Among 44 first-time mothers recruited from prenatal clinics in Stockholm, Sweden, over 90 percent with a history of anorexia nervosa or bulimia nervosa reported problems adjusting to motherhood in the first three months after childbirth, report Dr. Angelica Linden Hirschberg and colleagues from the Karolinska University Hospital in Stockholm.
The researchers found that 24 of women had a history of anorexia nervosa, an aversion to food and weight gain that can result in life-threatening weight loss. Another 20 had a history of bulimia nervosa, characterised by binge eating, self-induced vomiting, or excessive exercise to prevent weight gain.
The investigators compared the level of adjustment among this group with 67 first-time mothers without such a history of an eating disorder who served as a control group. All the women were between 29 and 30 years old on average, Hirschberg's group reports in the International Journal of Eating Disorders.
Thirteen percent of the women without a history of eating disorders reported problems adjusting to motherhood. By contrast, 92 percent of those with eating disorders reported adjustment difficulties.
For example, the women with eating disorders were more likely to worry they may not be a good mother; did not feel proud of being a mother; and felt they no longer had enough time for themselves. The researchers also found this group much less likely to enjoy feeding and caring for their babies, and more likely to worry their child would turn out unhealthy or not normal.
Adjustments to motherhood did not differ between those who relapsed and those who didn't relapse during pregnancy; by the type of pre-pregnancy eating disorder, or by the length of recovery from an eating disorder.
Fifty percent of the eating disorder group, compared with 10 percent of the controls, said they sought help for depression or other mental problems during the three months after childbirth.
This research indicates that first-time mothers with a history of an eating disorder are at extremely high risk of "less favourable maternal adjustment," the researchers conclude.