Category Archives: eating disorders and pregnancy

Helping Moms Eat Intuitively and Accept Their Bodies During Pregnancy and Postpartum

In the last blog, I introduced you to Lindsay Stenovec, Registered Dietician, and her Meet-Lindsay experience healing disordered eating and becoming a dietician. Lindsay is now a Mom who works with women recovering from disordered eating. Here is some of the fabulous insight she shared with me during her interview:

What are some of the things you work with that are specific to moms recovering from eating disorders?

Something that has become more and more apparent to me is that there’s a lot of shame when a mom who’s in recovery has an increase in disordered eating. They could be in recovery for 2 years, 10 years, 15 years, but if they start to realize during their perinatal journey, they’re struggling, it brings up shame. They forget to take into account that this is actually one of the riskiest times for recovery. And a small or large amount of eating disorder behaviors or thoughts that can come back into the mind are not uncommon.

When I get  initial calls for support, a lot of the self-talk I hear from recovering moms is “I feel  so stupid,” or “This shouldn’t be happening,” or “I can’t believe this is happening again. I thought this was far behind me.”

I’m always really quick to say:

“This is actually something that a lot of women in recovery experience. It’s one of the riskiest times for recovery. And it doesn’t say anything about your recovery or how much work you put into it. And look here you are on the phone with me! You have totally recognized what’s going on. You’re getting support. That’s you taking care of yourself. This is exactly what you need to be doing: reaching for and getting support!”

Right off the bat it’s important to make sure that they know they didn’t do something wrong; that there is nothing wrong with them. A lot of the times disordered eating thoughts and behaviors come up as a result of the hormonal changes that women experience. And pregnancy/postpartum, are big life changes. It isn’t surprising that disordered eating “coping skills” come up.

Shame: 

pregnantI also see that there’s a lot of worry around body changes during pregnancy and postpartum. This is a big time of change, not just physically, but also emotionally. What I have noticed is, for women in recovery, it may take a little while to open up about that. I’ve notice a trend with not wanting to say out loud or fully express the distress around body changes, because they don’t want it to be there. They don’t want to be feeling this way about their bodies. They feel shame about feeling bad about the change in their body. And so keep that really close to their vest. But over time it starts to organically come out. For moms in recovery, just know that this could be a risky time, and seeking support can help.

(Side note: shame is such a big obstacle for recovering women. I tell my clients shame stands for the false message of SHAME= Should Have Already Mastered Everything. Let’s challenge that message, again and again. You get to be human and in-process, just like the rest of the world. And you deserve compassion, just like you offer your little one.)

How can pregnant and postpartum women sort through all the food recommendations that are in magazines, doctor’s offices, and diet-culture and  find what works (and doesn’t) for them?
We do have some changing nutritional needs during the perinatal period. However, oftentimes they are presented in a way that reinforces diet culture. And so there’s some work to be done regarding how we consider nutrition. How do we incorporate that into our own bodies’ wisdom? For example, if I’m working with someone who is early in pregnancy, the first trimester is often survival mode for many women who have pregnancy nausea. The cues from your body are so strong, they are very chaotic, and they are not to be messed with. So if I were to say, as a dietician

“Hey you know you should really more broccoli during your first trimester because vitamin C is very important and broccoli has lots of vitamin C,”

and then you go home and you can’t even look at broccoli because you’re going to be sick, that nutrition information is not that helpful for you! You have to say to yourself:

“OK, vitamin C might be important, so I could probably take a vitamin supplement to help myself during this time.”

And then, in the meantime, you might be eating saltines and apples. It’s a really interesting time to explore, because the cues from your body are so strong. You have really very little choice other than to go with the flow of what your body is asking for. This level of intuitive eating- of listening to your body’s cues- can be very scary or it can be very empowering. I’ve seen it go both ways.

I believe it’s very helpful to have that dietitian with you to say something like this:

“Oh, you got this piece of nutrition information. Let’s look at whether it’s supportive or not supportive to you and how could we use it in a way that honors what your body is telling you right now.”

