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Ashley Solomon, Psy.D is a psychologist who specializes in the treatment of eating disorders, body image, trauma, and serious mental illness.

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Pregnancy, Vulnerability, and Misinformation

October 23, 2012 9 Comments by Ashley @ Nourishing the Soul

{image via pinterest}

Please note that this post makes reference to weights and calories. If you’re in a vulnerable place, please do not read.

My body shuddered with a chill as she opened the door and took her chair, smiling briefly before looking down at the chart in front of her. It had been some time since I last saw her, and I couldn’t tell if she recognized me or had just done a once-over of the basics before entering. Regardless, her greeting had a modicum of warmth. I hung on to every last bit in that moment. More than anything, I needed reassurance.

I was eight weeks pregnant — for the first time — and this was my first appointment back at the “regular doctor” since seeing specialists for what felt like an eternity to get here. She acknowledged the journey, and then dove in to what I figured were the basics of a first-OB consult.

“What do you do again?”

Oh, I’m a psychologist. I work with people with eating disorders.

“Interesting. Well, you’ve gained a little weight since the last time I saw you.”

Thanks for noticing. Perhaps it’s the eight thousand liters of hormones I’ve been pumping in my body for the last year.

“So, we’ll need to watch your weight gain. You really don’t need to gain more than 20 pounds or so. You’re a small person.”

Wait, but I read that 25-35 pounds is what’s expected in a typical pregnancy?

“So I would suggest watching what you eat. You really only need a few extra calories per day to support the baby. So you’re normally need what? Like 1200? Get a couple hundred extra, but don’t go overboard.”

And how do you suggest I do that? Without starving and shriveling up into a weak, angry shell that no one will talk to?

“Make sure you’re exercising.”

Oh, I do. I’ve actually just started pre-natal yoga. 

“Pre-natal yoga is basically a joke.”

Oh, is that so? And here I thought I was connecting mind, body, and spirit, managing my stress, increasing my flexibility, and increasing bloodflow and oxygen to the baby. Silly me. 

Sadly enough, this was the actual conversation my OB had with me at that very first appointment. You’ll be happy to know that I fired her, and decided to seek services at another practice.

But the interaction left me reeling. What shook me was not only that this physician was so insensitive and misinformed, but that her behavior was likely reflective of a much more widespread issue. What kind of information are pregnant women receiving?

Pregnancy can be an incredibly vulnerable time in a woman’s life — physically, emotionally, and spiritually. While some women report feeling incredibly empowered by the experience, many others — most, in fact — report body image issues, decreased confidence, and fears about weight. Couple this with the way in which pregnancy alters your hormonal balance and increases risk for health concerns and you have many women feeling frightened of the physical beings.

That vulnerability makes them particularly susceptible to the mountains of inaccurate garbage that’s out there. Women who have struggled with infertility and/or pregnancy loss may feel even more vulnerable. Between doctors, tabloids, and water-cooler gossip, many women are heading into the journey to motherhood with all the wrong information.

Just as always, it’s crucial to not believe everything you hear. Particularly if something just doesn’t sit well with you, don’t take it at face value. I was fortunate to know just how inaccurate much of what my doctor was saying was, but I also consulted with other women who had been through pregnancy. And when they assured me that my instincts were right, I sought out another provider.

I was fortunate. But for many women with current or previous eating issues,  the vulnerability plus misinformation can create a perfect storm. For some, pregnancy exacerbates urges to engage in dangerous behaviors. Some experts suggest that numbers are upwards of 1 in 20 women who struggle with eating disorders while pregnant. The risks of an eating disorder to self, which are always high, are only exacerbated by pregnancy. And, as you would imagine, the risks to a growing baby are high as well. They can include poor development, premature birth, low birth weight, respiratory distress, other perinatal complications, and feeding difficulties.

If you are pregnant and struggling to make sense of all of the information out there, turn first to your medical provider. If you’re questioning what you’re hearing, ask to meet with someone else. Check out reliable sources online, such as the website of the American Pregnancy Association. Avoid putting too much stock in anything you read on online message boards or in the elevator. And, most importantly, trust your body and your own instincts above all us. They are ultimately what motherhood is all about.

