Dealing with body dissatisfaction during pregnancy

0:04 This is Crappita Happy and I am your host, Cas Dunn. I'm a clinical and coaching psychologist and mindfulness meditation teacher and of course author of the Crappita Happy books. In this show, I bring you conversations with interesting, inspiring, intelligent people who are experts in their field and who have something of value to share that will help you feel less crappy and more happy. Hello and welcome to another solo episode of Crappy to Happy. I had somebody reach out to me and share that she is going through pregnancy and really struggling with a negative body image, really struggling with the changes that are happening to her body as she goes through pregnancy, and I thought this is such a relevant and important topic to discuss. You may or may not know that when I was in my private therapy practice back in Australia for several years, the majority of my case load were women who were pregnant or postpartum, and I specifically worked with women who were struggling with perinatal depression and anxiety and all of the things that go along with that and negative body image, feeling badly about how your body is changing and growing during pregnancy is significant.

1:32 It's a significant concern. For many women. It is a huge contributing factor to postnatal depression. And we know that poor maternal mental health is a contributor to poor child health. And I feel bad just saying that, because I feel like mothers do not need one more thing to feel guilty about and feel responsible for. So I just want to preface that by saying your. Feelings are valid. You are entitled to feel how you feel. I don't want to for this to be one more thing to make you feel inadequate or not good enough as a mother. God knows, there's plenty enough of that around. However, I do think it's important to address because it is.

2:13 It is something that I think many women experience, and I think many women feel reluctant to talk about. And there are reasons for that, So let's get that on the table straight up front. Anytime a woman who is pregnant is struggling with any aspect of pregnancy, and there are lots of really uncomfortable physical changes that happen during pregnancy, and you know, lots of changes mentally emotionally, Like there's a lot going on, and I feel like anytime a woman expresses dissatisfaction or that she is struggling, then the standard response is that she should just feel grateful, just feel grateful that she's able to get pregnant, that she's able to grow a healthy baby. And of course most women in that situation.

2:57 Do feel very grateful. But adding like I said, more guilt, causing women to feel like they need to be quiet and shut down and not express what they're truly feeling. Is not good for anybody. And I feel like sometimes we go to such links to protect other people's feelings, to be so careful about how our experience or our thoughts and feelings might be impacting somebody else, somebody who potentially can't get pregnant, who would give anything to struggle with those issues that a pregnant woman is struggling with. But in our attempt to be sensitive to that person, if we're then indirectly or directly invalidating the pregnant person's experience, then that is not helpful either. So all feelings are valid, all feelings are welcome, and it should be allowed to be heard and to be expressed. I think the other thing about this is that it feels like such a superficial thing. We've gone so far in the world and in society to try to push back against toxic diet culture and the multi billion dollar diet industry that has worked so hard to convince women that they need to be thin and need to achieve this thin ideal and have this particular shape and sized body. And we have pushed so hard against that that then when a woman's body changes and she starts to gain weight, doesn't fit into her clothes anymore, bloated fluid retention, everything doesn't feel right in your body,

4:30 and it can feel like this is something that she shouldn't be dissatisfied with. This isn't something that is worth worrying about, because we should all be happy with the skin that we're in and we're not supposed to feel bad about how we look anymore. We're over that now, we're past that, when many women's reality is that we are not past that. That we do very much care about how we look, and we do very much care about how well our clothes fit us, and our physical appearance is a big part of what is part of our identity and what makes us feel good about. Ourselves or not. I mean, that is just the reality. We can deny it or we like and we can wish it was different, but that is the reality for many women. So there was a survey done here in the UK a few years ago by a particular mental health foundation, and they surveyed four and a half thousand adults fifteen one hundred give or take, were women who had been pregnant, and they asked those women how they felt about their body after pregnancy, after having a baby, compared to before they had been pregnant. And of those women, forty one percent felt more negative about their body after having had a baby. I think only twelve percent said they felt more positive about their body.

