Pregnancy and motherhood are wonderful and challenging times for women; physically, emotionally and psychologically.

A pregnant woman’s wellbeing and nutrition is critical. If a mother’s nutrition is not sufficient, both baby and mother can be adversely affected.

Pregnancy can also be a stressful time and can place a lot of pressure on someone who already has mental health concerns. If you have an eating disorder and fall pregnant, it is very important to seek support as soon as possible for the benefit of yourself and your baby.

Before falling pregnant

Eating disorders, particularly anorexia, affect fertility by reducing your chances of conceiving. Many women with anorexia or bulimia have irregular or absent menstrual cycles. If you are planning pregnancy, it is highly recommended that you get your eating disorder under control or in remission before falling pregnant. Try to eat balanced meals and maintain a healthy weight for several months before falling pregnant. Take important supplements such as folate for at least one month before falling pregnant, and during the first three months of your pregnancy.

Risks of eating disorders in pregnancy

Risks for the mother

• Malnutrition Dehydration and possible cardiac irregularities (particularly with bulimia)
• Taking longer to heal from caesarean, episiotomy or tearing
• High blood pressure and gestational diabetes (particularly with binge eating disorder)
• Depression during or after pregnancy
• Anaemia
• Increased risk of miscarriage

Risks for the baby

• Malnutrition
• Premature birth
• Low birth weight (particularly with anorexia)
• High birth weight (particularly with binge eating disorder)
• Poor development
• Feeding difficulties
• Respiratory distress

Managing your health during pregnancy

It is relatively common for women with eating disorders to be able to manage their eating disorder while they are pregnant, but relapse after their baby has been born. Other women find the changes to their body during pregnancy very distressing, and struggle with their inability to fully control their eating and weight gain. Food aversions or cravings can also be troublesome if you have an eating disorder.

It is extremely important that you are upfront with your health provider about your eating disorder, and that they fully understand your situation and treat you with sensitivity and care. Your pregnancy may be classed as “high risk” and you may be monitored very carefully to manage your health and that of your baby.

Consider a team approach to your pregnancy – an obstetrician/ gynaecologist, mental health professional and a nutritionist or dietitian. A mental health professional or counsellor can help with any concerns you may have around weight gain, body image, food and becoming a parent. A dietitian can inform you about nutritional requirements for yourself and your baby during pregnancy, and help you with appropriate meal plans.

Tips during pregnancy

• If you find yourself worried by your weight gain during your checkups, stand backwards on the scales and ask your health provider not to share the number
• When you are pregnant, it seems that everyone you know (and many you don’t!) feel it’s OK to comment on your body. Don’t dwell on their comments, even if they are insensitive.
• In some cases, pregnancy may trigger binge eating. Make sure your food intake is healthy in quality and quantity
• If you are taking anti-depressants for your eating disorder, make sure your health provider knows you are pregnant so your medication is appropriate
• Remember your weight gain is caused by a growing baby
• Avoid magazines with unrealistic post-pregnancy weight loss stories.

After your baby has been born

It is important to seek support after your baby has been born. Parenting a baby requires a great deal of time and energy, which will be affected if you are giving time and energy to your eating disorder.

Remember to look after yourself as well as your baby. Many women with eating disorders are affected by postnatal depression, and it is very important to seek help if you are feeling vulnerable.

There is an immense societal pressure on women to lose their pregnancy weight as quickly as possible after their baby has been born. Many women feel they need to start exercising excessively and dieting immediately, and this can trigger old eating disorder behaviours.

Try to take the time to enjoy your baby without focusing on your weight or body shape. Just as your body changes as you grow older, it will change after pregnancy. Be proud of what your body has done, not just what it looks like.

Breastfeeding

Many women with eating disorders are not sure if they are able to breastfeed. There is no reason you can’t breastfeed; in fact breastfeeding provides your baby with the best start in life. If you are able to breastfeed, remember that it is normal to need more food while you are breastfeeding. Restricting your calorie intake while breastfeeding can affect the quantity and quality of your breastmilk.

If you choose not to breastfeed, don’t feel guilty. Your baby is loved and cherished, no matter what feeding method you choose. If you are able to get your eating disorder under control, you are more likely to have a normal, healthy pregnancy and a healthy baby.

Download a fact sheet on eating disorders and pregnancy