 

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9 Comments

  1. Dana Udall-Weiner
    1 year ago

    Ugh–this is all too familiar. And yet it still makes my blood boil to know that it happens! I’m SO glad that you fired this doc. And by the way, I’m also amazed when I hear docs say that 1200 calories is enough for a non-pregnant person. In my book, 1200 calories constitutes a diet! Sending you lots of good wishes that you continue to trust your instincts, for your sake and the baby’s.
    Dana Udall-Weiner recently posted..Is Facebook Making Your Child a Narcissist?

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    • Ashley @ Nourishing the Soul
      1 year ago

      Thanks, Dana! I totally agree. 1200 calories is ridiculous — a diet for the average, sedentary woman. Unfortunately, it’s pretty common to hear things like this. I think it really shows a lack of nutrition education among the medical community.

      Reply

  2. JJ
    1 year ago

    Congrats on your pregnancy, but oh man, what an experience. That conversation would seriously mess with my head. I feel like OBs are particularly bad in terms of weight insensitivity. Is it just that most prenatal checkups are boring and they want something else to talk about? My OB always says gain 20-25 lbs because he doesn’t want his patients to gain too fast, but it just makes someone like me extra vigilant and compulsive. Not helpful. He made comments about whether I was on track in that regard every single visit. Really??? He has a 6 month postpartum weight check-in. Even when I told him at my annual exam this year that my weight had noticeably increased due to restoring weight after the previous year’s ed relapse, and that I had just gotten off four months of crutches from overexercise… all he said was “well, just make sure you’re exercising enough and eating right.” Really?

    I KNOW from counting calories that when I’m pregnant I gain weight eating the exact same amount that didn’t make me gain weight when not pregnant. Bodies do what they want to do when they’re pregnant–this is a good thing, though not always fun. It would just be so nice if doctors could get with the program and look up from their numbers obsession.

    Reply

    • Ashley @ Nourishing the Soul
      1 year ago

      Very good point about bodies doing what they want – or NEED – to do when pregnant. I really question whether it’s wise to address weight or calorie needs at all with pregnant women if there isn’t a problem (e.g. gaining very quickly which could put them at risk for gestational diabetes).

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  3. Bek @ Crave
    1 year ago

    Oh my! What a terrible person- she has no idea! ARGH makes me angry that people like that are bloody educated doctors!
    Bek @ Crave recently posted..Change- MBMS 3

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  4. PTC
    1 year ago

    CONGRATS! That’s very excting.
    PTC recently posted..Big two days

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  5. Eating as a Path to Yoga
    1 year ago

    I’m so sorry you had that experience! How frustrating and disappointing. I’m glad you advocated for yourself and fired the dr. Blessings on your pregnancy!

    Reply

  6. leora
    1 year ago

    I experienced the exact same thing. I am also a psychotherapist specializing in treating eating disorders, which my OB knew, and he, a 70+ year old man told me that I was gaining too much to quickly. He told me that I should gain around 25 pounds. I gained 40. I ate healthily, no restricting, no bingeing, and no overexercising. I was also lucky enough to get pregnant after trying for 2+ years, then was on bedrest for the first 18 weeks of my pregnancy. I ate when I was hungry, and I was hungry a lot. I explained to him that I was eating healthy whole foods, not bingeing, not eating lots of candy or sugar, but he still insisted on testing me for GD, not just once, but twice because of my weight gain. Both times my test came out exceedingly normal. I told him that I would be as healthy as I possibly could but I wouldn’t deny myself food. He said, “I don’t think you should, I’m just asking you not to pig out on junk.” I explained to him that it wasn’t what I did. My body was just doing its own thing. Well guess what, I had a healthy, big, beautiful 81/2 pound/ 21 inch long baby. When they pulled this little one out of my body, my doctor wiped his brow and as he walked out of the room, he exclaimed , “8/8– where was she keeping it?” And my body went back to itself without me doing anything special besides breastfeeding. I stayed with him because I had been seeing him for a long, long time and I trusted him, but he definitely had an old school attitude. He also told me to make sure I was eating tons of protein, and that was all my body really needed. I had an aversion to meat most of my pregnancy. I was mostly eating fruit. So there you go. When you listen to your body and your intuition and your baby… you will be lead to what you need.
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