5:44 And then there was. Various you know, eighteen percent very negative, twenty three percent slightly more negative, but on the whole outputs of eighty percent felt more negative about their body after they had had a baby. So this is a significant issue that affects many many women. Add to that, body image and body dissatisfaction is just one of many factors that contribute to mother's poor mental health, and it is just one of many aspects of pregnancy and parenting that is misrepresented to us. I think is probably the best way to describe it. A big cause of women's dissatisfaction in pregnancy and postpartum is this gap between what we are sold, the pictures that we see in the media and in advertising and in magazines and now on social media, about what it's supposed to look like, what we think it's going to be like, compared to the reality of it. So, for example, we've all, you know, most of us have turned on the TV and we see TVs and movies and Huggies ads and all sorts of media representations of happy, smiling, giggly babies and they're always clean, and mum's got glowing skin, and they're a happy family and the house is tidy, and maybe there's lots of family support and that this is not the reality for many people. And so the reality of motherhood and pregnancy when it is physically uncomfortable, it's indigestion and fluid retention and sleepless nights and not being able to get comfortable, and it's a crying baby,

7:15 and it's not having a shower for four days because you literally can't find the time, like it is not the magical miracle and the joy that is presented to us. And you know what, you try to say that to somebody like before they have a baby, and then you kind of get shut down for that as well, because it's like, why, why are you trying to scare me or why are you trying to make me feel bad? It's not going to be like that for me, Like many people don't want to hear it or aren't willing or able to hear it before they have a baby, And so this is why for most of us, myself included, it's really when you're in the thick of it then that you realize how tough it actually is. But I guess all I'm. Saying is that there are many reasons why women struggle emotionally physically men after having a baby and during pregnancy, and much of that is because the picture that we have of how it is supposed to be is nothing like the reality of it, and the body image aspect of it is a big part of that. We see images of women with these perfect little round bumps, and we see them snapping back into their skinny genes six weeks post natally, and it's just not the reality for most people. But if that's the expectation that we have set up, then that's going to cause us to feel really inadequate, like a failure and dissatisfied. Obviously, how much of an issue this is for you personally is probably going to depend on a lot of things, Like obviously everybody is very different and has their own individual personal history and experience. And if you are somebody who has

8:45 struggled with body image issues even before becoming pregnant, and I know many women who have had experienced disordered eating and have perhaps recovered to a point where they have much health relationship with their body and with food, but then becoming pregnant can actually like kind of reactivate some of that disordered thinking and that very you know, the perfectionism and the control that is often tied up with a history of disordered eating and perfectionism in terms of physical appearance, et cetera. The being out of control during pregnancy, the fact that this craving is out of control, your body is changing in ways that you can't control, then this can kind of reactivate body image issues that have been may have been dealt with and may have been managed pretty well, so you may be more at risk during pregnancy. And on that, I think it is really important to mention that there is a condition called pregorexia. Now, this is one of those conditions that's a little bit like orthorexia, Like it's not in the DSM, but it is becoming increasingly recognized as a form of eating disorder.

9:55 So in the same way that orthorexia doesn't actually have a criteria diagnosis in the DSM, but we know that it is an obsession with wellness and with healthy eating and really rigid food rules. Then pregorexia is. A kind of eating disorder that emerges during pregnancy, and it has some very specific warning signs. And if you're concerned about your body image and some of your behaviors around restricting eating and accounting calories is becoming prevalent and is a problem, then this is a sign that perhaps you need to be going and seeking some professional help because it is potentially very concerning for the health of your baby and for your own health. So the majority of this episode, I really just want to talk to kind of the standard body image dissatisfaction that many women experience when they gain weight and they don't feel good in their own skin. But I really think it's important to highlight what some of the science might be that this is an issue that really warrants some more serious attention.

10:58 So there are some physical signs of pregerrex obviously pregorexia combination of the words pregnant and anorexia. But it does involve disordered eating at a time when nutrition is obviously crucially important. Restricting food intake is obviously a classic sign. But if you are really being obsessively calorie counting, really concerned about gaining weight during pregnancy, then you know, that's obviously a warning sign. If you are vomiting deliberately, so obviously binging purging signs of bulimia, and during pregnancy, many women do experience nausea and morning sickness and they do become sick. But sometimes women go down the path of intentional purging when pregnant, So this has been kind of anecdotally reported back when this was first reported on in two thousand and four. If you are not gaining weight, you know, if there is little to no weight gain while pregnant, that that's a really worrying sign. Obviously, again, every single person is different. Women are going to gain different amounts of weight, and the more over weight you are before you become pregnant, then the less weight you're likely to gain during pregnancy. So clearly personal factors, individual factors that are going to come into this. But pregnant women are expected to gain some weight during pregnancy, so if you're not, then then that's concerning. So things like all of the usual kind of disordered eating things, you know, excessive calorie counting, really compulsive calorie counting, excessive exercise routines.

