The experience of pregnancy in women with a history of anorexia nervosa: An interpretive phenomenological analysis

Abstract

Background and aims:To explore the experience of pregnancy for women who have a history of anorexia nervosa (AN), in relation to the impact of AN on pregnancy, and pregnancy on AN. Methods: Semi-structured interviews were conducted with six women with a history of AN. Data were analysed using Interpretive Phenomenological Analysis. Results: Four super-ordinate themes emerged: 'Effortful resistance of AN'; 'The unvalued self, valued other dialectic'; 'In new territory'; and 'Feeling distanced'. Conclusions: Various factors motivated the women to try and change their AN behaviours. This was achieved with varying degrees of success. Attempts to manage AN cognitions and emotions were less successful, and this aspect of their illness persisted. Whilst the baby was viewed as worthy of nurturance, the self was not. Pregnancy represented an unfamiliar experience, and was a time of relative isolation and lack of psychological support. Findings are discussed in the context of theory, research and practice.

Transition to motherhood in women with eating disorders: A qualitative study

“…In a paper from Bailey (1999), the participants talk recurrently about the 'unreality' of the experience, and the fact that they had to look constantly at their body to be reminded about the changes that were about to take place. For women with ED, this experience can be particularly disruptive; on the one hand, they feel uncomfortable with changes in their body, and on the other, they are not yet identified with the mother-to-be (Mason et al, 2012).…”

“…Tierney, Fox, Butterfield, Stringer, and Furber (2011) described how women with ED seem to be caught between opposite loyalties (between their ED and the future baby's demands) during pregnancy. A study of women with AN (Mason, Cooper, & Turner, 2012) highlighted the theme of 'new meaning of embodiment', which the authors define as a difficulty in adapting to a new status and the emergence of a new relationship with the body during pregnancy. Other studies have focused on one particular aspect of motherhood, such as the post-partum period (Patel, Lee, Wheatcroft, Barnes, & Stein, 2005) and found that women with ED reported being highly distressed by the intensity of body and shape concerns, or breastfeeding (Stapleton, Fielder, & Kirkham, 2008).…”

Recognising the Symptoms: How Common Are Eating Disorders in Pregnancy?

“…Women with eating disorders are often reluctant to disclose their illness to healthcare professionals (Freizinger, Franko, Dacey, Okun, & Domar, ; Morgan et al, ), which may be due both to a fear of stigma (Mason, Cooper, & Turner, ) or fear that services might respond in a negative way to the disclosure. Many women with eating disorders therefore go undetected and untreated during pregnancy.…”

Pregnancy outcomes in women with active anorexia nervosa: a systematic review

“…Two case reports and two case series found that the behaviour symptoms (such as purging behaviour, restrictive eating and the use of laxatives) related to disordered eating in the woman with AN were worsened during pregnancy [ 29 – 32 ]. One case report found the opposite, where the patient had reduction of behaviour symptoms during pregnancy, but emotional and cognitive symptoms persisted [ 33 ].…”

“…Increased hyperemesis was mentioned by one cohort study and one case study [ 23 , 33 ]. As pre-pregnancy rate of vomiting behaviour was not reported, it is uncertain if the finding of the studies could be attributed to purging behaviour from AN.…”