We really have to learn what intuitive eating calls gentle nutrition. We have to learn how we can incorporate that gentle nutrition into our lives. We have to think about the different stages someone’s at, and to realize that healthy eating doesn’t mean rigidity. Healthy eating doesn’t mean restriction or not allowing yourself to enjoy food. There is no such thing as a right way to intuitively eat. There’s only listening to your body and going by what it needs. Your body does have wisdom, and it is going to be giving you different information every day. The only way you’re going to know what it needs is to is to pay attention to it and just do the best that you can.

In conclusion? Pregnancy (and postpartum) are great times to practice:

*letting go of perfectionism and shame,

*eating intuitively and listening to your body’s needs,

*being present what what-is (rather than what your fantasy wants it to be) and

*receiving support and practice being good enough.

To connect with Lindsay’s Nurtured Mama podcast, Facebook group, and resources, click HERE

 

Moms, Food, and Diets

In continuing with the fabulous interviews for the forthcoming book Good Enough Mama: Taking Care of Yourself and Your Recovery During Pregnancy and Postpartum, today I want to introduce you to Lindsay Stenovak, Dietician, Mom, Recovery advocate, and host of The Nurtured Mama podcast

Lindsay+Stenovec

What made you want to become a dietician that specializes in eating disorder recovery?

My own journey definitely led me to this area of specialty. Having suffered from disordered eating and body image distress informed it. In college, as a nutrition major, thought I was doing the “right thing,” eating “healthily” when really it was diet mentality. I thought I was being a good nutrition major. I was following the rules that were given to me. I genuinely thought there was something inherently wrong with myself in my body for not being able to adhere to these recommendations that just weren’t realistic or appropriate for my body. And that would send me into these cycles of struggling with disordered eating. So, long story short, I hit this point in late in my senior year of college where I said:

“Enough is enough. I just I have to let myself eat enough food!”

I started to experiment with this, and realized I could relax around food! And I found it was actually not so scary. And shortly after that I was introduced to intuitive eating as well as the world of eating disorder treatment.

(Intuitive eating can be defined as a nutrition philosophy based on the premise that becoming more attuned to the body’s natural hunger signals is a more effective way to attain a healthy weight, rather than keeping track of the amounts of energy and fats in foods. For ten principles of intuitive eating from authors Evelyn Tribole & Elyse Resch, go to: Ten Principles )

Intuitive eating – and using this approach to eating disorder recovery – fit in very nicely with my own personal experience. I realized there was this whole world of people practicing intuitive eating and “Health At Every Size” (HAES)  who were saying not only “It’s OK to eat,” but also “It’s ok to eat enough and enjoy it! You have permission to do this!” I realized, Oh these are my people and this is my jam! There was no going back.

What is diet-mentality and how did you break out of it?

Diet mentality says that a variety of body shapes and sizes are not OK and that you can’t trust yourself around portions. In my nutrition program at school, they were teaching us that you’re going to have to really work hard to help people not eat too much. It was fear-based: one wrong moved you are going to be out of control.

I remember having a discussion in my nutrition program about portion sizes and all of a sudden I realized “Oh my gosh, the ‘serving size’ on the box is just the unit of measure! No_DietingUnder no circumstances is this like the right amount for everyone to eat, every time they sit down to eat that food.” All of a sudden I had so much validation for myself in struggling with trying to stick with a cereal box recommendation, feeling so hungry, and thinking there was something wrong with me. I could eat more than one bowl of cereal because, even though it said one bowl was a “serving size,” one bowl didn’t fill me up!

I remember raising my hand in class and saying:

“I just realized that this is the unit of measure not the perfect amount everyone is supposed to eat! This is just a unit of measure that manufacturers picked and put on the boxes. It helps their product look good within diet culture, but it really has nothing to do with what you need in that moment.”

Everyone including the teacher just looked at me strangely, and went back to the lecture. But it was a revelation for me. Back in the day, they used to always say a bowl of cereal was part of a complete breakfast. Not your whole breakfast. And if you want to choose to have a cup of cereal, fine. But make sure to give yourself unconditional permission when you get hungry an hour later.

