I've been thinking quite a bit about the effect of pregnancy on recovery from an eating disorder. I have had clients whose resolve to feed themselves adequately, or stop purging, increases dramatically once the pregnancy is discovered, as would seem to make sense. But I am currently dealing with a young woman whose symptoms have become much worse; she has just been hospitalized in order to stabilize her medical situation, and hopefully, help her gain strength and motivation to continue caring for herself on an outpatient basis. So why is pregnancy a positive motivation for some and a significant stress for others?
One factor, I believe, is the extent to which the pregnancy was planned and is welcomed. Nicole, Erin, and Sarah, just to name a few, either desired children and sought the pregnancy, or adjusted happily once the pregnancy was confirmed. They are also in their mid to late twenties, in stable financial situations, and therefore more prepared for parenthood. My client, by contrast, is only 23 and on her third pregnancy in as many years. Although she and her husband seem quite happily married, they have really had very little time to establish themselves as a couple before the children began to appear.
Another issue for my client involves her medication. As soon as the pregnancy was confirmed, her OB doctor took her off her psychotropic medications - understandable and likely necessary. However, without the support of the medication she has not been able to control her irrational thoughts. Although she recognizes, at times, that it makes no sense to throw out the food in her house, at other times she is unable to fight back against the paranoia. While in a therapy session she can admit that her slightly rounding belly is a good thing, indicative of the growing life within; at home she can only see that she is getting fat.
Finally, I believe my client may be more isolated, lacking the positive support environment that supports and even rejoices in new life. Her own parents offer little encouragement. She has had precious little time to establish her own friends.
Perhaps for any eating disorder sufferer, pregnancy is both a positive AND a negative, as it can be for any individual. I would think it would be normal for feelings to range from joy to despair to ambivalence or frustration. If you are a professional who has treated individuals with eating disorders who became pregnant, I'd welcome your thoughts and comments. Until next time, Gail
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