Body image problems during pregnancy

There is an increasing body of scientific literature showing how pregnant women might develop problems with their body image. This article briefly outlines the underlying cause of negative body image during pregnancy and ways to overcome them.

What is body image?

Body image is the person’s view, mental picture, and the perception of own physical body (such as size, shape, appearance) and the attitude (such as emotional beliefs, feelings, and thoughts) towards own physical body.

This often refers to someone’s own perceptions about being viewed as ‘attractive’ by others in society.

Research has shown that there is a significant correlation between a positive body image and psychological wellbeing during pregnancy.

Some pregnant women are very happy with their body image as for the pregnancy is a symbol of fertility and perception. (1) On the other hand, for some others, it might remain unchanged.

However, for many women physical and psychological changes during pregnancy result in negative body image and perception. (2)

In fact, in a recent survey (March 2019) by the Mental Health Foundation (UK), 41% of pregnant women reported negative body image.

During pregnancy, negative body image does not only stem from the change in shape, appearance and weight gain, but also to the changes in health and fitness.

Body image problems can develop for the first time during pregnancy (even if you do not have any issues prior to pregnancy) may continue or even worsen following a post-childbirth period.

Why there is weight gain during pregnancy?

1. The growing fetus, placenta and amniotic fluid and enlarged breast size (to help with breastfeeding).

2. Increased blood volume.

3. Water retention with arms and leg swellings.

4. Fat redistribution.

Why some women gain more than the recommended weight?

– Sedentary behaviour

– Lack of regular physical exercise

– Medical complications such as preeclampsia.

– Eating an unhealthy diet or ‘eating for two’.

What are the causes of dissatisfaction with body image?

Although weight-gain is often considered acceptable during pregnancy,  research shows that many pregnant women show dissatisfaction with their body shape and physical appearance. This is perhaps related to the stigma and shame attached to obesity in society.

The rapid changes in the body during pregnancy can result in negative body image.

1. Gestational weight gain:

This is perhaps the most important contributory factor. In this modern era, often the vital part of looking attractive for many women is being skinny.

In fact, in modern times, the bodyweight of the models in fashion magazines is 13-19% lower than the healthy weight. (3)

As a result, extra weight gain during pregnancy can cause body image problem for some pregnant women.

2. Psychological changes:

Negative body image can cause depression. In turn, depression can worsen and perpetuate negative thoughts and feelings about the body. This could be a vicious cycle.

Women with excessive gestational weight gain are more likely to stay overweight and have difficulty in losing weight after childbirth.

 3. Other pregnancy changes:

Tiredness, lack of fitness, acne, skin pigmentation, varicose vein, the feelings of being ‘less able to do things’ (due to discomfort, aches/ pains, nausea/ vomiting, posture, and balance changes).

body image pregnancy weight gain ifwip

Is there any impact of the Internet on the body image?

Internet, especially social media and mobile apps have become an integral part of modern life.

Without a doubt, the internet now is a vast source of useful health information.

This also allows an opportunity to interact distally with healthcare professionals and peer groups, monitor the progress of health condition/ illness, and to also promote a healthy lifestyle (such as a fitness App).

In this current digital world, pregnant women are accessing social media and health apps more than ever before to obtain health information.

However, we have to remember that very often the life of a person portrayed on social media is far from reality. The life events could be shared in a carefully planned way, sometimes with a business purpose in mind.

Social media also allows comments/ criticisms of any life events shared, which can result in self-doubt and humiliation.

Therefore, people need to be aware of the harmful effects of social media use, especially during pregnancy.

Research has shown that the use of social media can lead to negative body image.

The internet is now flooded with photos of pregnant celebrities and fashion brands promoting maternity clothes.

The photos are often professionally edited on computer software, such as Photoshop.

However, pregnant women may assume that they should ideally look like them and create a mental picture of a ‘perfect’ body.

This can result in a negative body image and self-comparison in subconscious mind trying to look ‘perfect’ and attractive to the outside world.

A study showed how the use of Facebook can result in body image problems during pregnancy.

What are the risks of body image dissatisfaction?

The negative body image can lead to the following:

1. Antenatal and postnatal depression: Research suggests that body image problems are likely to be an important factor of depression in the perinatal period. In turn, depression can result in or worsen negative body image.

2. Low self-esteem, anxiety, and social isolation

3. Excessive dieting (which might lead to poor nutrition)

4. Poor parent-infant attachment

5. Increased smoking

6. Obesity

7. Reduced breastfeeding rate.

8. Persistent body image problem beyond pregnancy

9. Can have a negative impact on relationship.

10. Intergenerational transmission: eating and body image problems can pass on to the baby.

“It is her attitudes towards bodies, and her own bodily sense which she will pass on. As she absorbs the cultural messaging about thinness and fatness, she makes the culturally praised values her own but the means to manage those values inside of herself may clash with her ability to moderate her own appetites in a healthy way” – Government Equalities Office

How you can minimise body image problems during pregnancy?

1. Understand the physiological and psychological changes your body goes through during pregnancy to ensure a safe transition to parenthood. Also, learn about your posture and balance changes.

2. Talk to people you trust and share your thoughts and feelings.

3. Participate in regular exercise (if there is no medical restriction) and change sedentary behaviour.

4. Eat healthily.

5. Try a relaxation technique or massage.

6. Speak to your healthcare provider if the symptoms are worsening.

7. Please remember that you are not alone.

What healthcare providers should do?

1. Have education and training to learn body image issues during pregnancy and beyond.

2. Display images of healthy and well pregnant women of different bodily appearances.

3. Careful wordings during communication.

4. Inform pregnant women of body image problems and explore their views and perceptions.

5. Refer promptly to a psychologist or a relevant team if someone develops a significant negative body image condition.

6. Inform them about possible post-partum changes.

Reference

1. Mayes’ Midwifery. Fourteenth Edition.

2. Midwifery essential: Antenatal. Volume 2. Helen Baston, Jennifer Hall. Churchill Livingstone 2009.

3. Cusumano DL, Thompson JK. Body image and body shape ideals in magazines: exposure, awareness and internalization. Sex Roles 1997; 37(9).