Pregnancy and the self: a qualitative exploration of the impact of pregnancy on self-identity and the relational self in women with a history of anorexia nervosa

Abstract

Objective: To explore the impact of first pregnancy on self-identity and the relational self in women with a history of anorexia nervosa (AN). Method: Semi-structured interviews were conducted with six women with a history of AN. Data were analysed using interpretative phenomenological analysis. Results: Three superordinate themes emerged from participants' accounts: (1) ‘the negative self’; (2) ‘making way for self as mother’; and (3) ‘social isolation and relational strain’. Discussion: Women with a history of AN may find the psychological process of adapting to pregnancy and motherhood particularly challenging. Pregnancy was also a time of social isolation and relational strain for many women. Findings suggest a need for clinical interventions that address the potential impact of becoming a mother, taking into consideration practical, psychological, and relationship issues.

Keywords:

• pregnancy
• anorexia nervosa
• self-identity
• relationships
• qualitative

Notes on contributors

Dr Zoe Tillotson graduated from the Oxford Doctoral Course in Clinical Psychology in 2010 and completed the research presented in this paper as part of her doctoral course, supervised by the co-authors. She currently works in chronic pain management in Suffolk.

Dr Myra Cooper qualified as a Clinical Psychologist in 1984 and completed a DPhil in 1991. She works as Senior Research Tutor on the Oxford Doctoral Course in Clinical Psychology. She has a longstanding interest in clinical and experimental research relevant to eating disorders.

Dr Hannah Turner qualified as a Clinical Psychologist in 1999 and completed a PhD in 2008. She currently works as a Consultant Clinical Psychologist and is Clinical Lead at the Southern Health NHS Foundation Trust Eating Disorders Service, Hampshire, UK. She has an on-going interest in facilitating research in clinical settings.

Notes

Notes: ^aNames, along with other significant identifying details, have been changed throughout this report.

^bThis is based on the women's accounts and was not measured formally.

^cEAT-26 scores can range from 0 to 78; a score of ≥20 is considered ‘high’.

^dPregnant at the time of interview.