Stay tuned next for part two of this interview, when Lindsay discusses some of the ways she helps moms with the massive food and body changes during pregnancy and postpartum!

Advanced Maternal Age and Recovery: Sharing Grace



This week, I will share Part Two of Recovering Women and Advanced Maternal Age: A Story of Hope (and Grace, who you will meet at the end of this blog).

To read Part One of Sheira’s story, click here.ama

Last week, Sheira shared about some of the obstacles she worked through in order to have a baby at age 50.  Here is the final excerpt of the interview in which she shares the obstacles she worked through, and the miracle that she birthed, at age 50:

Emotional Clearing

There was all this evidence stacked up supporting the fearful belief that I couldn’t have a baby. It was important to go in there, make conscious those fearful beliefs, and express them. When I touched in those beliefs, I felt like throwing up. I had just tried an embryo donation that had fallen through. I touched into this very deep grief about my family life not working out. And I really felt like throwing up. That’s what my body really wanted to do. This sounds strange, but I let myself dry heave and tear up and cry all at the same time. And it was cathartic! It was a layer of grief that was so unconscious. It felt good for it to be out. So that was one of the turning points.

I had another turning point when I was deciding between two sets of embryos. I didn’t know if either one would work out. I had reason to believe I wouldn’t be able to carry a child. I was afraid there had been too much damage done. I was telling this to a friend who’s had three children. I was explaining how it doesn’t get to work out for me and I have evidence supporting this belief.  She turned her around and she said:

“This sounds like depression.”

She had a word for it. It was a relief to name it as depression, as it had only ever been the truth to me. And then she said:

“Having children came really easily to me. Give your depression to me. I can help you with that.”

And she did. She put her hands out and we kind of held on each other’s forearms and I just closed my eyes and I said “OK, I’ll give it to you. I give you my depression about family.” And she just accepted it, and it ended in her unafraid psyche.

My fears finally had someplace safe to go. There was another human being who got in there with me. After, that I would still get fearful thoughts sometimes, but they just didn’t have the same hold. And then some events happened that went counter to the (fear-based) evidence.

Practical Steps

After my second marriage ended, I knew I was going to have to do it on my own. So I got my mind around adopting the embryo and I went on an embryo donation web site.  I knew two people who had embryos, and they both came forward and offered them to me. Then it became a question of what the requirements and wishes of the donating families, and which was a better fit. I decided on a certain set of embryos. Then there was a very expensive legal transfer of the embryos to my posession. There was no legal precedent for transferring embryos, so my lawyer had to do original scholarship on it. The lawyers fees and transferring the embryos from one physical location to another took a lot of time and money. But finally, I was able to move forward.

Happily (Mostly) Ever After 

And then I met someone who basically was a much better suited partner for me than the other two I had chosen. For me that really settled and we entered into a long honeymoon period. I was having all this evidence that contradicted the fearful belief that I wouldn’t be able to have a family. (NOTE: Finding my partner was a very important piece, But I had already made the decision to have a baby. I know many single mothers, and anyone who wants to be a single mother, I would encourage you to do that. I made the decision to have a baby first, and then the right partner came.)

The embryos were transferred and then I began the medical procedures that I needed to do. I was in full menopause in 2009 and in 2014, I got pregnant.

On Fertility:

I was 45 when I went to through menopause. I think it was related to my eating disorder. Eating Disorders mess up your hormones. That’s probably why I went into menopause early. My mother was 55 when she was in full menopause and I was 45. If you have had an eating disorder, the good news is you can have a baby. There’s so much help now, in so many ways, to get pregnant.

So once we had the embryos in the right place, I started doing the medical procedures. I got the green light from the head of the fertility department that we could implant. It was an amazingly easy procedure. I had a very mild dose of the pain medication and I was completely awake. There was a teeny tiny tube that had the embryo in it and they had to look at it with a magnifying glass to make sure the embryo was in it. And then they put it into me and checked with their magnifying glass that there was nothing in the tube. The they said:

“That’s great, it must be in there.”

