Eating disorders affect approximately seven million American women each year and tend to peak during child bearing years. Pregnancy is a time when body image concerns are more prevalent, and for those who are struggling with an eating disorder, the nine months of pregnancy can cause disorders to worsen.
Two of the most common types of eating disorders are anorexia and bulimia. Anorexia involves obsessive dieting or starvation to control weight gain. Bulimia involves binge eating and vomiting or using laxatives to rid the body of excess calories. Both types of eating disorders may negatively affect the reproductive process and pregnancy.
How do eating disorders affect fertility?
Eating disorders, particularly anorexia, affect fertility by reducing your chances of conceiving. Most women with anorexia do not have menstrual cycles, and approximately 50% of women struggling with bulimia do not have normal menstrual cycles. The absence of menstruation is caused by reduced calorie intake, excessive exercise, and/or psychological stress. If a woman is not having regular periods, getting pregnant can be difficult.
How do eating disorders affect pregnancy?
Eating disorders affect pregnancy negatively in a number of ways. The following complications are associated with eating disorders during pregnancy:
- Premature labor
- Low birth weight
- Stillbirth or fetal death
- Likelihood of Cesarean birth
- Delayed fetal growth
- Respiratory problems
- Gestational diabetes
- Complications during labor
- Depression
- Miscarriage
- Preeclampsia
Women who are struggling with bulimia will often gain excess weight, which places them at risk for hypertension. Women with eating disorders have higher rates of postpartum depression and are more likely to have problems with breastfeeding.
The laxatives, diuretics, and other medications taken may be harmful to the developing baby. These substances take away nutrients and fluids before they are able to feed and nourish the baby. It is possible they may lead to fetal abnormalities as well, particularly if they are used on a regular basis.
Reproductive Recommendations for Women With Eating Disorders:
If you are struggling with an eating disorder, you have an increased risk of complications, and it is recommended that you try to resolve weight and behavior problems. The good news is that the majority of women with eating disorders can have healthy babies. Also, if you gain normal weight throughout your pregnancy, there should be no greater risk of complications.
Here are some suggested guidelines for women with eating disorders who are trying to conceive or have discovered that they are pregnant:
- Prior to Pregnancy:
- Achieve and maintain a healthy weight
- Avoid purging
- Consult your health care provider for a pre-conception appointment
- Meet with a nutritionist and start a healthy pregnancy diet, which may include prenatal vitamins
- Seek counseling to address your eating disorder and any underlying concerns; seek both individual and group therapy
- During Pregnancy:
- Schedule a prenatal visit early in your pregnancy and inform your health care provider that you have been struggling with an eating disorder
- Strive for healthy weight gain
- Eat well-balanced meals with all the appropriate nutrients
- Avoid purging
- Seek counseling to address your eating disorder and any underlying concerns; seek both individual and group therapy
- After Pregnancy:
- You are more susceptible to postpartum depression
- Continue counseling to improve physical and mental health
- Inform your safe network (health care provider, spouse, and friends) of your eating disorder and the increased risk of postpartum depression; ask them to be available after the birth
- Contact a lactation consultant to help with early breastfeeding
Compiled using information from the following sources:
National Eating Disorders Association, http://www.edap.org/
Eating Disorder Referral and Information Center, http://www.edreferral.com/
American Pregnancy Association, http://www.americanpregnancy.org