Dedicated to my son…
Black, White, and In-between
He sees himself in black and white
Rarely any colors in-between
He doesn’t know what they mean
But he’s still trying
He sees the sky in black and white
No shades of blue
Or different hues
It’s just day and night
But he keeps trying
He sees the world in black and white
Sometimes he’s in fright
Fears the darkest of night
Like there’s no end in sight
Can’t take the colors when it’s too bright
But if it’s a question of might
He’ll keep trying
He’ll try to see between these fixed colors
The white of light
The black of night
To the in-between of gray
Where he seems to stray
But the longer he stays
More colors come out into the warmest of day
Then fades in a cold way
So he’ll keep on trying
Hope he finds those bright colors to help see
himself, the world, the sky
As he grows to reach the utmost high
And take in all that gleams
Just to reach his dreams
There are many things I don’t understand
There’s much from me that life demands
But I can do some things
Like smile, sing, and dance
I won’t give up, so give me a chance
If you give me acceptance back,
Then I’ll do better than white or black
I’ll solve this puzzle that’s a part of me
Even if the pieces are all you see
I’ll show more colors of the in-between
To shine brighter than red, yellow, blue, or green
I just know there’s a light, an end in sight
But it’s not as simple as black
By Lisa Malabanan-Vasquez
Support Educate Advocate Love
We’ve all heard the phrase “I’m eating for two.” Even though you’re eating for two, or three, the recommended weight gain during pregnancy is based on your height and weight. The two values together calculate a measure of body fat, which is called Body Mass Index (BMI). So it’s important to know your pre-pregnancy BMI to understand how much you should put on.
It’s easy to believe that you can eat anything when you are pregnant. Perhaps the craving for chili dogs or ice cream in the middle of the night is OK because “the baby wants it.” Depending on your BMI and the average distribution of pregnancy weight gain for a single or multiple gestation, women must be careful not to put on too much or too little. The amount of weight gain outside the normal recommendations may lead to complications. Getting the right amount and eating the right foods help support a healthy pregnancy.
Here is the average distribution of weight gain in pounds for a baby:
Baby = 7 ½
Placenta = 1 ½
Breasts = 2
Uterus = 2
Amniotic Fluid = 2
Blood Volume = 4
Fluid Volume = 4
Fats, Protein, Nutrients = 7
TOTAL POUNDS = 30
Most women don’t need to increase calories in the first trimester. According to the Institute of Medicine, women only need an extra 340 calories a day in the second trimester, and 452 calories a day in the third trimester. If you are having twins, then the recommendations for weight gain are a bit more.
Health care providers advise a steady weight gain for a healthy pregnancy outcome. Women who get more than the recommended amount may have a large baby, and are at higher risk of having a premature birth or cesarean section delivery. However, women who don’t put on enough weight may have a low birth weight or premature baby.
The chance of having pregnancy problems is higher for overweight and obese women. These women are at increased risk for health issues like gestational diabetes, preeclampsia, deep vein thrombosis, cardiac and respiratory complications, or death. The probability of a miscarriage and a recurrent miscarriage is more likely for an obese woman than a normal weight woman.
Babies of obese women are at higher risk for congenital abnormalities (neural tube defects, cardiac problems, cleft lip or cleft palate), macrosomia, or fetal death. Macrosomic babies are at danger for birth trauma like shoulder dystocia. Premature babies have an increased chance for lung and heart complications after delivery. Large babies are more likely to have obesity in childhood and as an adult with health issues.
Talk to your health care provider about managing your weight throughout the pregnancy. Eat healthy foods, exercise regularly (if not contraindicated), and go to your prenatal appointments to keep your pregnancy and weight on point.
Here are some helpful links and resources:
Centers for Disease Control and Prevention Adult BMI calculator
Institute of Medicine Healthy weight gain during pregnancy
Baby Center Pregnancy weight tracker
March of Dimes Eating healthy during pregnancy
- Institute of Medicine
- American Journal of Obstetrics and Gynecology
- American Congress of Obstetricians and Gynecologists
- American Pregnancy Association
- Mayo Clinic
- Association of Women’s Health, Obstetrics, and Neonatal Nurses
Are you thinking about having a baby?
If the answer is yes, then start planning the right way! Taking care of your health is the start to a healthy pregnancy. Preconception care is your chance to address any medical problems you have or screen for potential risk factors that may affect your baby before getting pregnant. The baby’s major organs and body systems form in the first 8 weeks of pregnancy. Your physical and emotional health influences fetal growth and development. So don’t be afraid to schedule a preconception checkup with your physician.
What should you expect at your appointment?
The medical practitioner will ask you questions and discuss your health history:
- Reproductive – Periods, previous pregnancies, birth control, Pap smears, STD’s and vaginal infections affect a woman’s ability to conceive.
- Medical/Surgical – Medical issues like diabetes, asthma, hypertension, or thyroid disease can complicate your pregnancy. Reasons for surgeries, procedures, or hospitalizations can affect the management of your prenatal care.
- Medications – Some prescription and over-the-counter medicines, vitamins, supplements, or herbs could be harmful to the developing fetus or contraindicated in pregnancy.
- Family Health – The health history of you and your partner’s family helps the doctor screen for medical problems that could be inherited or often seen in certain ethnic groups. He/she may refer you to a genetic counselor who can discuss genetics, birth defects, or other medical conditions that run in families.
- Emotional and Social – Disclosing a history of mental health issues like depression, eating disorder, or domestic violence helps the practitioner give the appropriate referral for counseling.
- Lifestyle – The habits of you and your partner such as smoking, drinking alcohol, drug use, diet, exercise, stress, or caffeine consumption could affect fertility and/or pregnancy. Stopping harmful habits may reduce the risk of fetal complications and birth defects.
- Home and Workplace Environment – Possible hazards like exposure to X-rays, cat feces, mercury, lead or solvents are dangerous and affects your ability to conceive and maintain a healthy pregnancy.
- The doctor might perform a standard physical, especially a pelvic exam.
- Vital signs such as height and weight to calculate your BMI, blood pressure, and/or urine sample to screen for glucose and protein may be recorded.
- Your health care provider may order lab tests as indicated like rubella, hepatitis, RPR, HIV, CBC, Pap, or carrier screening for genetic diseases and other conditions.
- If you have a medical condition such as diabetes, thyroid disease, hypertension, or asthma, the practitioner may refer you to a specialist for management.
- He/she will discuss your menstrual cycle to determine the time you are more likely to get pregnant.
- The physician will prescribe a prenatal vitamin with folic acid.
- He/she may suggest lifestyle changes like weight loss for obesity or increasing caloric intake for being underweight, quit smoking or drinking, stop medications that are harmful to the baby, updating your immunizations, and avoiding stress.
Women should be healthier before conceiving to prevent problems that could affect the pregnancy and the baby later. The preconception visit with your medical provider is a great opportunity to learn about your health and the right steps to plan for a healthy pregnancy.
For more information, here are some helpful sites about preconception care. Good Luck!
acog.org – Good health before pregnancy FAQ pdf
marchofdimes.org – Your checkup before pregnancy
marchofdimes.org – Family health history form
womenshealth.gov – Preconception care
babycenter.com – Preconception checklist
- ACOG – The American Congress of Obstetricians and Gynecologists
- March of Dimes
- Baby Center Expert Advice
- Office on Women’s Health, US Department of Health and Human Services
- Cleveland Clinic
- AAFP – American Academy of Family Physicians