What I want people to know is: it felt like a conception. One of the members of the embryo donation family was there, and my partner was there, and a very dedicated acupuncturist. It seems futuristic and scientific, but that’s how my baby got conceived! It was love. It was different, but it was still love. It was not anything like I pictured, but it was still great.

I was afraid to get my hopes up. My whole world had been turned around as far as what I thought I knew about finding a partner, the kind of partner that I thought would be a good partner, and what I thought I knew about how I would make my family. So I didn’t want to get my hopes up. Looking back, I realized that there was a knowing, but it wasn’t like fireworks at all. Then I went to the doctor for a real pregnancy test. And I was pregnant!

How was the pregnancy?

I have terrible insomnia and I have had terrible insomnia since I was born. I didn’t sleep through the night till I was three years old. When I was pregnant, I slept great. I could sleep anywhere. I could fall asleep in 10 seconds, get woken up, and go right back to sleep. My experience of being pregnant was I was never so calm. I still feel that way when I hold my daughter. My whole system just goes calm. And I feel her system going like that. You know we just got lucky on that.

But in other ways, the pregnancy was very difficult. One way I had recovered from my eating disorder was to learn to eat when I was hungry and stop when I was full. But I didn’t feel hungry. I actually lost weight in the first trimester. I was getting worried because I thought the baby wouldn’t get enough nutrition. People were saying I looked funny. I was at my goal weight of what I wanted to be when I was in high school. I was so skinny. Why did I ever think that was attractive? I had to require myself to eat. As the pregnancy progressed, people said the sickness was going to go away. It didn’t for me. It kept going. I was worried I was carrying small. I had an ultrasound and the technician stopped the appointment to call the doctor and say:

“We have a 6th percentile here.”

My baby was only in the in the sixth percentile of growth. I became very worried. I was instructed to stop working. I had to stay at home. I was instructed to stop exercising. Then I had to come in every week, just to make sure the baby was growing.

Miracles happen

By about a week before she was born, my baby was in the normal range. It’s very unusual if you start out at the sixth percentile that you would get back into the normal range. I can’t say exactly what happened. The doctor thought it was because I was working at home and stopped exercising. Clearly that helped.  But it’s still a mystery to me how she could have grown that much.

Labor and Delivery

10 days before the baby was born, I found a doula to interview. We met on a Friday and we planned to meet again on the following Monday. Well, on the Sunday night before I had to lay down for a nap. And I felt all this wetness. Throughout the night the fluid that was coming out was pink, and then it came out brown and the doula said:

“You have to go to the hospital now.”

My friend drove me and I got there and they wanted to give me pitocin. I had heard that there was a cascade of interventions that they give you from there. I wanted to have a childbirth with as few interventions as possible. But an hour later, I still wasn’t progressing and they gave me a drip of pitocin.

I dilated very, very quickly. I pushed with no pain medication, doing everything with the help of the doula. I pushed and her head crowned. I could feel her. I did tear, and it really hurt. I’m never going to forget how painful it was. It’s not fair to women that you don’t remember it. This should be remembered.  My beautiful baby came out and she was strong. She was five pounds eight ounces at five pounds seven ounces, they take the baby into the NICU. She just made it. When they sewed me up, they were singing songs to her. It was very sweet.

Grace

The strange part was I thought I was going to have a completely empowered expansive experience when I was giving birth. I thought it was going to be like the earth mother would come through me and I would feel so competent. But it wasn’t like that. My inner critic was huge and loud every minute. It said I was doing it wrong.  That’s the only voice I heard in my head. I was so surprised. I was so pissed off!

After the birth I heard them talking about me at the nurses station. They said “No pain medication?”  Then the nurse came into my room and she said:

“You are my queen. I’m going to give you a tiara. All other all the other girls on this floor are 25 years old and they’re asking for epidurals. And you came in here with your doula and you did your thing.”

That was exactly what I needed to hear. I could not undo my own critic and this lovely nurse did it for me. It prompted a healing where I realized I am complete in all of my body. I can’t believe I ever rejected it. I realized I had thought the hardware was flawed. But the hardware was not flawed- it never was. The software was flawed. I had

miracle-babybelieved that my body was incompetent and wrong. But It wasn’t my body. My body knew what to do. My actual body is like a strong and powerful tree, or a flower in its infinite wisdom.

