Pregnancy Questions

[kids]

I am pretty sure everybody knows that my oldest is pregnant with my first grandbaby...she will be 20 weeks on the 18th (same day as the US for sexing).

Andrea had her pregnancy test done at Planned parenthood, they gave her some "How to have a healthy baby" type brochures and she started following them immed: no alcohol, went from daily caffene of a pot of coffee + pop + iced tea + chocolate to almost none (she chooses carefully and less than daily), went from 2 ppd smoking to 2-4 cigs/day, limits tuna to 1 can/wk, is very careful about seafood, washes her fresh fruits & vegies, bought prenatal vitamins etc. In other words, this pregnancy may have started out unexpected and unwanted but she has from day ONE been determined to have as healthy a baby as possible.

All of her prenatal care is coming from a "welfare" clinic staffed by CNMs...not the best option but it is the only one available. They have to do the referral up to an OB/Gyn.

I/we have some questions/concerns that have been blown off by the clinic dispite my going to an appointment with her to press for answers...

I had gestational diabetes with several pregnancies..."they" say it is relevant to her pregnancy-but have done no testing.

I had inutero exposure to real estrogen (not DES)..."they" say it is relevant to her pregnancy-but have done no testing.

I had 7 (yes-seven) pregnancies lost at 14-20 weeks due to incomp cervix (probably d/t the estrogen) "they" say it is relevent...

She has had 2 ER visits for lady partsl bleeding with no problems found on work up(blood/US/exam)-we suspect caffene(2 glasses of pop and a candy bar the day after having a mocha frappacino)...the clinic has not done a vag exam since her 1st appointment at 10 weeks.

One thing this clinic does (that I am not sure how I feel about) is they start doing drug testing Q month at 16 weeks and they report you to childrens services for refusal and positive tests. Fortunately drugs are not an issue for Andrea-but she feels a little violated.

I realize that by virtue of what I do as a Nurse I tend to be a bit paranoid. But does sound (to anyone eles) that she is being a little bit undermanaged?

An additional question tho less of a concern...pre-preg Andrea was 5'3" 140#) the CNM told her that they like to see a weight gain of 1#/week...she has gained 19 pounds...at her 1st WIC appointment this past week she was told to slow down on her eatting, that she had gained all of the weight she is "allowed" for the pregnancy (gee thanks, like the kid isn't already struggling with her body image)...what is a "normal" weight gain in pregnancy?

I don't expect anyone to go out on a limb and give advise...I would just like your opinions of all of this based on your experiences.

Thank you all (in advance). I am not a lot of help to her as I have no clue what a "normal" pregnancy is like...and don't want to scare the h*ll out of her.

-nancy (& Andrea)

[OBNURSEHEATHER]

WINKY, WINKY, WINKY, WINKY.........

I just love boys! Although I have to admit that 3 generations of women does sound like an awesome thing.

Heather

[kids]

Between you and Brownie we are so jinxed.

Andrea has started working on boy names...she figures she wants a girl so bad it will of course be a boy.

None of us (her friends included) can "see" her with a boy.

Girl name so far: Kaylee, Madison or Taylor-middle name Nicole

Boy names so far: Taylor

[Brownms46]

oooh my...I didn't even realize I wrote grandson..OOops..:) Changing that to granddaughter..:chuckle

[WICMissy]

I just wanted to say that I have many clients at my WIC clinic that prefer CNM to OBs due to the more personal care that they get. Our "welfare" type clinic that you referred to in our town is very highly regarded and I have not heard ONE negative reaction from a client post-partum.

As a WIC certifier, I understand that some staff might not have the best counsing techniques regarding weight issues. However, what the certifier is looking for is "risk" criteria to be able to keep your daughter eligible for the WIC program (WIC is NOT an entitlement program like Food Stamps or Welfare). So, a client that gains over 7# in a month during pregnancy is said to be at higher "risk" and can be kept on the program. According to our WIC guidelines, someone with your daughter's height and weight would probably be advised to gain between 15-25 pounds total by the end of her 40 weeks of pregnancy.

It's so great that your daughter has been able to make so many healthy lifestyle changes for herself and her baby. I hope she's able to give up smoking all together.

Another thing about WIC - our office gives free breast pumps to women who need them, and really nice ones for ladies that are returning to work or school. Check out your clinic! Also, if you are concerned about her weight and/or diabetes, most WIC clinics have staff RDs and your daughter could request to be seen by one. Good luck!