Eating Disorders and Pregnancy
From LoveToKnow Pregnancy
If you have an eating disorder and are thinking about having children, you need to learn about the risks of eating disorders and pregnancy. The good news is that women who have had anorexia or bulimia can still get pregnant and go on to have normal, healthy babies.
Weight and Conception
Being very underweight can prevent you from being able to conceive. Women who are very underweight generally do not ovulate regularly. They may stop getting periods altogether. Often, simply returning to a normal weight will make a woman fertile again.
Women who binge eat may be significantly overweight. These women may also have irregular ovulation. Losing weight on a healthy diet can return fertility to normal.
Eating Disorders and Pregnancy: What Are the Risks?
Pregnancy is a challenging state for a woman's body. Your natural fluid balance changes. You need more calories, plenty of vitamins, and lots of protein. Eating disorders and pregnancy make a dangerous combination, both for you and for the baby.
Complications for the baby include premature birth, low birth weight, and breathing problems. The baby may also have trouble regulating his/her temperature and blood sugar. The rate of miscarriages and stillbirths appears to be higher, too.
Problems for the mom include dehydration, irregular heart rhythms, labor complications, and trouble nursing. One study suggests that moms with eating disorders are more likely to need to deliver by Cesarean section and to suffer from postpartum depression. In addition, if a woman's body is malnourished, it will divert energy and vitamins to help the baby grow. That means that, even if the baby is doing well, the mom is putting her own body at risk.
The Importance of Folic Acid
Folic acid, also called folate, is especially important for preventing birth defects. You need to start getting enough of this vitamin before you get pregnant. Doctors usually recommend starting about three months in advance.
Low levels of folate are linked to serious neurological birth defects including spina bifida and anencephaly. Babies with spina bifida may be unable to learn to walk, or to control their bowels and bladder. Anencephaly is a birth defect involving the brain. These babies do not survive.
You need at least 0.4 mg of folic acid per day to help reduce the risks. Some women need more, so check with your doctor.
Pregnancy as a "Cure"
Many women are able to control their eating disorders when they decide to become pregnant. In fact, studies suggest that in about one fourth of cases, the new responsibility for a baby helps a woman overcome her eating disorder.
Unfortunately, a substantial number of women are unable to stop their unhealthy eating habits even during pregnancy. An eating disorder is not a choice; it's a medical problem. That means that many women find they can't just "decide" to stop, even if it puts the baby at risk. A woman may even make healthy food choices during her pregnancy, but revert to unhealthy habits after the baby is born.
If you have an eating disorder and are thinking of getting pregnant, your best choice is to get your health under control first. That way, you'll have the emotional and psychological tools you need to stay healthy during the pregnancy and throughout your child's life.
Self-Image and Pregnancy
During pregnancy, your body goes through a lot of changes. Many women enjoy seeing their bellies grow as the baby develops. They accept a certain amount of additional weight gain as part of the pregnancy. Women with eating disorders, though, are sometimes very upset about seeing their bodies change.
Often, a misconception about what looks normal is part of having an eating disorder. Women who are very thin think that they still look fat. For these women, a growing pregnant belly and the associated weight gain can be disturbing. Although intellectually they may know that the changes are normal, these women still feel unpleasantly "fat." They may feel frightened and wonder if they will be able to lose the weight after the baby is born.
At the Doctor
If you have an eating disorder and pregnancy is in your plans, tell your doctor. It's common for women to try to hide their eating disorders from their obstetricians. But, it's your doctor's job to help keep you and your baby safe. Knowing what's really going on with you is the only way he/she can do that.
You'll need to be weighed at each prenatal visit, and if you're not gaining weight normally, you'll need to talk about your diet. Most women need to gain about 25 pounds during pregnancy, although more gain may be necessary if you were underweight before becoming pregnant. If this worries you, consider talking with a therapist before and during the pregnancy. You'll be able to share your fears and get some guidance on keeping yourself and your baby healthy.
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