Her name is Gracie. It’s my way of thanking the family who donated the embryos and thanking God for finally giving me what I what I had so much.

Sheira Kahn, MFT, is a marriage and family therapist in the bay area who gave birth to a beautiful baby girl at age 50. To read more about her professionally, you can visit her website here

 

 

A Letter To My Belly

 

Dear Belly,

Every morning my little one pulls up my shirt, kisses you, and says, “I came from there!” You are fleshy now, stretched. I feel warmth and softness when I touch you. Mother. You hang over my jeans a bit. My sagging muffin top. I try not to mentally airbrush you out of pictures- the little traces of shame that still linger, the empire cut shirts, even though I haven’t been pregnant for five years.

Twenty years ago disgust for you filled my world. And crushed my spirit. All the self-loathing, anger, fear and shame were stuffed into you. I’m sorry. So many apology letters written to you in those first years of eating disorder recovery. But I did grow to accept you! And fed you. And then you created an amazing child! (Ok it was my womb, but you are the flesh that stretched to accommodate). You grew and stretched beyond what I thought was possible

Belly, I’m sorry that there are so many images in the world that don’t look like you. I know those images make you feel unloved, disgusting, flabby. I’m sorry those images make you feel wrong.

Those images tell you all kinds of crazy sh*t:

“Be smaller! Be flatter! Do this to be loved! Be big and full of yourself until age seven and then be flat and hungry. But don’t feel hungry! Just look thin! Don’t get angry! Hide your intuition. Don’t listen to it. Be attractive by not being yourself! Don’t get stretched. If you get stretched, get sucked and stitched back in.”

I just want you to know, Belly, they’re wrong, those messages. Contrary to what the images tell you, there is nothing wrong with you. Let me say it again as you have received those other brutal messages so many times.

Belly, there is nothing wrong with you.

What You Need to Know About Pregnancy and Eating Disorders: A Podcast

In introducing this month’s Butterfy Effect theme of CONNECTING, I am honored to share an interview by the founder of Recovery Warriors, Jessica Raymond, MS. Recovery Warriors is a multimedia resource hub for hope and healing from an eating disorder. Here is a link to the podcast: RecoverywarriorsPodcast

An overview

The desire to become a mom can be a motivating factor in eating disorder recovery. However,the challenges of pregnancy and the postpartum period mirror the early stages of recovery. Both pregnant and new mothers and women recovering from eating disorders experience anxiety, body image distress, difficulty sleeping, hormonal changes, appetite changes, and ambivalence/excitement/distress around cultivating a new identity. In this episode of The Recovery Warrior Show, expert Dr. Linda Shanti shares personal and professional stories of recovering from an eating disorder and entering into motherhood. Listen in regardless of where you are at in the biological cycle because there is much to learn.

What You’ll Learn

  • Why people don’t talk about miscarriages
  • How pregnancy is similar to early stages of recovery
  • Why you need to be proactive in seeking professional help before having a baby?
  • Why how a mother eats affects her child
  • Is there a right time to have a kid

 Favorite Quote

The moment a child is born, the mother is also born. She never existed before. The woman existed, but the mother, never. A mother is something absolutely new. -Bhagwan Shree Rajneesh

Advice to Former Self

You’ll get through this honey, you will. It’s going to change you and it is changing you and that’s ok; that’s the way it’s supposed to be. There’s no parallel life that you’re supposed to be leading; this is it, this is not a detour. Just because you’re suffering doesn’t mean you’re on the wrong path; you’re absolutely on the right path. Keep going.

Definition of Recovery

Taking care of yourself physically, emotionally, psychologically, and spiritually. Not engaging in behaviors that hurt me. Moving toward growth edges. Accepting my body as it is. Allowing and inviting all feelings. Lowering the bar on perfectionism. Thinking in the rainbow between black and white. Listening to my heart and connecting with a larger purpose.

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