Pregnancy and Childbirth

Will she be able to have children? If your daughter developed an eating disorder as a teen or young adult, that question may have gnawed at you before she was ready to address it. Chances are your relationship with your daughter is complex. Your emotions pertaining to her health and future tend to run deep; add to that the prospect of change-of her becoming a mother and your becoming a grandparent-and it's only natural that you are experiencing a whole spectrum of intense feelings (excitement, joy, fear, anger, sadness), many of them mixed. Understandably, you have many questions. Can she get pregnant? Will the pregnancy make her eating problem worse? Will her baby be healthy?

When a woman does not take in enough nourishment, her body tries to protect itself against starvation by making some changes, one of which is to channel fuel that was formerly available for the reproductive system to the life-sustaining heart and lungs. Under these circumstances, the hormone system that perpetuates the menstrual cycle slows down and the woman's periods stop. The absence of periods (amenorrhea), a defining feature of anorexia nervosa, results from a combination of factors, including undereating, overexercise, low weight, and particularly insufficient body fat. Infertility can occur as a complication of anorexia nervosa.

In order to reactivate her hormones and resume her periods, the patient needs to regain the weight and fat tissue that her treatment team recommends. If she continues to maintain adequate nutrition, her overall health will be better, increasing the likelihood that she will be able to get pregnant.

As you might expect, pregnancy can be challenging to an individual who struggles with or has recovered from an eating disorder. Although some moms with a history of this type of illness recall pregnancy as a positive experience, others report troubling thoughts and feelings. "For the entire nine months and beyond, I continued to see my treatment team," states Sybil. "Without therapy, I'm not sure I would have been able to accept the changing shape of my body. Even with professional help, it was hard to hold my abnormal eating habits in check. On one level, I knew that I had to eat right and gain weight, and I took these responsibilities very seriously, even posting handwritten reminders such as 'I can and will eat healthy,' and 'I can be proud of my progress,' around the kitchen. On another level, the tyrant in my mind was never quiet. My perception that my belly and breasts were puffing up made me more irritable than ever at the sensation of clothes against my skin. Early in the pregnancy, I was constantly tired, and that bothered me because I'd always pushed myself hard, and napping during the day made me feel lazy, spoiled, and good for nothing.

"Intellectually, I was aware that it is normal and necessary for a woman's appetite to increase during pregnancy. When I'd get a hankering for a snack, the rational part of me said, 'That's good.