What can qualitative studies tell us about the experiences of women who are pregnant that have an eating disorder?

Objective: pregnancy is a life-stage during which women undergo significant changes to their body and can feel acute responsibility for the development and well-being of the fetus. A synthesis of qualitative studies was conducted to increase our understanding of pregnancy experiences among women with an eating disorder. Design: a systematic search of eight electronic databases was carried out to identify relevant investigations. Studies were appraised by two authors. Data were combined using framework analysis. From 459 references, seven papers were included in the review. Findings: an overriding concept of inner turmoil transpired from the synthesis. This personal conflict related to the fear and guilt expressed by interviewees and stemmed from their association of self-worth with their body, concerns about their child's health and worries about others' response to their eating and weight control practices. Key conclusions: participants reported vacillating between wanting to do the best for their child, being motivated by social pressures and feeling the need to control their body for self-preservation purposes. This created the inner turmoil they experienced while pregnant. Implications for practice: midwives should be sensitive to the possibility of an eating disorder among pregnant women. In such cases, practitioners could act as a conduit for any assistance required, guiding these mothers towards appropriate nutritional and psychological support. To do this, professionals must have knowledge of such conditions and be aware of services available for women disclosing disordered eating behaviours. © 2012 Elsevier Ltd.