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May 12, 2017

Trigger Warning: Pregnancy After an Eating Disorder

Eating disorders affect many lives and can have long-lasting physical, psychological, and emotional consequences. Fortunately, many former ED sufferers will go on to live “normally”—pursuing higher education, careers, love, and family. Many recovered/recovering women who have struggled with eating disorders in the past will experience the numerous joys and pains of being pregnant and becoming mothers.

The Looking Glass Foundation

May 12, 2017

By Lauren Kresowaty

Eating disorders affect many lives and can have long-lasting physical, psychological, and emotional consequences. Fortunately, many former ED sufferers will go on to live “normally”—pursuing higher education, careers, love, and family. Many recovered/recovering women who have struggled with eating disorders in the past will experience the numerous joys and pains of being pregnant and becoming mothers.

What we may not always anticipate are the numerous pregnancy-related triggers we may encounter as we navigate this new state of being, including triggers brought on by peers and care providers, and by our own constantly-changing bodies.

Our Bodies

For many former sufferers, pregnancy may actually offer a reprieve from post-ED stresses and pressures. Pregnancy and childbirth can help many women gain a new sense of respect for their bodies and the amazing things they are capable of (like nurturing a new human life). Some women find that the responsibility of carrying a developing fetus overrides their own anxieties about their bodies’ appearance. And many others simply find comfort in the fact that pregnancy is one of the very few times in a woman’s life that western society actually “allows” her to grow/be larger free from guilt (the idea that anyone needs societal permission to be comfortable with their own body is persistent and problematic, and deserves closer examination; but that’s for another time). All this is to say that pregnancy can, in fact, be a really nice time for people who have struggled with eating disorders.

However, for those of us whose recovered/recovering state relies on a hard-won peace between the self and the body, achieved through the feelings of capability and well-being that accompany a specific exercise regimen/physical practice, nutritious diet, or a general sense of health and balance, the physical and hormonal changes that accompany pregnancy (especially early pregnancy) may feel like a betrayal. If you enjoy potentially high-impact or contact sports (like alpine skiing or rugby), you may have to give them up for the next 9+ months. Fatigue and nausea (sometimes severe) may prevent you from being as active as you’re used to, or prevent you from eating the way you want to (in my first trimester, my stomach couldn’t tolerate my favourite vegetables or fruits, and I had to subsist mostly on bland pastas and dry Cheerios). Despite your best intentions, a lot of how you will feel (and what you can do and eat) during pregnancy is going to come down to your hormones. These hormones will fluctuate and impact you in unpredictable ways, which can be very hard for women who crave control, or who have only recently learned to trust their bodies.

Our Peers

Nowadays, most of us should know that making unsolicited comments on women’s bodies is in poor taste. This polite notion flies right out the window, however, as soon as women become noticeably pregnant (or as soon as they tell their friends, family, colleagues, etc. about their pregnancy). A lot of the hoopla and excitement is harmless (folks trying to guess the gender of your fetus by how you “carry”, for example), but much of it is not. Comments about your belly (whether people think you are too small or too big for your gestational week), your size (whether you’ve gained weight on the rest of your body or not), your face (whether you’re “glowing” or “look tired”), intimate questions about how your body is handling your pregnancy and about your “cravings”, and the increased scrutiny you, your body, and your nutritional choices will be under can be very upsetting for any woman, never mind a woman with an ED history. Once again, the troubling idea of “societal permission” may come into play, with friends expressing jealousy that you’re “allowed” to eat whatever and as much as you want (even though that’s not necessarily true, depending on your pregnancy and medical condition). 707

While some one-off remarks (“Are you sure there’s just one in there?”) can occasionally be shrugged off, you may need to be assertive with your friends and family if you find their comments are getting to you. You have every right to say “That’s actually a bit inappropriate/rude,” or to gently remind your well-meaning but nosy mother/grandmother/aunt/in-law that you and your caregiver have everything well in hand, and that you are not interested in discussing your pregnancy and personal health with them. After all, while you are temporarily housing another being for a few months, your body belongs to YOU, and both you and your baby need for YOU to be okay, regardless of what others think.

Care Providers

For the most part, I’ve loved my midwifery team. I feel informed, cared for, and supported as I approach delivery and the big changes that lie ahead. That being said, care providers in pregnancy are, generally speaking, focused mostly on one aspect of you (that baby you’re carrying and how your body is handling it), and may not have as comprehensive an approach to you as a whole person. I was asked about and disclosed my ED history in my first midwifery appointment, so this information is in my file notes, however, since at the same time I also declared that I’m “fine now”, I haven’t found that any of my midwives have been particularly tuned in to this issue, especially when it came to discussion about gestational diabetes, which affects between 3 and 20% of pregnant women.

Fortunately, I did not screen positive for gestational diabetes, but I did still receive mini-lectures about cutting back on my sugar intake, including dire warnings about the “hidden sugars” in my favourite breakfast foods (I tried it their way and switched up my breakfast menu for a while, but I felt awful so I went back to what I know works for me). Although it was all very gentle and well-intentioned, I never take kindly to advice or edicts about “good” or “bad” food, and I resented being placed in a position where I was once again judging myself for and feeling guilty about my nutritional choices. For those women who do develop gestational diabetes, unfortunately the treatment/management of their glucose levels (which includes a fairly restricted diet) can be very triggering, especially if you’re trying to move away from micro-managing your food. Be sure to reach out for help if you’re not okay.

As with any care provider-patient relationship, you may sometimes need to be assertive and forthright with your care provider, and ask for what you need depending on where you are in your recovery journey. If you feel your doctor or midwife’s advice or admonitions are triggering ED-related behaviours and anxieties, you can ask them to dial it back. If they are unable or unwilling to work sensitively with your post-ED needs, you may want to switch care providers. You can also ask for referrals to specialists/therapists who are familiar with eating disorders and can help you navigate through the various minefields pregnancy may place in your path. Remember: resources do exist and you deserve to access whatever you need to be healthy.

The Good News

Pregnancy is not all gloom and hidden triggers! Pregnancy hormones can also bring about some very welcome (albeit temporary) changes as well. Personally, I’ve never felt as beautiful as I have since half-way through my second trimester—my skin is great, my hair is full and shiny, and for some reason I’ve barely needed to shave my legs (a bonus since they’re getting increasingly difficult to reach). I also have this big beautiful belly that says to the world, hey, look at me! My body is doing something amazing! Though every pregnancy is different, what binds them together is the truly miraculous biological event taking place in our bodies. Just one more reason they, and we, deserve our respect and care.

Lauren is a Vancouver writer and blogger, and currently a graduate student in the MA in Liberal Studies program at Simon Fraser University. She is excitedly awaiting the birth of her first child.

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