Body Dysmorphia in Pregnancy: How to Combat Negative Body Image
It’s certainly not breaking news to say that your body goes through massive changes during pregnancy. It’s a miraculous, life-giving transformation for sure, but it can be a difficult one—physically and mentally—nonetheless. The reshuffling of internal organs, the too-tight skin stretching and that ever-expanding bump can make you feel less than physically comfortable (and less than physically attractive). The literal growing pains of pregnancy can be downright consuming. What’s more, for someone with body image issues, or body dysmorphia, seeing an evolving reflection in the mirror can weigh heavily on their mind. So what exactly is body dysmorphia in pregnancy, who is most likely to experience it and how can you work to overcome the negative thoughts? Read on for expert advice.
Body dysmorphia—or body dysmorphic disorder—is a mental health condition that causes someone to fixate on perceived flaws in their physical appearance, explains Charlie Nicely, MHC, a psychotherapist and wellness coach. It can be related to weight, but it can also be tied to other physical attributes. This unrelenting preoccupation can occur during pregnancy, as the body you once knew and loved (or maybe never really loved) changes right before your eyes.
While others may dotingly touch your bump or appreciate your body, you may fixate on things you don’t like about your form. How you look—or how you think you look—becomes something of an obsession. Kristin Yeung Lasseter, MD, founder and president of the Reproductive Psychiatry Clinic of Austin in Texas, says that this can manifest as certain habits, such as constant mirror checking.
Of course, waking up to see you’ve suddenly sprouted a bump, you have varicose veins down your legs and your bra size is now a double-D can be shocking (or exciting! or appalling!) for any newly pregnant person. While some people may absolutely relish in their changing bodies, others feel less than enthused about the noticeable shift.
Additionally, trans, non-binary or gender-expansive pregnant people, who may have previously struggled with their bodies, can have especially strong feelings about their changing size, shape and form. “Feelings of incongruence are likely to become more pronounced, and dysmorphia-related anxiety is likely to increase due to physical changes, as well as the social role changes that accompany pregnancy, postpartum and parenting,” says Nicely. “Pressure to conform to norms concerning femininity and maternity—being in a body that is socially coded and related to as feminine” can add fuel to the fire. Nicely adds that, “increased instances of being misgendered and incorrect assumptions of one’s sexual orientation” can further stoke the flames.
It’s okay to not enjoy every part of pregnancy. And if that means that you don’t particularly love your current figure, that’s fine too. “Individuals who start experiencing body image concerns in pregnancy are not alone. Many people struggle with the way their body changes in pregnancy,” says Yeung Lasseter. Recognizing that this is but a moment in time helps. Of course, if a negative body image is getting in the way of you living your life, or if it’s affecting your mental or physical health, you’ll want to take some steps to take back control. Here’s how to get started on facing body dysmorphic disorder in pregnancy and beyond.
If you’ve previously struggled with body image, know that you might be more at risk for experiencing body dysmorphia in pregnancy. “Prepare to regress. Anything that [you’ve] worked on or haven’t worked on prior to becoming pregnant can and will be stirred up and likely magnified,” says Gertrude Lyons, EdD, director of family programs at The Wright Foundation for the Realization of Human Potential in Chicago, Illinois. “Your ‘stuff’ will come up, so it’s best to be prepared.” Identifying your risk before pregnancy can help you take proactive steps to keep your physical and mental health strong during those nine+ months and beyond. “Have support lined up. Be ready to do the work and see this as a transformational experience—an opportunity to go deeper,” says Lyons.
Seek out therapy
Body dysmorphia symptoms may be omnipresent in your life—or they might just sneak up on you. If you’re feeling depressed or anxious, or are experiencing negative thoughts about yourself and your body, therapy can help. “The first suggestion is to seek out a skilled therapist who has experience navigating these challenges and who you feel you can be yourself with,” says Nicely. “In my work with clients, we work towards developing the skill set of self-compassion.”
