• May 15, 2024

Eating Disorder Recovery During Pregnancy with Tanya Kretschman: Episode 54

In this episode of the podcast, we are joined by the incredible Tanya Kretschmann to discuss her recovery journey, eating […]

In this episode of the podcast, we are joined by the incredible Tanya Kretschmann to discuss her recovery journey, eating disorder recovery during pregnancy, and the challenges she’s faced along the way.

Tanya is a is a passionate consumer advocate, lived experience consultant, recovery speaker and peer mentor. She’s also the mum to an energetic 2 year old.

 

 

Q1: Can you tell is a little bit about your history and your recovery journey?

It’s very challenging to distill down 20 years of experience and summarise it. 

I started struggling with disordered eating in my primary school years in response to anxiety. That eventually evolved into an eating disorder, anorexia nervosa, during my high school early teen years, where I also developed depression. 

I moved away from the country town that I grew up in. My eating disorder really escalated in the freedom of not having a lot of family and support and people to really keep an eye on me. I thought the best idea would be to move overseas to a non-English speaking country without realising that, when you move you take yourself with you. So, I took my eating disorder and my challenges with me. 

I then started struggling with bulimia, and the predominant symptoms for me were bingeing and purging. I was brought back home, I had a period of being diagnosed with Other Specified Feeding and Eating Disorder (OSFED). My behaviors or my symptoms at that stage were really mixed, being both restrictive, and bingeing and purging. 

Suicidality became a big part of my experience. A lot treatment followed for the next 10 years, alternating between outpatient treatments, inpatient medical treatments, and inpatient mental health treatments. 

Then, when I was about 23 or 24, I had a really solid period of recovery. That’s when I entered the eating disorder peer support space, and had about six years of being in solid recovery and working in the space. 

When COVID hit, I relapsed into my eating disorder, and quite significantly fell into a lot of medical compromise. Then I swiftly fell pregnant and experienced pregnancy with an eating disorder. This meant the focus shifted to trying to keep my baby and myself safe throughout eating disorder recovery during pregnancy. 

 

Q2. With your pregnancy experience, are you comfortable sharing a bit more about what that was like for you? 

I had always wanted to be a mum. 

I remember very early on when I was 18, I was in an eating disorder inpatient unit at the time. The threat of not being able to have children kept being thrown at me – ‘if you don’t recover, then you won’t ever be able to have kids’. 

I always remember thinking because I was experiencing, and had experienced a severe and enduring eating disorder of approximately 15 years, that I would never become a mum. 

To get to a point where I was physically nourished enough and able to fall pregnant, I did not take for granted the responsibility of trying to not only make sure that my body was nourished,  but, the importance of recovering for my family’s future for our family’s health and happiness. 

It made eating disorder recovery during pregnancy become much more tangible and meaningful and personal for me, which made my efforts towards it so much more real.

 

 

Q3. What helped the most with eating disorder recovery during pregnancy – in terms of your support team and those around you?

I would not be where I am today, and have the beautiful baby girl that I have today without having a remarkable support system. I was very lucky when I fell pregnant to already have that existing system because it’s very hard. 

We all  have our mental health side of things. But,  when you go to a gynecologist, or you go to an obstetrician, they don’t necessarily have a deep understanding or sensitivity to eating disorders. 

You’re thrown into this world of going –  ‘you’ve gained this amount of weight’, and ‘you should be this amount of weight by this time’, into a world that’s not really sensitive to the incredible changes that happen to your body. 

There is often little understanding of what that might mean for someone who’s very sensitive internally and externally about those changes. So, I was very lucky to have an existing team who was very communicative with my obstetrician. 

Also, having worked in advocacy and speaking up, I was not backwards in coming forwards in saying that I did not want to be weighed, and I did not want to know about the minute changes to my body. I just wanted to know that baby and I are safe, happy, and healthy. 

Keeping an eye on my nutrition and making sure that I was directly asked about my behaviors was absolutely important. There’s an expectation on mums, in particular, when building a little human inside them, that we always make the best choices for our babies and for ourselves without understanding the complexity of distress and living with an eating disorder. 

The amount of shame increased tenfold throughout pregnancy because it’s hard enough to say, ‘I struggle with an eating disorder’. But, it’s even harder to say, ‘I’m still engaging in x, y, and z’, even though I have this incredible reason not to. 

