Body Dysmorphia During Pregnancy

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Written by Psychologist Nikolina Miljus

Negative body image and body dysmorphia can make your pregnancy feel like nine months of torture.

Your body is changing dramatically and so do your feelings about your appearance.

The first step to coping with body dysmorphia is understanding how it works.

Unhappy With Your Body

Pregnancy is the time of tremendous physical and psychological change.

Your body transforms to nurture and grow a new life, and this process is mostly out of your control.

For many women, pregnancy can also be very unpleasant physically, with endless “morning” sickness, heartburn, back pain, constant tiredness, and, of course, a weight gain.

On top of the physical reality of pregnancy, the psychological fact of your changing body is fuelled by intense emotions and hormonal shifts.

The additional pressure of your upcoming new role as a mother while remaining the romantic partner can challenge the way you feel about yourself and your body.

Overall, women tend to have more issues with body image than men.

One of the explanations about the root causes of body dysmorphia and why it affects women more frequently than men is closely linked to how our modern society and media work.

Young girls and women are usually praised for how they look, instead of what they know or do.

This creates a subconscious idea that the prettier you are, the higher is your worth.

Even in cases when these issues don’t reach the full extent of eating disorder or a body dysmorphic disorder, feeling unhappy in your own body can make your pregnancy even more difficult than it needs to be.

What is Body Dysmorphia?

Body Dysmorphia, also known as Body Dysmorphic Disorder (BDD) and Dysmorphophobia, is a mental health condition where a person becomes obsessed with a physical flaw.

The imperfection could be imagined or if existent, is unnoticeable to most people.

Your body image involves how comfortable you feel in your own body and how you feel about your appearance.

These feelings are usually mixed with your thoughts and feelings about what other people think about how you look.

The worries about your body image usually center around weight, but there are also women with negative body image which are focused on one specific part of their body, for example, their nose, stomach, face or skin.

The main difference between being unhappy with how you look and clinically disturbed body image is in how realistic your worries about your appearance are, and to what lengths do you go to reach the “ideal body” that you envisioned for yourself.

Notable, negative body image is also a significant aspect of eating disorders such as anorexia and bulimia.

Women who have one of these disorders see themselves in a distorted way that is vastly different from how other people see them.

As some of the women who recovered from anorexia testify when they look back at pictures of themselves, they saw themselves as overweight in the mirror even when their ribs were clearly visible.

No amount of food restriction, purging, dieting or exercise was ever enough to reach their ideal body.

Similarly, women with BDD perceive a specific part of their body as ugly, no matter what.

Even after cosmetic surgeries they still keep finding details that are less than perfect, despite reality clearly showing that their appearance is perfectly normal.

Additionally, the symptoms of body dysmorphic disorder can include:

Obsessing over your weight and appearance
Constantly seeking reassurance from others
Constantly comparing your appearance with other people
Dieting, calorie counting, chewing and spitting out food
Exhausting your body with the exercise
Relationship issues: feeling unloved, unattractive or undeserving of love
Feeling depressed, anxious or panicky
Avoiding situations in which you think your appearance might be judged
Obsessive skin-picking

How Body Dysmorphia Affects Pregnancy

The negative body image doesn’t always have to reach the proportions of life-threatening weight loss or extensive plastic surgery to become damaging to your psychological wellbeing.

This is especially true in pregnancy, when you’re already sensitive to all changes happening in your relationships.

Negative body image involves negative, self-judgmental and hurtful thoughts, ranging from disgust with your own body to negative self-talk and low self-esteem.

It would be impossible to find a woman who is not to some degree disgusted with feeling sick all the time, or a woman who wishes she wasn’t as large as she is in the closing months of her pregnancy.

The critical difference that separates reasonable feelings of disgust and the hurtful thoughts arising from negative body image and body dysmorphia is in the object of disgust.

Women who don’t have issues with their body image may feel disgusted by their morning sickness, for example, and say “I hate this constant vomiting – it is disgusting!”

But a woman who suffers from body dysmorphia is more likely to say or to think “My vomiting is awful. It must look disgusting to others.”

A significant part of self-deprecating thinking in women who have body dysmorphia or view their body negatively involves making inaccurate conclusions, often based on incorrect assumptions.

For example, when she says, “Nobody will love me with stretch marks” she is making a generalized conclusion based on one single negative fact, without any particular proof.

Having stretch marks doesn’t make you less worthy in any way, and if you were to ask people closest to you why they enjoy spending time with you “the lack of stretch marks” would be a very unlikely answer.

In pregnancy, these feelings and negative self-talk can only add guilt and make you feel like you are not going to be a good mom since they easily push out of your perspective the main reason why are all these changes happening.

Seeing the photoshopped images of smiling pregnant celebrities with perfectly toned bodies doesn’t help either.

Expecting you’ll return to pre-pregnancy weight “in no-time” and that it’s OK to take part of exhausting daily workout routines only a few days after the childbirth just isn’t a reality for most women.

Comparing yourself with their unrealistic standards will only make you feel worse about your body.

What you’re not taking into account when you make these comparisons is the fact that you are comparing yourself not with your peers, but with women who have “looking perfect all the time” as a part of their job description.

A regular woman who takes care of the household, works a full-time job, and takes care of her body in her free time, is no match for a professionally groomed (and later photoshopped) appearance.

What To Do If You Have Body Dysmorphia During Pregnancy

The overly restrictive diets and vigorous exercise are not an option in pregnancy.

If you are even considering going along this path, please share your plans with your OB-GYN or a midwife first.

There are moderate workout plans and ways to eat healthy that don’t harm you or your baby, so focus on those.

In case you notice any of the symptoms of eating disorders, or body dysmorphic disorder resurfacing – don’t hide them. Get professional help before they complicate your pregnancy.

The alternative to self-hate is in acceptance: your pregnant body is beautiful because of the new life it nurtures.

The stretch marks and your stomach mean little when you get to hold your baby in your arms for the first time.

Reaching this level of acceptance is a process. It involves realizing that your value as a human being is much more profound than just the way you look.

Your body is capable of bringing a new life into this world, a life that you and your partner created together.

Here are some ways you can reinforce a more positive body image in pregnancy:

Keep the End Goal in Mind

The way your body looks and feels during pregnancy is not permanent. It is only the temporary price for nurturing your unborn baby that enables it to grow and develop.

If you need to remind yourself of this fact, take a look at your sonogram image. You are not gaining weight because you’re overeating, but because there is a life growing inside you.

Self-Care

A great way to reconnect with your body in pregnancy, while also giving you a way to be moderately physically active is a light prenatal exercise, or even better a prenatal yoga class.

Yoga, in particular, can give you a chance to enjoy your body for what it can do, rather than keeping your focus on how it looks.

Therapy

When self-hating, hurtful thoughts and possibly self-harming behaviors become too severe and become a threat to your and your baby’s wellbeing, the psychotherapy becomes the best option to cope.

Cognitive-behavioral therapy, for example, targets these irrational thoughts and helps you learn how to defuse their harmful content.

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