Pregnancy and Eating Disorders
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It is hard to imagine two medical conditions that are seemingly more diametrically opposed: eating disorders and pregnancy. While one condition is concerned with bringing a new life into the world, the other is focused on the damage or outright destruction of a current life. Though seemingly at odds, this situation does occur.
Because anorexia centers on starvation, the woman’s body usually shuts down the reproductive function. Indeed, one of the primary physical indicators of anorexia is amenorrhea, which is the discontinuation of the menstrual cycle. This is why many women going to fertility clinics right now are either actively anorexic, or have been previously involved in the behavior. Unfortunately, the doctors do not always ask questions about weight, eating habits or exercise history. Ovulation can be induced and pregnancy can occur. With these women, the odds aren’t good. There is a higher miscarriage rate than in the general population, 38% vs. 16%. If the pregnancy continues, often there is poor fetal growth, especially in the third trimester. The baby’s health can certainly be compromised, as can the mother’s. When it comes to reproduction, the female body provides for the baby first. This means that any available nutrition will go to the child, causing the mother’s body to suffer even greater depletion.
For those women who have actually recovered from anorexia, pregnancy can trigger relapse. This can be do to weight gain, the out-of-control nature of the changes that are occurring, or insensitive remarks made by those around her regarding her growing body.
Different from anorexia, bulimia focuses on consuming huge quantities of food, then purging the food from the system, usually by vomiting. These women often use diet products, laxatives and diuretics to an excessive degree. Unlike anorexia, it is difficult to tell exactly who suffers from this disorder by simply looking; this is because these women maintain an average, or even above average, weight. This is important because, despite the fact that menstrual periods may be irregular, they can achieve pregnancy at any time. A full 75% of pregnancies occurring in women with bulimia are unplanned and the rate of early miscarriage is two-and-a-half times higher than with healthy women. A woman could easily still be abusing substances far into a pregnancy without even knowing she was carrying a child. Fortunately, studies show that those with bulimia do tend to binge and purge less often when pregnant and abuse substances less frequently.
Certain obstetrical complications are common to both disorders. Pre-term delivery is 70% higher in eating-disordered mothers and their babies are at twice the risk of having a low birth rate. In addition, there is a heightened risk of still births, breech presentation, and congenital malformation. The baby’s health immediately after birth, as indicated by the APGAR scores, is not as positive as babies born to healthy women.
Once no longer pregnant, the incident of postpartum depression is significant: 60% for those with bulimia; 40% for those with anorexia. Compared to the general population where this condition is experience by only 13-18% of women, these numbers are very high.
The truth is if a woman continues to practice eating-disordered behaviors throughout a pregnancy, it can be very harmful to both her and her child. However, if she can eat well and gain normal weight, the heightened risk of pregnancy complications or birth defects will be negated.
In fact, if she can concentrate on the health of her developing infant and the subsequent desire to be the best mother she can be for her new baby, a woman may discover a new commitment to recovery.
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