A lump has mysteriously appeared – weight gain or worry?
By week 14 you are truly into your second trimester. And while some women flourish, others find this a time of great anxiety. You know you’re pregnant, but there’s few physical changes that really show this to the outside world. Friends may have thought you looked a bit under the weather or maybe that you’ve put on a bit of weight, but they won’t have thought much is out of the ordinary. Meanwhile, you know you have a precious tiny life inside you and every twinge of discomfort or slight change in your well-being can feel like the scariest thing in the world.
Week 14 won’t be the same experience for every pregnant women, but here one mum gives her perspective on the early part of the second trimester.
What’s that I can hear?
A strange thing happened to me when I was 14 weeks pregnant. I quite literally went to bed with a flat stomach and woke up with a bulging lump low down on my right hand side. Since the morning sickness had worn off my appetite had gone crazy and I was aware that I’d been putting a bit of weight on, but this didn’t feel like a baby bump. I made my husband inspect it and, apart from commenting that it looked ‘weird’ (thanks husband!) he didn’t quite know what to make of it either. So, being the nervous first time mum that I was, I phoned my midwife and she agreed to see me that afternoon.
I’d kept a detailed weight and temperature diary before I got pregnant and just so I didn’t look like a complete fool, I sat down and wrote out all the increases in my weight, when I’d had what symptoms and then I tried to recall a rough food diary. As a group fitness instructor I’d kept a careful eye on what I ate and drank. I relied mainly on carbohydrate-rich food to boost my flagging energy levels and ward off morning sickness when it struck me and I’d developed a sweet tooth as part of my pregnancy, so a fair number of bowls of Coco Pops also made it onto my list.
By the time I got to my midwife that afternoon, my mysterious lump had disappeared. Of course it had – typical – bang on the time that I was in front of a professional who could have examined it.
My midwife laughed, “Don’t worry,” she said, “these babies will make a nuisance of themselves.”
I described the lump, what had happened (including my husband’s helpful diagnosis) and mentioned my extra worry that it had only been on one side.
“It sounds like your uterus has expanded enough to be pushed over the top of the pubic bone when your bladder is full,” she explained. “That would be the reason why it happens overnight. It’s nothing to worry about, it’s just your pregnancy advancing normally.”
“Let’s see if we can get a heartbeat,” the midwife said. “Often we can’t detect it this early on but I’ll give it a try.” She pressed the sonicaid against my tummy and almost immediately a sound very like thundering hooves filled the room. “There we go! That’s perfect.”
“It sounds very fast?” I said nervously.
“It’s supposed to be, the fetal heart beats at roughly 180 beats per minute, that’s double the heart rate of you or I. We actually worry if the heartbeat is slower.” The midwife then weighed and measured me and took some blood and I left, very relieved and excited to have heard my baby’s heart beating away.
My midwife phoned me five days later. She needed to see me again apparently.
“It’s nothing awful,” she said, “I just need to have a bit of a chat with you.” Obviously I was pretty anxious, but I tried to console myself that nothing wrong with the baby could have been detected from a blood test at this early stage. And it turned out that I was right.
“I’ve asked you to come in because we found high glucose levels in your blood. Have you been eating anything out of the ordinary?”
“No,” I said.
“Have you put on more weight than you’d expect?”
“Well – yes. But I thought that was normal?”
“It can be, but sudden extreme weight gain can also be a sign of gestational diabetes.”
I have to confess that I had never even heard of gestational diabetes. Alarm must have showed in my face because the midwife immediately put my mind at rest, “It’s really nothing to worry about. It just puts you at risk of having a larger baby. Diabetes is when the pancreas can’t make enough insulin to keep up with demand, which leads to much higher glucose levels in your blood. This then filters through to the fetus and can be responsible for you having a bigger than average baby.”
“Is there any treatment? Do I have to do anything?”
“We need to do another blood test, an oral glucose tolerance test, so you can’t eat for twelve hours before. We always do pregnant women first thing in the morning so you just fast overnight – don’t worry you can have water. They will take some blood, give you a glucose drink, and then take some more blood after two hours.”
“And then, is there medicine to take? Are there any risks?”
“Gestational diabetes is normally controlled through your diet, you’ll need to cut out sugary treats and excessive carbohydrates. Sometimes you might need medicine and/or insulin injections, but for this stage of pregnancy it’s nice and early so we’ll probably just keep an eye on your progress. The main risk is having a large for dates baby. If you’re worried, or if you have any questions, then just give us a ring, anytime.”
When I got home I was sorely tempted to read absolutely everything I could find about gestational diabetes, but I managed to persuade myself to step away from Google. Instead I decided to wait and see what gestational diabetes meant for me.
It took quite a long time for me to adjust to thinking, and properly fuel my body, like a diabetic. My blood sugars were erratic for a while and then I swapped to wholewheat bread and pasta, brown rice and wholewheat tortillas. I ate a lot of nuts, beans and lentils, plus cheese and Greek yoghurt and I tried to drink a glass of soy milk every day. The Coco Pops went in the bin (well, actually, they went into my husband!).
In my case, I was lucky and managed to avoid medication and insulin injections. I can’t really imagine what my pregnancy experience would have been like if I’d had to learn to inject myself daily. But, if I’d had to, then I would have just had to get on with it. After all – if something is in the baby’s best interests, then the path that you should take is generally quite clear.