Pregnancy and Eating Disorders

Pregnancy and motherhood require a great deal of strength, both physically as well as psychologically and emotionally.  During pregnancy, the growing baby receives all its nourishment from the mother’s body.  When stores of carbohydrates, proteins, fats, vitamins, minerals and other nutrients are low, a woman’s body will drain them to support the growth and development of the baby.  If reserves are not sufficiently restored through healthy eating, the mother can become severely malnourished, and this in turn can lead to depression, exhaustion and many other serious health complications.

The average woman gains between 25-35 pounds during pregnancy.  While this amount is required for a healthy pregnancy, for women with eating disorders, having to gain this amount can be very frightening.  Some women with disordered eating are able to more easily cope with weight gain during pregnancy because they see it as a sacrifice for an important cause. But others may plunge into deep depression as they struggle with the tension between the idea of weight gain and their body image issues. Most women with eating disorders fall somewhere between these two extremes.

The Relationship between Specific Eating Disorders and Pregnancy

Women with anorexia nervosa are underweight and may not gain enough weight during pregnancy.  They risk having a baby with abnormally low birth weight and related health problems.  Women with bulimia nervosa who continue to purge may suffer dehydration, chemical imbalances or even cardiac irregularities.  Pregnancy heightens these health risks.  Women who are overweight due to binge eating are at greater risk of developing high blood pressure, and gestational diabetes.

Risks for the Mother: Poor nutrition, dehydration, cardiac irregularities, gestational diabetes,     severe depression during pregnancy, premature births, labor complications, difficulties nursing, post-partum depression.

Risks for the Baby: Poor development, premature birth, low birth weight for age, respiratory     distress, feeding difficulties, and other perinatal complications.
Professionals recommend that women with eating disorders do their best to resolve eating-disorder related weight and behavioral problems before they attempt to get pregnant.  It is important to consult with your physician, counselors and/or registered dietitian before attempting to get pregnant.  Women with eating disorders who become pregnant are advised to seek specialized medical and psychological help. Pregnant women with eating disorders should inform their obstetrician about these problems and may require high-risk obstetrical care.

REMEMBER: Eat healthy, well-balanced meals and maintain a healthy weight for several months before conceiving and throughout pregnancy to protect the health of yourself and your baby!

What If I Become Pregnant While Struggling with an Eating Disorder?

Though having an eating disorder may decrease the chances of pregnancy, sometimes women with anorexia or bulimia do become pregnant.  When this happens, steps should be taken to protect the health of the mother and the baby.  Professionals can address the specific needs related to pregnancy and disordered eating only if you are willing to be completely honest with them about your struggles.

If you are pregnant and struggling with disordered eating:

  • Be HONEST with your prenatal health provider regarding past or present struggles with an eating disorder or disordered eating.
  • Extra appointments with your prenatal health provider may be necessary to more closely track the growth and development of your baby.
  • Consult a nutritionist with expertise in eating disorders before or immediately after becoming pregnant.  Work with the nutritionist throughout the pregnancy to create a plan for healthy eating and weight gain.  Continue to see her post-partum.  She can help you return to a normal weight through healthy means.
  • Individual counseling during and after pregnancy can help you cope with your concerns and fears regarding food, weight gain, body image and the new role of mothering.
  • Attend a support group for people with eating disorders.
  • If your doctor approves, attend a prenatal exercise class. It can help you practice healthy limits to exercising.
  • Other classes on pregnancy, childbirth, child development and parenting skills can also be helpful in preparing to become a mother.
  • Allow your prenatal health provider to weigh you.  This information is essential to track the health of your baby.  If you would prefer not to monitor your weight gain, ask your doctor about standing on the scale backwards and instruct them to not share the number with you.
  • Under certain circumstances, for example if you suffer from severe depression or obsessive- compulsive problems, you may require medications for these conditions even during pregnancy.
  • Tailor your schedule to your pregnancy instead of trying to keep your regular schedule; cut back on commitments and activities if necessary.

The skills and support of a multidisciplinary team of health care providers and of family and friends can help you deliver a healthy baby and protect yourself.