Confused about fundal measurement vs. weight gain

greeneyed_bride

Yesterday, I had an appointment with my OB. She measured my belly, and based on my fundal height, I am measuring at 31 weeks (3 weeks ahead of where I actually am.) So far in my pregnancy, I have gained 20 pounds total, which puts me right on track to gain the 25-35 pounds that my doctor told me she wanted me to gain. But when I asked her about my weight/fundal height, she said that I maybe needed to be just a little more careful with what I'm eating and maybe eat a fewer carbs and sugars (which is obviously good advice for anyone, but the way she said it made me feel like I'd gained a little too much.) She said that she wanted to avoid me having a really big baby.

When I came home and talked to my husband about it (he's an ER doctor), he pointed out that I literally haven't gotten bigger ANYWHERE other than my belly and boobs, and that fundal height is measuring your uterus, not your fat. He said that because I'm thin, the baby basically has no place to go but out, which could explain why I'm measuring a little bigger. Last night a friend of mine who is an ER nurse and a new mom was over for a little party I had, and when I told her what my OB said, she said essentially the same thing that my husband said. Neither of them seemed to think that I needed to adjust my diet based on my weight and fundal measurement.

My OB is an excellent doctor, I feel very comfortable with her, and I have no intentions of finding another doctor. I'm just curious as to what other people think. If my weight gain is on track, why would my doctor suggest altering my diet based on my fundal height?

(For the record, I do eat a lot of carbs, but I also eat fairly healthy foods including a lot of fruit and lean protein. I had my gestational diabetes screening last week and passed with an 81, so my body definitely doesn't have any problem processing sugars.) 

pinksweetpea2

I think your Dr. response was over the top.  It is very rare for a woman to grow a baby that is too big- especially when you do not have GD.  Actual macrosomia is a medical that is associated with babies under 11 lbs and usually due to untreated GD.

Fundal height measurements should be taken with a grain of salt.  They can be off for many different reasons including your providers method and the position of the baby.

My MW said that 2 cm in either direction is considered normal, so you are really only off by 1 cm...and as I said there is probably a very logical explanation for this other than jumping on the "big baby" bandwagon.

I know you really like and trust your care provider and that is a GOOD thing, however I think you should also make sure to inform yourself about unnecessary interventions that are performed every day because of the fear of a "big baby-" which in most cases are unnecessary and not research supported opinions.

GL

GotMilk9

Sorry your OB made you feel like you were gaining more than necessary I think your DH and friend are right though, that some people just have a bigger bump than others, despite healthy eating. All other indicators (weight, GTT) show that you're healthy, so i would really try not to worry about it. 

My friend was the same way and ended up delivery a 6lb1oz baby at 37 weeks. Sometimes i think our bumps aren't a very good indicator of how big baby is goingto be, its just how our body grows - embrace it as best you can, cause you know that you're healthy and that's what counts! 

pevila

My doctor is also giving me a hard time with my weight, but I passed my glucose test with 96/130. I have an appointment today, let's see how that goes. I think I've gained 4 pounds since my last visit, but I swear I'm not eating anythink aout of the ordinary. I have enough to worry about! When the Dr. told me about my HUGE weight gain I just couldn't sleep, but now I've decided I'll continue eating normally, and if I gain weight, then I gain weight! I swear I'm all belly and boobs, and EVERYBODY tells me so (I even still fit in my pre pregnancy pants!).

 

I think it's time to compare ourselves with others, or that our doctor compare us with others, I just think that every body is different!

greeneyed_bride

Thanks for your input, ladies! I did have a brief period of feeling like I was abnormally huge, but between DH, my friend, and you guys, I'm feeling better. I plan to try to be more conscious of how much sugar I'm eating, but this is a particularly difficult season in which to do that!! (Actually, the party I hosted last night was a cookie exchange! Of all the rotten timing. Of course I was hosting a party that was all about sweets the same day my doctor told me to cut back on them!)

MigenMigen

Maybe your OB was saying to lay off carbs to prevent bloating that could lead to larger measurements?

 I'd ask her to clarify the next time you see her if there is still an issue. 

christinak22

Just another personal testimony about fundal height...my friend was measuring about 3 weeks too big and went more than a week over her due date and gave birth to a 9 pounder--so not huge for being a week over due.  She was the same with her last pregnancy and her doctor told her it may have been because she carried more amniotic fluid than most women.  There are plenty of explanations besides just having a huge baby in there.

That is weird that your doctor told you to lay off carbs when you don't have GD, though... 

ClaireBear90

pinksweetpea2:

My MW said that 2 cm in either direction is considered normal, so you are really only off by 1 cm...

This! My MW said the exact same thing.

92405bride

I'm sure it just depends on the doctor. I was measuring at 30cm at 27 weeks at my appt today and my midwife said it was just because of the baby's position (breech currently). I've also had a few appts where I've gained more than "normal" - the only thing the midwife did was check to make sure I wasn't swelling. I also totally didn't care or even ask anything about my weight gain though since I knew overall it was fine because I gained nothing until 20 weeks due to puking. Currently I'm up 17lbs so pretty close to where you are and there was no concern expressed at all by my midwife today.

I agree that if you expressed concern about weight gain, perhaps she was just responding to that. I personally would just totally ignore that comment completely - it sounds like you're eating and gaining completely normally.  You'd probably have to eat a LOT to really impact the size of your baby  by more than maybe an ounce. I know several people who have gained upwards of 60+lbs and had 7-8lb babies.

Kyle523Nicole

I think your OB was confused as to what you were asking her.  The fundal height shouldn't have anything to do with weight gain - it's supposed to give her a better look at where you are measuring week wise (if you were measuring 31 weeks - that means that your fundal height was 31cm.  That's how they do that - so basically if you are actually 28 weeks, your fundal height was 3cm larger than what it should be)

As far as her response - she was probably thinking that you were asking her if you SHOULD be concerned, and it sounds to me like she gave you the generic "watch what you eat, be careful with calories, focus on fruits and veggies" speech to calm you down.  

I think you're doing great - and honestly, I wouldn't worry a bit. 

RNmommyof2

My doctor told me on Tuesday that measuring fundal height is archaic and not very reliable. Baby's position can affect it a lot. I wouldn't worry.

2chatter

I've been concerned about this, but in reverse, as well.  I'm going with the archaic/inaccurate theories...

 My fundal height is 2 cm less than my LMP or EDD based dates.  Baby is measuring a few days ahead in size.  I'd think that if baby is big and fundal height is low, there's some sort of space issue, but my OB said he's not worried.  I'm not worried, but it IS something I have been wondering about.

Jen&Louie

That is ridiculous, your DH is right. Your fundal height could be ahead just because of how the baby was positioned at the time of the measurement and likely has nothing to do with your weight gain, especially because you are right on target.