Swelly belly time, but gluten ain't to blame: Coeliac and pregnant

It's safe to say, I'm not getting any younger. I was aged at 30 the other day by one of my patients, and I will take that, but in October 2020, we (my husband and I), decided that it was time to try for a baby. I must add, at the time of writing, I am half way through my pregnancy - 20 weeks to be exact, and this is my humble take on the first trimester as I experienced it.

Lockdown has done strange things to folk, and we're no exception. With fluid travel plans to Japan and Canada hanging in the balance for 2020 and 2021, we thought, "we may as well get cracking now". I was convinced that because of my health issues, conception would take some time, but two months in, we had a very surprising two lines on our first pregnancy test.

"So what do I do now?"

Immediately, there was disbelief, then excitement, followed by absolute fear and trepidation as you realise you struggle to look after yourself most days; never mind someone else, solely reliant on you for survival. After the positive test result, you are very much left on your own or the first 10 weeks - until you get to meet your lovely midwife for the first time, and all your avid Googling can be replaced by more tangible advice. There isn't much out there in the way of coeliac disease and pregnancy

10 weeks of knowing you are already riddled with vitamin deficiencies that you've been trying to manage for years, and the awareness that you still have regular digestive flareups makes for a worrying time, and a feeling of being in the dark with what it may mean for baby. Given my past experience with diagnosis and follow-up care (summarised in 'My so-called coeliac life' blog post if you fancy a read), requesting a blood test for general screening was deemed necessary from my perspective. It's pretty difficult to request a 'general' test at the best of times, let alone during a global pandemic, but I persisted. Surely prevention is better than the cure?

If you're unsure, get checked out

Luckily for me, I have a good GP, and I was eventually able to drop in to a blood clinic for my peace of mind. Then, it was up to me to make sure I was doing everything I could to stay healthy, absorb the nutrients needed for baby during the most "dangerous" time of development, and prevent myself from keeling over when baby took what it needed from me.

This 10 week period of the first trimester is typical for everyone receiving pregnancy care, however, it was a particularly trying time; especially as 'morning sickness' and extreme fatigue took its toll. I had to return to bed for at least two hours after work each day and my mood went downhill for a while. I'm still baffled at the term 'morning sickness', as for me and many others, it tended to last all day long. It got worse at night however, and some days I could only manage two very small meals at very best. When I say meals, I mean generic beige, carby, processed rubbish as that was all I could stomach. All I kept thinking was, how was I going to get the nutrients that baby needed, and how could I have a balanced GF diet when I felt constantly sick and painfully tired? There are so many positive depictions of pregnancy in social media, and I could not find anything that spoke to me about the trials and tribulations of long term conditions coupled with one of the most significant journeys your body will ever make.

"No BS, what about my IBS?"

One joyous thing to occur with all things coeliac from weeks 6 to 10 was hardly any IBS flare ups. I have no idea how, or why, but the added discomfort of an immune reaction on top of my already alien body would not have been funny. Perhaps I was too distracted with nausea? When they did return, however, it coincided with my appetite returning and although it was uncomfortable, I am pleased to say this eventually eased too. Luckily, because my flareups often made me appear to be in my third trimester anyway, the secret I had to keep from many for some weeks could be disguised by the usual "oh Kayley, what have you eaten this time?" scenario. One my work colleagues, family and friends had seen frequently in the past.

The real deal for pregnant coeliacs

When my blood results returned, I was pleased to see that the only real issue was my Vitamin D. And this could be easily remedied with a high dose supplement every day. Due to having coeliac disease, this also automatically places you under the care of a consultant; rather than the more common midwifery-lead pathway. The concerns in real terms are ensuring baby has enough nutrients to grow and develop at the rate normally expected; due to the mal-absorption that coeliac disease is attributable to. Having a consultant with an understanding of this, and a midwife proactively highlighting it at the beginning stages of consultation was reassuring. It also means additional scans to measure the baby's development, and regular blood testing to ensure I am not stripped of everything I need to get by.

I now feel more excited than nervous, and as the sickness has subsided and the balanced diet is prevailing, our fully GF kitchen is enticing me to enjoy cooking and eating for me and baby. Making the announcement online (after our nearest and dearest heard first hand of course), resulted in other GF Mums reaching out and offering support and advice. I look forward to hearing their experiences and top tips living as a coeliac and prospective Mum; doing a very important job. This isn't talked about enough, and I hope that we have more conversations about it.

It has led me to formulate a list of tips myself, and here they are:

Top tips

- Once you have that wonderful positive pregnancy test, speak to your GP as soon as you can. I called the next day to discuss screening, and be persistent if you don't get the answer you initially need. You know what's best for you, and you'll soon know what's best for baby too.

- Sounds obvious, but listen to your body. If you are craving something, eat it. If you need a lie down, do it. If you only want to eat beige rubbish for a while, that's OK. Just make sure you talk to your midwife and they will help you find the balance you need with supplements if necessary.

- Don't beat yourself up. There is so much out there about 'the right thing' during pregnancy, and sometimes you won't always get 7 groups of fruit and veg in a day. Just do your best, and that's good enough.

- Talk to others - especially those with long term conditions, and be honest about your experiences. The more we can be open about things, the more people may benefit in the long run. My midwife also stated she learnt more about the correlation between autoimmune deficiencies and pregnancy in our first assessment appointment, so tell them everything too. Don't hold back, we can only learn more through lived experience. AND, if they don't know, they can't help you.

- Trusted support networks. The first trimester can be a lonely time. You may not wish to tell many folk about your position, many wait until the end of the initial 'danger zone' 12 weeks. Talk to your partner/family and friends you trust, and remember you are doing an incredible thing. You're growing an actual human being!

- Focus on the positives (no matter how few there may be in this time!) It's likely to make you feel rubbish and overwhelmed at times, but also enjoy the lovely moments when you're hungry, or energised, or just plain relaxed. Sorry to 'labour' the point, but again, you're growing an actual human being!

- It DOES get easier. You may be lucky enough to not have many or even any issues during the first stages, or in-fact throughout pregnancy. But many told me when I was glued to the couch or the toilet bowl, "it will get better'. And they were right. Week 12 things really settled down for me, and long may it continue. Everyone is different, but stay hopeful, you will have lovely moments. I mean, the glow thing, I'm still waiting for, but hey! At least I can actually look at, smell and taste a variety of food now without immediately wanting to vom!

If anyone has any thoughts from their own experiences being gluten free and pregnant, or are currently trying for a family, do get in touch or comment below. It would be great to hear from you.

Coeliaclass x

Nope, that's not gluten, that's actually my ever expanding womb. Sh***'s getting real.....

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