Bulimia During Pregnancy Raises Anxiety and Depression Risk

A new study from the Norwegian Institute of Public Health (NIPH) shows that women who have bulimia in pregnancy have more symptoms of anxiety and depression as compared to pregnant women without eating disorders. They also have lower self-esteem and are more dissatisfied with life and their relationship with their partner.

The findings come from the world’s first major population study of psychosocial factors in bulimia (bulimia nervosa) during pregnancy, which can have serious consequences for both mother and child.

The study analysed more than 41,000 pregnant women who responded to a questionnaire from the Norwegian Mother and Child Study (MoBa).

Sexual and Physical Abuse Higher

Women suffering from bulimia reported a higher incidence of life-long physical abuse, sexual abuse and major depression compared with others, said Cecilie Knoph Berg at the NIPH, lead author of the study. Titled Psychosocial factors associated with broadly-defined bulimia nervosa during early pregnancy: Findings from the Norwegian mother and child cohort study, it is published in the Australian and New Zealand Journal of Psychiatry.

Women who had bulimia six months before pregnancy but who were free of bulimia symptoms in the first trimester, experienced higher self-esteem and satisfaction with life compared to women with persisting symptoms.

Anorexia nervosa and bulimia are ten times more prevalent among women than men. At any one time, women in Noway of the age group 15-44 years have an eating disorder: 0.3 percent have anorexia, two percent have bulimia and three percent have binge eating disorder. Approximately 30 percent of persons with bulimia have a history of anorexia.

Sexually Abused Women’s Birth Terror

A somewhat related study, also from the Norwegian Institute of Public Health, further highlights the negative effects of abuse on pregnant women. Researchers found that women who have experienced sexual abuse as adults are at greater risk of experiencing extreme fear during childbirth.

Certain women have feelings of intense fear or panic during birth, and obstetricians and midwives have clinically noticed that this can be associated with sexual abuse. In this first major study of this link, 414 women who had given birth completed a questionnaire about their experiences 6 weeks post partum.

Three percent of the women reported extreme fear, 13 percent had some fear and 84 percent experienced no fear during the birth. 12 per cent had been sexually abused as an adult. The stronger the fear, the greater was the risk that the woman had been subjected to assault. Among the women with extreme fear during the birth, a third had a history of sexual abuse in adulthood.

May Prolong Birth

Severe anxiety during delivery is known to sometimes slow down birth, which may deprive the child of oxygen. It is also common to use more pain-relief in such situations, which can affect the womans ability to co-operate.

Researchers also found that depression in pregnancy, a long birth, vaginal delivery with vacuum, forceps, breech birth and twin births were other factors associated with extreme fear during birth.


Australian and New Zealand Journal of Psychiatry, Volume 42, Issue 5 May 2008 , pages 396 – 404
DOI: 10.1080/00048670801961149

Fear during labor: the impact of sexual abuse in adult life. J Psychosom Obstet Gynaecol. 2008 May 28:1-4

Image by Ibrahim Iujaz, Creative Commons License.