Background: Eating disorders in pregnancy have been associated with poor outcomes for both the mother and her baby,  including miscarriage/stillbirth, hypertension, Caesarean birth, low birthweight, 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 (Brinch, Isager, & Tolstrup, 1988; Franco et al., 2001; Kouba et al., 2005; James, 2001; Gura, 2007). Women with a history of an eating disorder are also at a higher risk for developing postpartum depression (Gura, 2007; Franco et al., 2001; Patel et al., 2005).

Case: 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, and her height 5’6” with a BMI of 17.8, which is slightly below the recommended healthy BMI of 18.5 - 24.9 as recommended by the CDC (2008). 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 obstetrical 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. She restored her self-esteem and realized that her eating disorder simply did not fit into her life as a new mother with a new family.

Conclusion: 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 obstetrical patient in order for her to be comfortable in disclosing an eating disorder. Once this occurs, they and other healthcare professionals can lower the risks and enhance the outcomes for mothers and babies vulnerable to negative effects of an eating disorder.

Keywords: Pregnancy, Eating Disorders, self image, interdisciplinary approach