
  • Get enough calcium and iron

I’m sure there’s more that I can’t think of right now, but you get the point.  And these are just the dietary recommendations.  I haven’t even gotten into recommendations for exercise, sleep, stress relief, and so on.  The fact is, we have so many expectations placed on us.  This is the advice from reliable pregnancy books, the emails we receive from our healthcare providers, and directly from our doctors.

And then those of us who are perfectionists feel guilty, because inevitably we’re not going to be able to follow all of the recommendations exactly.  As I’ve learned, thanks to no longer feeling normal, I just don’t want to eat healthy foods all the time.  I’m not saying I should give in to every single craving/inclination that I have, but we perfectionists also need to be nice to ourselves and know that it’s ok to be imperfect, or even fail miserably sometimes.  In pregnancy, we’re just doing the best we can in a situation where our body has literally been taken over by another being, and we are no longer our normal selves.

Sandwiches

So much for the honeymoon period.  As I mentioned in my post a couple weeks ago, I thought by now I’d be eating normally.  I had this whole plan of getting the carb craziness out of my system by going a little buck wild when I felt back to normal, and then going back to the Paleo foods.  More so than that, I had this whole grand plan that I’d be eating a variety of foods, starting prenatal yoga and staying fit, etc.  Well so much for that.  At 18 weeks, there hasn’t been significant improvement since a couple weeks ago.

I still can’t eat as much as I used to normally, or I’ll feel sick.  But the food tastes so good as I’m eating it, so inevitably I’ll end up eating too much (which is still less than a normal large meal for me), and not feel so great later.  My weight just in the last day or two is finally creeping past my pre-pregnancy weight.  And this is with me eating carbs all the time.

Lately I’ve been on a sandwich kick.  I love going to the places that have their own freshly baked gourmet bread.  Here in the SF Bay Area, we have Le Boulanger and La Boulange.  Both are places that I can get bread, pastries, and tasty sandwiches.  One has contracted with Starbucks, and the other is next door to Starbucks in my neighborhood.  Not confusing at all.

The problem is the guilt.  Not so much for the sandwich meat, and I do try to get the hot sandwiches.  I feel guilty for eating so much bread and other carbs all the time.  It’s this sickness- I can’t stop!  Ultimately, I give in to my immediate wants- I just eat what I wanna eat.  Which lately usually involves carbs.  It’s like I have an eating disorder- I’m thinking about food all the time.  I finish one meal, and I’m already thinking about what I want to eat next, whenever my stomach stops feeling gross and wants to eat again.  And then I feel guilty for all the carbs, worrying that I’m gonna give myself gestational diabetes and/or make my baby grow too big, but ultimately I still can’t help but give in to the fact that it feels SO GOOD to eat whatever it is that I have my sights set on at the time.  You’d think that the logic of knowing how healthy/unhealthy I eat affects my fetus would help.  But it doesn’t.  I guess now I relate to most of obese America.

Sigh…the guilt certainly doesn’t help things and just makes me feel worse.  I’m not looking for a solution, and frankly right now don’t know what the solution is.  I guess I just needed to vent yet again, after weeks and weeks of this.  Working long hours, feeling sick daily- it just makes for lack of motivation to exercise, and makes me continue wanting carb-laden foods.  I’m just hoping that one of these days I’ll be able eat normally again, or at least have some motivation to start eating healthier.

Listeria

Thanks for the great comments on my last post.  One of the commenters mentioned a book called Expecting Better by Emily Oster.  She’s an economist who decided to look into the research behind advice given to pregnant women.  I hadn’t heard of it before, and haven’t read it, but sounds like she got some flack because some people misinterpreted what she wrote about the research on alcohol.  I guess a small amount is thought to be unlikely to cause fetal alcohol syndrome.  They equated it to her saying it’s ok to drink in pregnancy.

Apparently per the book, the research on listeria in pregnancy is pretty strong.  This is the beauty of being pregnant (and of getting feedback on my blog posts).  Now I’m taking the opportunity to look further into it.  As doctors, we generally learn a lot about things that are common (like low back pain and heartburn in pregnancy), as well as things that are very important (knowing what to do about preeclampsia and postpartum hemorrhage).  This other stuff, like the nitty gritty details of food safety in pregnancy, has not been at the top of my priority list.

Now, with my 50-60 hr workweeks, I still don’t have time to be going through all the research articles.  My go-to source is the website UpToDate, which many of us docs subscribe to so that we can quickly look up what the latest research and practice recommendations are on various topics.  It has its limitations, but I generally find it to be a reliable resource.

The FDA website in my last post says that Listeria monocytogenes is a harmful bacterium that can be found in refrigerated, ready-to-eat foods.  It is unusual because it can grow at refrigerator temperatures, where most other foodborne bacteria do not.  The site says that pregnant women are about 10 times more likely to get listeriosis than other healthy adults, and that an estimated 1/7 of all Listeria cases occur in pregnant women.  They cite the CDC for those stats.

UpToDate says that listeriosis occurs most commonly in the third trimester.  Listerial infection in pregnant women can lead to fetal death, premature birth, or infected newborns.  I won’t list all the bad stuff it can cause, but it’s definitely very serious when it occurs.

But getting back to me and my roast beef sandwich.  More recently, at a work lunch where again sandwiches with cold cuts were being served, I did a non-scientific poll of several of my colleagues about whether they’d ever seen listeriosis.  And none of them had.  The fact is, it’s one of those things that’s rare- like none of us had ever even had a co-resident or colleague that we’d heard of with a patient with listeriosis.  Which is why until now, I’ve never really looked into it.  I’m sure none of us can remember to tell every single pregnant patient to avoid cold cuts and unpasteurized foods.  And even if we do, not everyone remembers or follows our advice 100%.  So inevitably a fair number of our patients are eating these “forbidden” foods, and still very rarely get listeriosis.

According to UpToDate, in the US, the incidence of laboratory-confirmed cases of listeriosis between 2009 and 2011 was 0.29 cases per 100,000 persons. In pregnant women, the incidence was 3.0 cases per 100,000 population. The highest incidence was observed in pregnant Hispanic women (7.0 cases per 100,000 population).  According to the FDA site, this is thought to be from these women eating soft cheeses and other traditional foods made from unpasteurized milk.

Like many things in medicine, we doctors have to be cautious about what we recommend to our patients.  You don’t want to tell your patient it’s probably fine to eat cold deli meat, and then have her be that one patient who gets listeriosis.  But when it comes to my own behavior, I’m willing to take some educated risks.