The thought of being perceived as harming my daughter when I was simply trying to get through a challenging period of my life was very hard. Making sure that there were people around me to ask those direct questions in case I was feeling shame or not able to communicate, was incredibly helpful for me.

Also to have those really safe spaces where I could sit in a room and say, ‘I feel like an absolute horrible mum because I engaged in x, y, and z today’. It’s important to have those dedicated spaces because we’re not going to be perfect. We’re not perfect mums. None of us in the human race are going to be perfect mums. We’re going to go up and down and make mistakes. And that’s absolutely fine and absolutely expected. 

We just need a safe space to help us and lead us through that space and out of that shame cycle and perhaps even a cycle that promotes re-engaging in eating disorder behaviour.

Woman in a white dress lovingly holding a new born baby with a white headband against a white background

 

Q4. When you mention these safe spaces – can you tell us a little more specifically who was there for you? Who did you feel comfortable with?

Firstly my psychologist – I continued to see my psychologist weekly for eating disorder recovery during pregnancy, and she’s someone that I feel safe with whom we built that relationship with. 

My partner, Dom, has been incredibly supportive throughout all of my experience, even pre-pregnancy. I will admit though, it was hard to even tell him at times if I was feeling suicidal, if I was harming myself in any way, or engaging in any behaviors, because it’s his baby, too. I was obviously worried that I would be perceived to be a bad mom by my partner at times. Having sessions together so that we could have those open discussions was critical. 

Having my dietitian was really important, in understanding what was enough when pregnant. Working with a dietitian was also really helpful in combating the misinformation that goes around during pregnancy, around what you can and can’t have, or trying to avoid gestational diabetes. 

And, also my psychiatrist, I live with co-occurring generalised anxiety disorder, as well as major depressive disorder. So for me, managing my medication and feeling confident with that, and feeling safe with that, when pregnant, was really important.

 

Q5. Can you talk a little more about eating disorder support post-birth? 

When we look at eating disorder recovery during pregnancy, we often forget all the challenges and pressures that arise once baby is here. 

For me, some of these challenges included:

  • The pressure to return to pre-body
  • The increase in life strain that a small child brings
  • Sleep deprivation
  • Not being able to take extra sleep if mental health is struggling
  • Only being able to really eat with one hand, and what that looks like in order to get enough nourishment

As a little family, we really struggled after Rosie’s birth. We don’t have a lot of family support. 

I was really conscious of my attachment with Rosie and wanting to maintain that. The idea of being separated from my daughter in order to receive mental health treatment, whether that be for postnatal depression, whether that be from a major depressive disorder, or whether that be for my eating disorder, was really challenging because there weren’t many places available at the time. 

It would mean separating myself and my baby from my partner, so my partner not having access to Rosie and interrupting his ability to form those attachments. 

There’s no way that if I was struggling, that I could go and still have access to see Rosie. There is a real gap when we understand the importance of maternal and paternal bonds in those first 2,000 days. 

To think that I would need to be separated from the big thing that inspires me and motivates me so that I can seek support, isn’t good enough. It isn’t good enough that we don’t have those spaces. 

I did on several occasions get admitted to the hospital after Rosie was born. Being admitted impacted not only myself but also Rosie, as she was exclusively breastfed. Her level of separation anxiety would take over four or five months to resolve following a week of admission. 

The idea that mum doesn’t come back really hit us. So, it became a juggling act of determining what’s going to harm me or my family more: not seeking a higher level of treatment or seeking a higher level of treatment. 

I don’t think we should need to make the choice between ourselves or our kids; we should have choices that support the whole family.

On a more positive note, there’s a lot of advocacy in the space. There’s been progress, like the addition of Catherine’s House, which will take individuals experiencing eating disorders. 

Just like the awareness around eating disorder treatment, the options available are increasing, and we will see the development of these services, step by step.

 

break up with diets ebook

 

Q6. You spoke a bit about your experience of body image across pregnancy and the postpartum period, which isn’t often discussed. Would you be comfortable sharing more about that and any tips for coping, given the pressure to regain your pre-baby body?”

My number one advice that I received from a fellow mom was to say “thank you” when advice was given, recognising that I didn’t need to take any of it on board. 

