Maternal Mental Health and Eating Disorders

It’s Maternal Mental Health Week in the UK this week, so in this latest blog, we hand the pen to Abi Reynolds, to share her thoughts.

"An awarenss week for maternal mental health is undoubtedly a much-needed opportunity to highlight the importance of supporting mothers and their families when mental health issues arise during the vulnerable perinatal period.

There will rightly be a lot of focus on conditions such as postnatal depression and anxiety, and postpartum psychosis - devastating illnesses which can turn families’ lives upside down.

Ensuring there is awareness, understanding and support for those experiencing these mental illnesses is hugely important in keeping women and their families safe and well.

But just for a moment, I’d like to turn a spotlight onto the issue of eating disorders in the perinatal period.

“Wow, I didn’t even think it was possible to have anorexia when you’re pregnant!”

“Well, you just need to park the eating disorder until after the baby’s born.”

“Don’t worry; if mums don’t manage to eat enough during pregnancy, their babies just start eating them.”

“You said you’re struggling to eat enough, but the baby’s growing fine so you’re clearly managing ok.”

“Look, if you’re that worried about gaining too much weight, we could maybe induce you a few weeks early…get you back to exercising sooner.”

“No, I don’t think you need to worry about your eating or running. You were a healthy BMI when you conceived so we’re not about to tell you to eat more or exercise less. That’s the opposite of what we’re here to encourage.”

“Oh come on, you’re an intelligent woman, you know you need to eat properly for the baby.”

These are just some of the many comments I personally received from health professionals two years ago during my second pregnancy, when I found myself deeply and terrifyingly entrenched in an eating disorder.

Midwives, consultant obstetricians, GPs – the people who were in charge of making sure that my baby and I stayed well during these exciting, challenging and nerve-wracking nine months – consistently demonstrated a complete lack of awareness, education and understanding of these debilitating and extremely dangerous illnesses.

I’m not here to bash the NHS – I have been hugely fortunate to receive excellent care from my local eating disorder services and have been supported by the most wonderful health visitor throughout my treatment – but comments such as these do highlight the additional challenges that expectant and new mums with current or historical eating issues face.

I won’t go into the nitty gritty of what my particular eating disorder looked like during pregnancy – anybody struggling with disordered eating will have their own unique bundle of behaviours, thinking, fears and feelings – but I will say that the guilt, shame, terror and isolation I experienced during those nine months and beyond were like nothing else I had experienced previously.

Here I was with this innate, ferocious, hormone-enhanced, protective love for my unborn child, and yet every single passing day brought an ever more seemingly-insurmountable drive to eat less, move more, and punish myself.

I had been suffering with an eating disorder for a few years before this pregnancy (though it had remained undiagnosed, thanks to the system’s obsession with relying on BMI to assess someone’s mental health), but my illness ramped up during this period of having to watch my body stretch, grow and change in a manner so utterly repulsive and reprehensible to my eating disorder, and the number on the scale determined to increase.

I felt hopeless; utterly and overwhelmingly hopeless. If a mother’s love for her unborn child wasn’t strong enough to curb my urges to starve myself, how could I hope ever to be free of this disordered prison? And how could I possibly think I even deserved recovery, or another beautiful child, if I was selfish and broken enough to fail to fulfil the most basic parental requirement of nourishing your baby properly?

So, dismissive, ignorant and judgemental comments from healthcare professionals – especially when I was baring my soul, admitting to behaviours I felt deep shame around and pleading for help – added fuel to an already blazing inferno and took me to breaking point.

I dug deep, channelled my last shreds of mental energy and advocated for myself and for my baby. At seven and a half months pregnant, I reached out for help once again, and this time was not taking no for an answer.

This is where my story very slowly, very gradually and extremely messily begins to turn from one of utter despair to one of hope.

One of possibility. One of recovery.

With a community eating disorders team taking me under their wing, and going above and beyond to learn, listen and adapt treatment to take into account the pressures, challenges and practical issues that come with having a newborn, I embarked on a recovery journey which, two years later, is still ongoing but most definitely proving both possible and incomparably worthwhile.

It has been a slog. A relentless, exhausting, terrifying and certainly non-linear experience, but I am getting somewhere now and have no regrets about making the decision to channel those last shreds of energy into investing in a future for my whole family which will not be dominated by anorexia.

I still deal with disordered thinking and urges on a daily basis, but they are becoming weaker each day. I still feel a certain degree of anxiety around spontaneous eating or days spent relaxing in our pjs rather than clocking up steps, but I can now not only do these things, but actually enjoy them.

I still have fears and “what ifs” around how my body will continue to grow and change and whether I will manage to tolerate those changes, but I can also bring my attention back to the present, to the moment I am in, and honour my body’s needs and wants.

And I frequently find myself worrying about the impact my illness has had and continues to have on my children, and the potential for passing it onto them, but I can also feel totally confident that by persevering in healing my own relationship with food, exercise, my body and my sense of self-worth, I am doing everything in my power to model and provide a healthy, compassionate and nurturing environment for them to grow up in."

*Do check out our latest podcast for more on this topic.