Eating disorders in pregnancy have been associated with poor outcomes for the mother and infant, including miscarriage/stillbirth, hypertension, cesarean birth, low birth weight, fetal abnormalities, low Apgar scores, breech presentation, forceps delivery, cleft lip and palate, increased risk of bleeding during and after birth, and healing problems after lacerations or episiotomy. Women with a history of an eating disorder are also at a higher risk for developing postpartum depression.
Felicia was diagnosed with anorexia nervosa during her teenage years. She stated that she could not remember ever having a normal menstrual cycle. Felicia claimed successful treatment for anorexia nervosa after several years of therapy; however, she still considered her relationship with food somewhat “stressful.” Her weight was 110 lbs, height 5′6″, and body mass index 17.8, which is slightly below the recommended healthy body mass index of 18.5 to 24.9. Despite attaining more acceptable weight, her periods never returned. Felicia turned to fertility specialists, and after 18 months she finally conceived.
Having the support of a therapist, a psychiatric nurse practitioner, a nutritionist and an understanding obstetric healthcare provider, Felicia came to terms with her depression and symptomatology early enough. She had a recurrence during the postpartum period. The interdisciplinary team immediately worked on the depressive symptoms surrounding her weight and worked on her diet with her nutritionist. With the help of a lactation support group, she was able to come to terms with her body image and pregnancy weight. Her self-esteem was restored, and she realized that her eating disorder simply did not fit into her life as a new mother with a new family.
Adjusting to pregnancy and motherhood can be overwhelming. With the recent literature on the negative effects of an eating disorder in pregnancy, there is an urgent need for nurses to be aware of the signs and symptoms of an eating disorder in the pregnant woman. Nurses need to establish trust with the obstetric patient in order for her to be comfortable in disclosing the disorder. Once this occurs, they and other healthcare professionals can lower risks and enhance outcomes for mothers and infants vulnerable to negative effects of an eating disorder.