Take good care of yourself
Work with your ob-gyn or midwife to make sure you’re prioritizing your physical health, getting adequate calories and nutrition and staying active in an appropriate way. Body dysmorphia isn’t always about weight, but the condition can sometimes go hand-in-hand with disordered eating and excessive exercise—two things that can be a danger to you and baby. “Some eating disorders can cause electrolyte imbalances and cardiac abnormalities in the parent, which can be detrimental to the life of the baby,” explains Yeung Lasseter. “Eating disorders may also increase the risk of high blood pressure, diabetes or malnutrition, all of which can impact the growth and development of the fetus.”
Encourage positive self-talk
When the negative thoughts creep up, counter them with positive self-talk. “Research shows self-soothing, positive talk is proven to calm your anxiety,” says Lyons. “Give your body and yourself new messages to believe. It helps to call yourself by your name when speaking positive, soothing things to yourself.” The truth is: You may not love your body right now, but it’s doing something quite remarkable. Remind yourself of how worthy you are to be a parent. What’s more, remember that your body is growing an actual human being. That’s pretty amazing—even if you’re not feeling so great about the way you look. Your body and your biased perception of your body are two different things.
Stop with the comparisons
“It’s natural to compare—welcome to [parenthood]! You can choose to participate in the constant comparison game or to have your own vision,” says Lyons. “Have acceptance of your journey, name your own values and criteria for success and identify how you want to feel.” With that in mind, know that social media is a breeding ground for unhealthy expectations. No two pregnancies are alike—and no two bodies are completely the same either.
Connect with your partner
When you have negative feelings about your body, your gut reaction may be to internalize these feelings. What’s more, you may shun physical and emotional connection from your partner. (When you don’t like something about your body, it’s hard to see why someone else might love it.) But Lyons says that this experience can actually make your relationship stronger. “This journey can bring a couple closer if you’re consciously communicating, exploring what it would take to trust and asking questions to understand what is needed to feel supported and safe,” she says.
Find a team that supports you
You want your ob-gyn or midwife and support team to validate you as a person. Don’t hide your feelings. It’s important they understand what you’re going through—physically and mentally.
Affirming care is especially important for those in the LGBTQ+ community, who often experience implicit bias in care. “Affirming care is health care that attends to trans and/or gender-expansive people’s physical, mental and social health needs and well-being while affirming their gender identity,” explains Nicely. “It’s critical in the beginning to cultivate self-acceptance while engaged in supportive medical care. Finding providers that specialize in working with trans and/or gender-expansive people during and after pregnancy is ideal.”
Continue to show yourself grace
Body image issues don’t just disappear the second you have a baby. The postpartum period is another phase of physical and emotional transition. Your breasts may swell and leak, your tummy may staunchly remain and stretch marks can continue to plague you. You need to give yourself plenty of time and show yourself lots of kindness.
“Getting help and resources can make all the difference during the postpartum period, which is an important time of growth and development of a baby,” says Yeung Lasseter. “The healthy development of an infant is very closely linked with the mental health of a parent. By taking care of our mental health, we are taking care of our babies.” What’s more, keep perspective and remember what you just did: You brought a being into the world. And they love you unconditionally. Try to see yourself through their eyes.
About the experts:
Kristin Yeung Lasseter, MD, is a psychiatrist specializing in reproductive psychiatry and women’s mental health, and is the founder of the Reproductive Psychiatry Clinic of Austin, Texas. She earned her medical degree at the Long School of Medicine at the University of Texas Health Science Center in San Antonio.
Gertrude Lyons, EdD, is lead faculty member, senior life coach and director of family programs at The Wright Foundation for the Realization of Human Potential and the founder of Rewriting The Mother Code. She holds a master’s degree and doctorate of education.
Charlie Nicely, MHC, is a transgender nonbinary psychotherapist based in New York City. They work with other trans and/or gender-expansive people, sexual minorities and parents who are gender and sexual minorities.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.