For me, understanding that my bub would know what was best, and I would know what’s best for bub, was crucial. It meant I could filter out the white noise of shoulds and shouldn’ts and focus on my values. 

While fitting into pre-pregnancy clothes would have been nice, valuing being present with my daughter over engaging in eating disorder behaviors was paramount. Breastfeeding was important to me, and I understood that maintaining a higher intake was fundamental to that. 

Regardless of societal pressure, I wasn’t willing to sacrifice my breastfeeding journey. Having people around me who could speak truth through the noise was really important. My partner would support me by reminding me of the joys and connections gained through pregnancy and motherhood, redirecting my focus from negative body image. 

Managing body image involved focusing on what was important to me and not my eating disorder, which ultimately boiled down to being a present mum.

 

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Q7. Is there anything else that helps you to maintain recovery now?

There are lots of things that I think helped maintain my recovery now. Part of that is also broadening my identity. Pre-pregnancy, my identity revolved around my eating disorder, then around work, and then back around my eating disorder again. 

Now, my identity has expanded to include being a mum and engaging in different fields of work like Auslan and advocacy. Returning part-time to work has been beneficial, helping me see myself in various roles. I’ve become more passionate about perinatal issues, broadening my perspective. 

Continuing to see my support team is crucial for me. Life throws challenges, and I’ve learned that seeking support during rocky times is essential and nothing to be ashamed of. Regular contact with my team helps me navigate transitions, like weaning from breastfeeding and adjusting my diet due to my baby’s intolerances.

Ultimately, the antidote to our eating disorders, which thrive in isolation and as the dominant voice in our heads, is meaningful connection and activity. For me, it’s keeping those things in my life that keep me grounded and that are important to me. 

Whether it’s attending a yoga class, swimming with Rosie on Mondays, or going to ballet with my partner and Rosie on Sundays, these activities bring joy and remind me of my values. Safeguarding these moments ensures that my healthy self continues to grow, even amidst the busyness of mum life.

This often means doing things, even if I don’t want to, because I know my mood drops.  I know it definitely drops when I’m sleep-deprived when Rosie is up all night.  I also know that when I’m engaged in the eating disorder, my desire and my thoughts around wanting to do these things really drops. 

But, I also know I love them, and I know that they’re important to me. Sometimes I don’t want to go to that yoga class, or sometimes I would much rather not get wet, such as in the dead of winter. But I also know that when I’m there, and when I’m doing those things, then they’re the moments that are meaningful, and most aligned with my values. 

It’s all about doing them anyway, or enlisting support to help do them. For example, asking Dom to drive me to the pool because otherwise, we won’t go, or him booting me out of bed and taking Rosie so I can go to the yoga class. 

I think it is very easy for our eating disorder to take over and take away that momentum. Something my partner said to me – is that action precedes motivation. I think in eating disorder land that really translates really well, because I don’t think we will ever really have the motivation to engage in different things. 

But, we need to be doing the things to find our ‘why’s’. We need to be doing the things to gather that momentum. For me, it’s always understanding that I think my default mood position, particularly with major depressive disorder, is inaction. So whether or not I want to be doing the active things, I absolutely need to, because when I am, that’s when I’m more motivated to do them.

You don’t know what’s out there until you’re living outside the bubble that you’ve been in. The hardest thing to do is to step out of that bubble repeatedly. One thing I think that is really important to focus on during recovery is that it’s not just about attending our very important medical appointments. It’s not just about attending to meal plans or meeting those recovery-orientated medical  goals. 

A lot of eating disorder recovery during pregnancy is about finding out who we are beyond our eating disorders, or who we even want to be beyond our eating disorder. 

 

woman wearing white shirt and glasses faced away from the camera and kissing baby girl on the cheek

 

Q8. We always like to wrap up with one important question – what’s one key message that you hope listeners take away from this podcast episode?

My key message is that we can live life in recovery, and we don’t have to wait to be recovered to live life. It’s important to find those little moments and sparks of meaning. Recovery can be hard, so we need those sparks. 

I never thought recovery would be possible, and I never thought having a family would be possible. But I also know that recovery is about doing hard things, and I’ve had to do a lot of hard things through recovery. 

Now, there’s not much out there in the world that I don’t think I could tackle anymore. Being a mum is one that I’m tackling very well, and I think others can tackle too. So – don’t underestimate how strong you are. 

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