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Pregnancy after an eating disorder

For Eating Disorder Awareness Week, I reflect on how my history with anorexia has affected my pregnancy. Read on for the story.

"It only takes a reminder to breathe, a moment to be still, and just like that, something in me settles, softens, makes space for imperfection. The harsh voice of judgment drops to a whisper and I remember again that life isn’t a relay race; that we will all cross the finish line; that waking up to life is what we were born for. As many times as I forget, catch myself charging forward without even knowing where I’m going, that many times I can make the choice to stop, to breathe, and be, and walk slowly into the mystery." - Walk Slowly, By Dana Faulds

Last year’s Eating Disorders Awareness Week was the first time that I shared my silent rebellion publicly and candidly through writing. I would never say that I was healed from the battle wounds that anorexia left at the time that I wrote this article. Yet I had certainly distanced myself enough from my eating disorder to approach the topic more objectively and compassionately than I could have done in the past. However, since writing the article, I’ve had to come face to face with some of the demons of my disorder as I entered into a dramatic life change: pregnancy.

Being pregnant after an eating disorder makes me a terrible mother. At least, that was my greatest fear before entering my journey to motherhood. The first doctor with whom I shared my history with anorexia provided some unsolicited advice: I would clearly struggle with getting pregnant, and I should stop running immediately if I hoped to reproduce. I wasn’t trying to have a child at the time, so I chose not to heed her advice. But she did plant a seedling of terror in my mind.

Because I had semi-starved myself for 5.5 years as an athlete, I didn’t know if I could become pregnant. And because I had my period medically induced by the pill for a decade, I didn’t know if I could even have a period naturally. When I went off the pill last summer, I was shocked when my first natural cycle was a perfect 28 days. I was even more incredulous when I found out I was pregnant a mere three months later – after a single week of throwing precaution to the wind.

Beneath the initial surprise that I was expecting was immense relief that I could reproduce; beneath my relief was pure wonder that my body still had the capacity to conceive after so many years of potentially jeopardizing my journey to motherhood; and beneath the sense of wonder was a pang of worry that I would miscarry this fragile life if I didn’t mother my own body.

Yet at six weeks pregnant, I was already becoming overwhelmed by all the rules and restrictions that society places on pregnant women. I started building a wall of mental notes in my brain: No wine. No coffee. Okay, actually some coffee is fine, but think about the tiny baby who’s also ingesting all those jitters. Chocolate also contains caffeine, so don’t eat that. But chocolate contains a hearty dose of magnesium, so actually do eat it in moderation. No herbal or caffeinated teas. Only peppermint and ginger teas, but even those haven’t been proven to be safe…

No leftovers. No runny eggs. No soft cheeses. Only pasteurized drinks. Avoid probiotics. But some yogurt might be okay. No fish. Wait no, fish is a good source of DHA and EPA, so eat it twice each if you care about your baby’s brain. But pay attention to the type of fish, where it’s from, and how it’s caught so you don’t kill your baby from mercury poisoning. No sushi. No smoked salmon. No tuna. Actually, maybe just a can of tuna per week if it’s sourced the right way. Take DHA pills if you don’t eat fish. But supplements are never as good as the real thing, and researchers still don’t know if DHA pills can do more harm than good…

Prenatal vitamins every day, or your poor baby will have spina bifida if you weren’t already taking them, you terrible mother.

In the first pregnancy book I picked up, the author boasted about her raw vegan pregnancy during which she only gained 14 pounds. 14 pounds! To put this into perspective, most women gain between 25 to 35 pounds during pregnancy. Being underweight to begin with, I thought there was no way I would make it through the first trimester without miscarrying if I heeded her advice. Although I was admittedly triggered by her restrictive dietary guidance, I read on, noting where to cut back on sugar and making grocery lists of superfoods.

Then, around week 7, I experienced the best thing that could possibly happen to abolish any lingering thoughts of restrictive eating: nausea. I know what you may be thinking. Wouldn’t nausea eating more difficult to manage, not less? Initially, yes. But more significantly, being nauseous made me not care one morsel about all the prenatal dietary guidance that I had so poorly digested.

It quickly became apparent to me that I didn’t need to binge read prenatal nutrition information. The odd foods that I craved during the first trimester were so wildly different from my typical comfort foods that I couldn’t possibly fall back into old eating patterns or try to manufacture new, idealistic ones. Just as I did when I was recovering from my eating disorder, I had to relearn to eat by listening to my body.

My body would clearly tell me what it did or did not need to eat. And what I truly needed was not always “healthy” foods. More often than scarfing down salads, after spells of feeling sick, what I felt that I intuited that needed was something calorie-dense – mac and cheese, potato chips, or chocolate chip cookies. Call me a terrible mother, but I had a visceral sense that eating “junk food” was better than eating no food if I wanted to keep this baby.

I had already gained 2 pounds at my 8-week appointment, so my weight didn’t concern my doctor. However, the blemish on my medical record did. “I see you have a history of an eating disorder. That’s not a problem anymore, is it?”

It felt odd to me that my eating disorder, which had once calculated my every move and represented my core identity, had been reduced to a measly smudge on a perfect medical record.

Was she truly gone? I still hear the echo of my eating disorder each time I have a nagging voice of perfectionism in my head. Each time I’m overwhelmed with order or inundated with self-doubt, I feel the chill of her shadow emerge. When I look in the mirror lovingly at the round perfection of my growing belly, I sometimes catch a glimpse of her ghost, glaring disgustedly at the other parts of my body that have grown and softened with it. And yet I’ve learned to acknowledge her, to thank her for caring for me, and set her aside for the time being. Sometimes I brush her phantom off compassionately, other times vengefully, I’ll admit.

“No,” I said earnestly, knowing that it had to be the truth. “It’s not a problem.”

I cringed, letting the words hit the stale air and waiting for the doctor to overmanage me with her subjective instruction.

She paused, waited, and abruptly moved onto the next topic. I visibly relaxed in my chair, thankful that the doctor chose not to feed my eating disorder’s hungry ego. Once more, I watched her spindly ghost slip into the shadows.

Now at 23 weeks pregnant, Eating Disorders Awareness Week happens to fall on the same week that I've had to let go of running. How ironic that after years of striving for a perfect body - starving myself to be razer thin, but still secretly dreaming that I'd someday develop D-cups (or marry a plastic surgeon) - miraculously sprouting breasts is what's stopping me from running. I have a newfound amazement for how any regularly-proportioned woman can run at all let alone without painful chafing. But more importantly, I'm reminded of how great a role running plays in my homeostasis - and how triggering it feels to stop.

Since I was 15 years old, I have continued to repeat the myth in my head, as if it were a mantra: If I don't run, I can't eat. I've been lovingly gentle with my pace and mileage throughout my pregnancy, knowing that even a few miles can provide the emotional regulation I need to allow me to ingest my food without guilt. And now this. The inevitable day I knew would come coincides with the phase of pregnancy during which I'm supposed to be gaining the most weight. Will I be strong enough to listen to my body rather than get tangled up in my embodied obsessions? Will I even be able to eat?

Call it mindfulness, call it interoception, call it healing, or maybe call it love for the little snowpea growing inside me. Whatever you label me, I'm constantly ravenous, much more so now than for any of the marathons I've trained for before. Thank. Goodness.

In so many ways, pregnancy can be a process of learning to trust our bodies to lead us through the truly phenomenal feats that they are designed to accomplish. Instead of drowning in dietary directives, we can learn to set all the information we're fed aside, to accept the skeletons in our closets as pivotal parts of our stories, and to respect our beautifully imperfect bodies as our ultimate guides.



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