12:28 Exercise is very beneficial for pregnant women, you know, it's really important to remain fit and active and remain mobile and all of that. But excessive exercising to counter whatever food you're eating, manifesting in exhaustion, exercising too much, overheating, this is problematic. Secretive eating is often associated with anxiety around food and physical appearance. If you're avoiding doctor's appointments, So if you're avoiding your regular health checkups, if you have a fear of being weighed doctor's appointments, which many people do, that can often be a trigger for people who've had issues with disordered eating in the past. So if you're finding that you're deliberately avoiding those check ins for that reason, that's a worrying sign as well. So I have gone to a website which lists some of the physical symptoms of pregorexia. So if you are pregnant and if you know that you are concerned about weight and body image, you know that you kin'd of been concerned about what you eat, how much you eat, how much weight you're gaining them. These are some signs that you might want to just keep an eye on. So chronic fatigue is a very common symptom. Obviously, pregnancy is exhausting at the best of times, but if you're restricting your nutritional intake, it's going to really impact your energy levels.

13:44 If you're feeling dizzy, have blackouts. Again, some of these symptoms are kind of common to pregnancy and they're common to eating disorders, so when you combine the two, it can be tricky to know how much of this is pregnancy related and how much of this is to do with restricted eating. And I'm just flagging them so that you'd know that these could be signs that you know you need to go and get some help again. Gastro Intestinal issues bloating, gassy, acid reflux, constipation that can be exaggerated if you are not eating properly and well during pregnancy. If you are feeling shame, if you're feeling guilty about weight gain, if you are really preoccupied with weight it's making you really stressed and anxious. If you're feeling very disconnected from the pregnancy, feeling detached from the experience of being pregnant and growing a baby, that could be a concern.

14:37 Really obsessed with healthy eating, a bit of that orthorexia kind of presentation that can show up in pregnancy as well. So it is really important to seek support from somebody who has experience in this area, somebody who is a specialist in maybe pregnancy related eating disorders body image issues. So you know, talk to your GP obviously, but see if you're get a referral to somebody who is a specialist in this area, because it really is, you know, it's a very specific issue that you're dealing with. So, having said all of that, like I said at the beginning, this is an issue that is common to many many women, not necessarily those who have a diagnosable eating disorder. So I just wanted to flag that could potentially be an issue and just get back to talking about regular body dissatisfaction during pregnancy. If you are somebody who has always been very fit and healthy and active. I'm thinking about even tif my friend Tiff Hall.

15:46 Who you all know. You know, her whole career. Has been in fitness. She's been a media personality. Her whole identity is wrapped up in this image of being a very fit, strong, healthy woman. And so you don't have to be a media fitness trainer, you don't have to be a celebrity. But if that has been a big part of your identity, and that has been a big part of the way that you manage stress, the way that you interact socially with people, you get joy and satisfaction from fitness and fitness training and focusing on your nutrition and health, then again, you might be more susceptible when suddenly all of those things are out of your control and you are no longer able to potentially engage in some of those activities that you love. Your body is changing in ways that are out of your control, combined with things like not getting sleep, a brain fog, all of these things that we kind of.

16:44 Pin our identity to the things that we pride ourselves. On, they all can it can feel like it's all kind of slipping away and we're no longer the person that we thought we were. We feel like we're not ourselves anymore, and all the things that made us or gave us a sense of our selves and and being a competent person and intelligent person and a disciplined person, suddenly we don't have that to hold on to anymore. So it can really mess with your mental health. So I guess what I'm saying is that for many people, this is an issue. We need to be able to normalize it, and we also need to be able to have some strategies to help with it so that we feel better about it. And the answer is not to say to a pregnant woman, you should just feel grateful that you're growing a healthy baby.

