When I was pregnant I actually quite liked my body for the most-part, I enjoyed my ever-growing bump and have lots of photos holding my tummy and smiling. I was however also crippled with daily sickness and very painful SPD (symphysis pubis dysfunction) which often made me feel like a wadding duck. Despite this, I wouldn’t say during pregnancy I had a particularly negative body image.
However my birth plan did go as intended and I ended up having an emergency C-section. I was in hospital for a week and during this time only had bed baths until the end of the week when I got a shower, supported by my husband to do so.
I remember standing in the hospital shower cubicle and just feeling despair as I saw my body in the long mirror. I hadn’t see myself naked at all up to this point, and in front of me was yellow skin (due to bruising) and a scar that looked like the Jokers smile with sutures and staples across it. I felt like my body looked like a bloated, droopy, mouldy pear… those were pretty much the words I used to describe this and it took me quite some time to feel accepting of my body and certainly added exacerbated the issues I was facing regarding my mental health and postnatal OCD.
I therefore thought that perhaps there was some information on body image and its impact on women both antenatally and postnatally, and I was right. It seems however that it is an issue that isn’t addressed within the healthcare system as it should be. In 2014 a very in-depth report was published by the NHS upon a mother’s body image and resulting sense of self-worth and the potential impact of this upon her baby / child (see ‘Two for the Price of One: The impact of body image during pregnancy and after birth’).
What is body image?
The term body image was coined in 1935 by an Austrian psychiatrist and neurologist and it refers to the mental image and attitude we have towards our own body based upon how we believe others see us. A healthy body image involves us having an objective perception of our appearance and ability to separate the values we hold about ourselves / others from the way we / others may look.
Becoming a mother is a time of transition and transformation. Being pregnant is probably one of the biggest bodily changes a woman will experience within her lifetime; and following the birth of her child for many women, her body may just not return to how it was pre-baby.
Some of the many physical changes a woman may experience include:
v Weight gain: A woman will typically gain around 25-47lbs during pregnancy, with 6-8 lbs accounting for the baby’s weight and the remaining gain due to enlarged breasts, uterus, placenta and amniotic fluid
v Swelling: Swollen ankles & feet
v Teeth: Gums may bleed more easily
v Breasts: Enlarged & tender breasts; from week 6 onwards, a woman’s nipples may become larger and more prominent, they will also darken due to an increase of natural pigmentation
v Marks: Stretch marks / discolouration; Linea nigra (around 80% of women experience this dark line on their belly during pregnancy after the first trimester)
v Hair: Hair growth (due to increased oestrogen); Hair loss (following the birth of baby due to reduced oestrogen)
v Belly button: This may stick out (as the woman’s abdomen expands in the late 2nd trimester, or during the 3rd, her belly button tends to “pop out” and an “innie” may become an “outie”
v Growth: Foot growth: some women go up an entire shoe size, this may be due to an increase in growth hormone and / or their foot arches flattening out
v Scarring: A woman who has had a caesarean section will have a scar around 10-20 cm long at the top of their pubis, over time this scar will fade.
These changes are no terrible thing, and in fact they are changes that that we as women a as a society should be embracing, however for many women these bodily changes can cause emotional issues and distress regarding their body image.
Unfortunately there is a relentless pressure on all women regarding their outer appearance, with social media and fashion industry playing a huge part regarding the cultural insinuations of how a woman should present herself both pre and post birth. Bust and hip measurements have decreased and the body weight shown in magazines is 13-19% lower than a healthy weight.
Social pressures reinforce the desirability of the ideal appearance as thin and almost gaunt-like or otherwise super-athletic, can often make it difficult for women during pregnancy and during the postpartum period to maintain a positive body attitude and to be self-accepting.
‘Pregnancy is the time in a woman’s life when weight gain is encouraged and expected while at the same time female body is idealized in our society’. (Breda, Schumann & Arshad, 2015)
So what is the big deal?
No one is born with a negative body image, however people can begin developing dissatisfaction with their physical self at a very young age.
Studies show that approximately 50% of preadolescent girls and 30% of preadolescent boys dislike their body. 60% of adult women and 40% of adult men have a negative body image.
‘Images and experiences of pregnancy is usually a time of hope, joy and promise. Many women enjoy being pregnant. They revel in their growing roundness and feel good on the outside as well as the inside. For others, discomfort about bodily changes causes worry and creates a background of discomfort and anxiety about how large they are, how limited their control over their own bodies, and about whether they will ever get their bodies back. For still others, the difficulties are far more serious’ (Lemberg & Phillips 1989)
‘We learn about love, food, attachment and how to be in our bodies from our relationship with our mothers’. (Orbach, 2009)
There is a relentless pressure on all women, celebrities or not, to be thin all the time and many womens response to this may be to ‘self-focus rather than babyfocus in a way that is not about health but is about the reclaiming of skinny jeans after delivery’.
The first few months of life are critical in establishing the foundations for well-being in the mother-infant couple and for the building of security and resilience in the baby. However, unrecognized hindrances may arise out of women’s insecurities about their self-esteem, their body image and their own eating. These can intercept their ability to listen to the whispers of their maternal instincts.
‘All babies are attachment seeking and develop the psychological apparatus to depend on what is offered. Thus if the mother is available and attuned, the baby will make her attachment experiencing that security. If the mother is distracted or anxious, neglectful or preoccupied, the baby will understand in her or his very being, the experience of attachment in those terms’.
Research shows mothers who are preoccupied with body image problems are not only damaging their bodies but these negative attitudes can be passed onto their children. Young women may be more susceptible to developing poor body image if their mothers were worried about their weight or looks.
Becoming ‘an ordinary devoted mother’ (Winnicott 1960) is not as natural a process in our times as we might wish. It is often fraught with pressures and anxieties derived from women’s relationship to their bodies – including their ability to feed and nurture themselves – along with an avalanche of often contradictory parenting advice, plus media messages that the most important thing about giving birth is the retrieval of the pre-pregnant body (Orbach, 2009).
York and Anglia Ruskin Universities developed a self-reporting system called The BUMPS method. The reporting method relates to mothers satisfaction regarding their appearance during pregnancy and weight gain concerns. In a study of more than 600 women, the BUMPS questionnaire showed that ‘women who felt more positively about their body changes in pregnancy were more likely to have better relationships with their partners, lower depression and anxiety scores; and were better at interpreting their bodily signals’ (Open Access Government, 2019).
‘Combined scores from the questionnaire provided a strong predictor of whether a woman would have a positive attachment to their unborn child or not. Low scores, suggested that these women may need additional emotional support during pregnancy and monitoring after birth for signs of postnatal depression.’ (Open Access Government, 2019)
Steps to overcome and challenge a negative & distorted body image during pregnancy / the postpartum period:
1. Do a social media detox: limit exposure to diet culture messaging and images of the “perfect” pre and post baby body
2. Wear clothes you enjoy: Buy clothes that fit and buy something that helps you enjoy your mamma body.
3. Stop body checking: Stop weighing yourself, stop looking in the mirror repeatedly, stop taking selfies and using filters (certainly try and cut this down) and appreciate yourself for who you are. Allow yourself the right to live in comfy clothes and ditch the heels and skinny jeans and lacy undies, or allow yourself the option to embrac