On deciding to have a child/children, Part two: Some issues unique to women in recovery

scaleBody image can be a source of distress and/or relapse trigger for recovering women. This is not a superficial issue, but a deeper question around identity transition and transformations that happen for moms-to-be. For more on body image during pregnancy and postpartum, see “Does being a mom make me look fat?”

Fertility and secondary infertility can be challenging for women with histories of disordered eating or drug/alcohol use. Many women have damaged their fertility due to the eating disorder and can be challenged at becoming or unable to become pregnant. According to one study (Sterwart et al, 1990) “a total of 16.7% of infertility patients were found to suffer from an eating disorder. Among infertile women with amenorrhea or oligomenorrhea 58% had eating disorders. Because women often fail to disclose eating disorders to their gynecologists and may appear to be of normal weight, it is recommended that a nutritional and eating disorder history be taken in infertility patients, particulary those with menstrual abnormalities. It has previously been shown that disordered eating and nutrition can affect menstruation, fertility, maternal weight gain, and fetal well-being.” (1) 

Along with the choice about whether to and if so, how long and to what extent do fertility treatment is the often grueling process of trying successfully or unsuccessfully to become pregnant. Therapy can be helpful in this process in dealing with all the complicated issues and feelings this can include. One recent blog resource by Susan Allen, who is a LMFT in San Francisco, is: coping skills to center yourself through infertility

Family of origin attachment patterns can be deeply imprinted in the way we parent. This is something to be mindful of in not repeating past traumas and being conscious of what patterns we would like to keep and which we would like to change. Therapy is the most helpful resource in this regard.

Childcare Support from their families may be closer geographically or more emotionally available to women from families without eating disorders, alcoholism, or depression/anxiety. Building an “attachment village” of fellow mom friends and/or professional childcare support like nannies, babysitters, daycare, preschool can be an important part of keeping recovering moms sane and supported if the grandparents, aunts, uncles, etc aren’t available to help. One local mom resource is: Golden Gate Mother’s Group

Self care practices like getting enough sleep, the right kind of food, and not using/abusing substances such as alcohol, caffeine, and other drugs that can be difficult to maintain become excruciatingly during pregnancy and postpartum. Night doulas can be a helpful support resource for some moms. In the bay area, one such resource is bay area night doulas.

Many 12 step meetings also have phone support meetings for those people (like new moms) who are having trouble gettingmommy juice out of the house. Here is a link to phone meetings for Alcoholics Anonymous: aa phone meetings, and here is one to eating disorder anonymous phone meetings.

Perinatal mood disorders (ex Postpartum Depressiona and Anxiety) are common for women in recovery, as these are often what were beneath the disordered eating or alcoholism. Having a treatment team (Psychiatrist, Psychologist, support group specializing in perinatal mood disorders) ready and in place can be a crucial part of prevention and treatment for ongoing recovery. Postpartum Support International is a wonderful resource for moms and families struggling with perinatal mood disorders.

Survivors of abuse are often triggered at many points during the labor and delivery as well as breast feeding process. Many aspects of feeling one’s body is not your own or physical experiences that mimic what happened in abuse can be confusing for mothers who have abuse in their history. When Survivors Give Birth is a book published this past year that provides survivors and their maternity caregivers with extensive information on the prevalence and short- and long-term effects of childhood sexual abuse, emphasizing its possible impact on childbearing women.  For more information: Penny Simpkin’s website

Being “Advanced Maternal Age” (or over 35 years old) is becoming more common for many women during pregnancy, especially those that have chosen to solidify their own recovery and/or career path prior to having a child/children. Being an older mom brings with it potential medical challenges and choices during pregnancy as well as postpartum. The “advanced maternal age” project is a resource of information and stories: advanced maternal age project


1. Stewart, Donna, Robinsonm Erlick, Goldbloom, David, Wright, Charlene, 1990, “Infertility and Eating Disorders,” American Journal of Obstetrics and Gynecology, Volume 163, Issue 4, 1196–1199.

This blog is not to be used to diagnose or treat eating disorders, alcohol use problems, or psychological illness. If you would like to schedule an assessment for treatment, including a perinatal mood disorder, you are welcome to contact Dr Linda Shanti at Linda@DrLindaShanti.com.

For immediate assistance/crisis, call 911 and for a National Suicide Prevention Hotline and Website: 1-800-273-8255 www.suicidepreventionlifeline.org

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