17:27 You know you're eating for two now. All of these things that we all hear, like a lot of those things really don't land well with somebody who is really genuinely struggling with not being able to fit into their clothes, with not recognizing the person that they see in the mirror. And it's not just how you look. I think that the issue with body image and weight gain during pregnancy is that it's not necessarily just about physically being in a bigger body. It's all the other physical health aspects of physical symptoms that feeling achy and creaky and having pain in your wrists or your knees and carp tunnel, and it's the indigestion and the heartburn and not being able to eat the things that you used to enjoy eating. Like, there's a whole lot of other stuff wrapped up that is beyond just like I no longer fit into my skinny genes, it's a whole lot of things that wrap up together that contribute to this.

18:16 So if that is you, if this is something that you find that you are struggling with, or you have struggled with, or you know somebody who is struggling with this, then what can you do about it? I think some of the advice here is going to be very similar to the advice that I would give to anybody struggling with body image issues and body dissatisfaction. And the standard one is the one that we all know, is to focus on function. Focus on what your body is able to do, not how it looks. Really trying to shift that perspective to the fact that your body is having to change to grow to nurture another human being. It's like this is a season in your life. This is not forever. It is for a limited period of time that your body is required to change to cope with.

19:02 And I know that you've probably told yourself this one hundred times. I'm not telling you anything new, but as much as possible kind of remembering, you know, focusing on and appreciating what your body is actually doing, which is growing and nurturing another human being. I think taking that kind of zoomed out perspective, you know, like looking at your life and yourself from like a really really really really high up so that you're as small as an ant, and looking at it from the perspective of how important will this be in five years or in ten years, you know, being able to take that step back and see it from records, because right now, if you're right in the thick of it, and it feels like pregnancy lasts forever, and it feels like things are never going to be back to how they were before, But if you can zoom out and take that helicopter view, then that can really help to shift your perspective a little bit and give you some sense of the temporariness of this particular time in your life. I would recommend that you unfollow any social media accounts that cause you to feel bad about yourself. So fitness influences who have bounced back into their perfect body, who are perfectly groomed and doing all of their post natal or the pregnancy pilates and with their perfect little baby bump, and that is not how you feel at all, then it is totally fine to remove all of that media, remove that from what you're consuming, focus on following accounts that make you feel good about yourself at the very least, do not

20:33 make you feel bad about yourself. We have to take control of the media that we consume, and we can do that with social media, so do that. I would also highly recommend that as early as possible in your pregnancy, you get yourself some decent maternity clothing. You know, it's very tempting to say I'm just going to get through pregnancy with wearing my normal clothes or wearing my elasticized pants or whatever it might be, well fitting clothes. It's the way you feel in your clothing makes such a big difference to how you feel in your body. If you're wearing oversized, baggy clothes that just are like have no shape they're not really you know it, It might be economical to do that. You might not want to spend the money on maternity clothes you're not going to wear for that long, if you can borrow them, if you can get them.

21:22 From thrift shops. Wearing well fitting clothing that are designed to fit a pregnant body is going to make such a big difference to how you feel, to how you look and how you feel in your body. Definitely getting rid of the tight fitting clothing, the stuff that's probably you know, only barely fitting into pre pregnancy skinny jeans, all of those things, getting them out. You do not need reminders of the things that don't fit you anymore. So move them along, get you know, move in the clothing that makes you feel comfortable, that makes you feel good in your body, and especially well fitting maternity clothes. I would highly recommend.

22:03 The thing that I really like about acceptance and commitment therapy as an approach to dealing with any of these sorts of issues is the focus on values, the focus on valued living. So acceptance and commitment therapy, I've talked about it before on this podcast. You've heard me talk about it before. It's based on six fundamental processes, six core processes, and one of those is valued living. It's knowing what is important to you and appreciating that life is a struggle, life is difficult, life is uncomfortable. It's not always an easy ride in life. But that's okay. We can handle that if that discomfort that we're feeling is in the service of something that's really important to us, in the service of our values. So when we get really clear about our values, what is it that's really most important to me during this period? Who do I want to be? How do I want to show up?

