Eating Disorders and Advocating for Yourself in Pregnancy

Disclaimer: The information shared in this post has been collected by me from credible sources (shared below). I am not a clinical therapist or medical doctor. I am happy to provide resources to anyone interested in learning more however, it is out of my scope of practice and knowledge to give advice, diagnose or counsel.
Becoming pregnant can invoke many feelings; some expected, and some not. For those who actively have or have a history of an eating disorder, a whole other layer gets added to the experience. Pregnancy can be triggering for these people in several ways: from morning sickness (is this my pregnancy or my ED?) and reflux, to the feelings of losing control over your body. As someone who has struggled with an eating disorder in the past and who works in the pregnancy and birth world, I feel acutely aware of how overwhelming it could all feel. So I did what all doulas do and I read, I listened and I gathered information in the hope that it might help empower people to reach out for the support they need.
Here are a few of the ways I found to help you advocate for yourself in pregnancy if you have a history of an eating disorder.
Set up Your Support System:
Even if you’ve been recovered for years, it is essential that you get your support system in place. Call your therapist and let them know you’re pregnant and would like to check in with them to make a plan to keep you mentally healthy during this time. Consult with a nutritionist to help you with healthy eating during your pregnancy and into postpartum. Find and lean on people who make you feel safe and that you can talk to when you’re feeling triggered. Find support groups in your area. Pregnancy and parenting are unpredictable, setting up these supports either before or as soon as you become pregnant will provide you with the space you need to talk openly about your fears and experiences.
Be Open With Your Care Provider:
It is important to share your history with your care provider. I was shocked to hear of a population based study at a fertility clinic that showed that 20% of patients (1 in 5) met the criteria for an eating disorder and hadn’t brought it up with their care provider. This tells us that 20% of the pregnant population is not getting proper support for their eating disorder during pregnancy. OBGYNs acknowledge they don’t have enough training in EDs . Just as with the point above, even if you’re recovered, being honest with your care provider about your history with an eating disorder allows them to provide you with the appropriate care and provide referrals where needed. This also lets you tell them what you need.
Ask Your Provider To Not Share Your Weight With You:
This will help eliminate the trigger of numbers. Ask your provider if you can face away from the scale while they’re weighing you and request that they do not share or comment on the results unless there are serious concerns to your or baby’s health (and even then, you can request that they leave the numbers out of the discussion).
There is always so much focus on a pregnant person’s physical health and often their mental health is not recognized or validated. It’s important to remember that these two things are not mutually exclusive. Discussions surrounding mental health are becoming less stigmatized, but we still have work to do. I hope that the few suggestions in this post are helpful at providing a starting point in your journey to parenthood.
If you are struggling with an eating disorder and are looking for resources, I encourage you to make an appointment with a trained therapist or your family doctor. You can also visit the National Eating Disorder Information Centre for more resources.