Table 3 Themes and quotations extracted from included articles in a review of qualitative studies about wanted support expressed by pregnant women with eating disorders (ED). Quotes from the included articles were recoded into themes concerning wanted support during pregnancy with an ED. The themes were; ‘Wish för support from health care’, ‘Wish for Support from a partner’ and ‘Wish to use Self-help strategies’
Article | Quotations from included articles expressing wishes for support | Themes concerning wanted support |
|---|---|---|
Barriers to identifying eating disorders in pregnancy and in the postnatal period: A qualitative approach | “I didn’t have the same midwife for long enough to speak to them, it was rather stressful and upsetting” | Wish for support |
“I don’t like to talk about it and think I can manage on my own” | Self-help strategies | |
“I just wanted to deal with it myself” | Self-help strategies | |
Tierney et al. [35](2011) Treading the tightrope between motherhood and an eating disorder: A qualitative study | ‘‘I really, really wanted to be able to eat more in order to produce better milk and I couldn’t do it and I felt that I’d failed him. I can remember crying when I was buying the formula for the first time and I couldn’t...be around when he was given the formula because it upset me...I didn’t want anyone else to know he was getting the formula. There was only me and my husband that knew we were giving it to him.’’ | Whish for support |
‘‘I’d stopped like proper exercising, weights and biking and stuff like that at about six months and then I thought OK we’ll just see this as a little retirement. You can start it all up again once the baby’s here. And I just let go fullstop then. I just thought OK just monitor your weight, make sure you don’t put too much on and just be relaxed about it all. You can work at making it all better once [daughter] turns up.’’ | Self-help strategies | |
Waking up every day in a body that is not yours: a qualitative research inquiry into the intersection between Eating Disorders and pregnancy | “I certainly felt a lack of … communication between psychiatric care and maternity care and needing some sort of, it doesn't have to be a specialized midwife but just someone who can cross barriers and help you navigate your way through the pregnancy from both perspectives and not just one or the other.” | Wish for support |
“Fortunately, my husband, when they were in second grade and third grade … because I was making like bizarre food. He completely took over food. He brought in chips. He normalized food for my girls. I think that probably saved them, considering that my own biological mother had an eating disorder and then I did.” | Support from a partner | |
“somebody could know and do the checks, but it’s information that I’d rather not know.” | Wish for support | |
“I completely threw myself relentlessly into school at that point … because I had to distract myself somehow.” | Self-help strategies | |
“I forced myself to not keep track of things anymore … because at the end of day I knew I had to be consuming at least 2300 cal and if I hit that, I’d be upset, but then if I didn’t hit that, I’d be upset. So, either way, you’re never going to win in that situation … I just had to give up accountability all together and just say fuck it.” | Self-help strategies | |
“I don’t trust myself to make the best decisions regarding pregnancy. Maybe I would and I’m underestimating myself, but I would rather just have the outside support.” | Wish for support | |
“I go to the bathroom at the end of the meal and it's like I have to remind myself not to do it. I choose not to because I know it's not healthy, but it's a choice that I make.” | Self-help strategies | |
Mason et al (2012) [18] The experience of pregnancy in women with a history of anorexia nervosa: An Interpretive Phenomenological Analysis | “Um… the only thing that I did manage to do, mostly, was give up taking laxatives.” | Self-help strategies |
“Yeah, I did struggle with the changing body, yeah, I did find that hard…, but at the end of the day I knew that was what I wanted. To have kids. So I had to motivate myself to do it.” | Self-help strategies | |
“…You’re not really thinking about anyone else, and all you think about is food, and so… um… I just had to stop being like that, it was like ‘‘well I can’t think about myself anymore, I’ve got a baby that I need to, that needs to develop and it needs to be born and it needs to be perfect, and so I can’t think about myself anymore.” | Self-help strategies | |
“And it wasn’t just my baby, it was husband’s baby as well, and I didn’t want to let anyone down…” | Self-help strategies | |
“I didn’t react to [the feelings], that’s the important thing. I didn’t let them fester too much. I think the feelings were there, but I didn’t respond to them…” | Self-help strategies | |
“And the sort of eating thing, and how I eat, that could just sort of be kept on the backburner until after I’d had the baby. And then I’d start thinking about it again and how I was going to get, you know, lose the weight and get back to how I was before.” | Self-help strategies | |
“I think I almost… every time a feeling crept in, I almost saw it as a bag that I put to one side for the time being. It was like, you know, that’s an issue for later, that’s going to have to be dealt with later…” | Self-help strategies | |
“I was fighting the ED more, I was more prepared to challenge it, and I was more worried about the consequences” | Self-help strategies | |
“I suppose it I do it now as a way of, well, just punishing myself and things like that, but I suppose when you’re pregnant you don’t want to punish the child as well.” | Self-help strategies | |
“I was OK with the changes which I could directly attribute to being pregnant. I was fine with having a big bump, and I quite liked that. Um… but I wasn’t OK with putting weight on anywhere else at all… …I was happy to look pregnant, and I wanted to look pregnant, I just didn’t want to have any fat anywhere else, on my legs, or arms, or face, anything like that…” | Self-help strategies | |
“I just knew that that was going to be the precious, the most precious thing to look after, and actually my body was sup- porting and nurturing a little person in there, and that was more important to me than anything.” | Self-help strategies | |
“So I didn’t get any help. And I did actually say to my doctor as well, I remember saying to him I felt really depressed and low, and I wasn’t offered any help… I felt as if, ‘do people really believe me here? Do people believe that I feel…?’… And so I felt, yeah, I felt wretched… Yeah I didn’t feel good. I felt completely and totally miserable when I was pregnant.” | Wish for support | |
“I guess I felt as if… I had been abandoned to be honest… I wasn’t asking for a lot, I think. And that’s the thing that I feel so let down about. I wasn’t asking for a lot, I was just asking for a phone call, or someone to just pop by and see me, and just sit and chat for an hour, you know. I just wanted some contact with the outside world, and I’m not exaggerating when I say that just didn’t happen at all.” | Wish for support | |
“…a lot of what the midwives give you is geared towards staying active and not gaining too much weight during pregnancy, and all the health problems which could be caused by gaining too much weight. It’s aimed at the general population, and I can see that now. But… I think when you’re in the middle of an eating disorder, you could sort of use it to think ‘‘well, it’s just as unhealthy if I gain all this weight, and if I gain weight I’ll have gestational diabetes and pre-eclampsia and all these things”.” | Wish for support | |
Stitt & Reupert (2014) [30] Mothers with an eating disorder: “food comes before anything” | “…. directed at younger people and not older people... yeah there isn’t [aren’t] methods that include family life” | Wish for support |
“meal plans within the context of family life” “I can’t set my meal plans …. when you’ve got kids your life isn’t your own to manage as you would like ….” | Wish for support | |
“It’s not appropriate for me as an adult to have my mother come and take control of my food, and while my husband, I guess, was willing and able to do that, that’s sort of not really an appropriate balance in the relationship either.” | Support from a partner | |
“…. therapists don’t quite get that everybody doesn’t have babysitters they can ring up at short notice …. I actually had one woman who …. basically said ‘If you can’t commit to come every single week then I can’t treat you’ and I said ‘Look, I’m trying but if my kids are sick, what do I do’ ….” | Wish for support |