22:50 Then I can tolerate some discomfort because it's all in the service of something that really really matters to me. So just being able to hold onto your values can be just give you something to ground you and to hold you steady when you're feeling really kind of tossed around in the emotional storm that is pregnancy and parenthood. So values are really really important and we don't give them enough thought. I don't think so thinking about what are the qualities I want to most demonstrate, what are the what's the attitude? What are the core principles like, what are the core characteristics that I want to embody and express who am I, what matters to me? And how can I show up as that person even in the face of this thing which is actually really difficult and uncomfortable and painful, Like I'm not having a great time of it here, but I can handle it because of this, and I can. And the values are like the lighthouse. They give you the direction that give you something to focus on as you move through this particular period.

23:54 In your life. Another aspect of acceptance of commitment therapy that I really appreciate is the idea of self as context. So it's not self as content, self as content. I know this is a little complicated, but self as content is when I'm very overly identified with the content of my life, my thoughts, my feelings. Who am I, It's my ego, it's how I look, it's what job I do. That self as content, Self as context is much more transcendent approach. It's like the there is the ego part of you, which is all about identity and status and achievement and physical appearance and material possessions and all the thoughts that I think and all the stories that I tell myself, and then there is the self as context is the essence of you, the part of you that is beyond all of that. It's like your spiritual nature, your soul.

24:47 If that's an idea that appeals to you, it is without ego, it's without identification to all of these other non important things. Is who you are at your core, the personal qualities that you bring. So that can be a helpful idea to attach to as well. Acceptance obviously is a big part of acceptance and commitments therapy, but I've already talked to you about that. Something else that can be helpful is to think about if you were a person who was really focused on health and fitness and nutrition and you're feeling like it's all getting away from you now that you're out of control, giving some thought to what was it about that which was important to you. What was it about training or physical fitness or whatever your particular preferred exercise was, whether you were a CrossFit person, f forty five person or a pilates person, Like, what was it about that, and what was it about that that.

25:38 Really appealed to you? What did you enjoy about that apart from the physical appearance aspect of it, apart from just the you know, having a thin, strong, fit body. Was it the social interaction? Was it feeling strong that give you a feeling of confidence? Was this something we're interested in the study aspect, like getting curious about ways to put healthy meals together or what kind of combinations of foods work well with your body, Because maybe you could take whatever that was and apply it to this period of your life. You might not be able to do it in the same way that you did before when you weren't having a baby, but maybe you could apply it to pregnancy. You know, get tap into whatever the core motivator was, the core drivers were, and it's just have them expressed in a different way.

26:27 How do you eat well for pregnancy to support your growing baby and the nutrients that she needs. If it's a social aspect, how can you join some sort of social pregnancy group and tap into that community in a different way. And I think connecting with other women going through something similar. We often join a mother's group after. We've had a baby, and that can be a great opportunity to connect with other women who are going through what we're going through and experiencing similar things at the similar time. I personally never got to my mother's group because I was too depressed. My baby never slept, so it didn't work so well for me.

27:08 But I did make one or two friends who reached out to me when I couldn't make the meetings. Thank God for them. But when you are pregnant, there isn't really such a thing. Maybe there are online groups. I know when I was pregnant, I was a part of an online community where everybody who was giving birth in the same month was going through the pregnancy journey together. So I think connecting in with a community like that, even if it is online, there is so much available online, can be a really great way to find support. To have other people going through what you're going through who can really relate to where you're at, and who you can share with and not feel the need to censor yourself. You can be honest about what you're thinking and feeling and find out from them what strategies are working for them if they're going through something similar. Cannot underestimate the import of community, especially at a time like this like pregnancy and parenthood, essential for survival and for good mental health. Hope all leys some of those ideas are helpful for you. If you have any other questions, or if I have missed something, or if you've got an idea that you found really helpful that you want to share, then by all means message me DM me on Instagram, cast on underscore XO, or send me an email hello at Kaston dot com so that I can then take your ideas and share them on the podcast as well, because I don't have all of the answers, but that they are just some of the ideas that I thought might be helpful if

28:38 that is something that you're going through. Of course, if you've got a question you'd like me to answer, or something you would like some help with, by all means reach out. Happy, happy to hear from you, and I can't wait to catch. You next week for another episode of Crack It. A happy