On June 2, 2014, the Minister for Women, Jenny Elliot presented The Government Equalities Report, "Two for the Price of One: The impact of body image during pregnancy and after birth" written by AnyBody UK members Susie Orbach and Holli Rubin at the Royal Free Hospital. Orbach and Rubin introduce their report by defining the problem:
"Body image concerns are widespread. When women overestimate their size, they feel bad about their bodies and their well-being plummets. They tend to either curtail or override their appetites in an attempt to control the feeling of real or imagined fatness and this is leading many women to have to disturbed eating.1 When women underestimate their size, they also lose contact with basic physiological prompts signalling hunger and satisfaction.
The conjunctions of body image distress and disturbances in eating have tended to be seen as either trivial and vain, or as medical psychiatric issues. This has meant that they have rarely been in focus in considering health policies for expectant mothers. Understanding these disturbances explains why sound nutritional advice is often poorly taken up despite women wishing to do so.
Women’s concerns are anything but trivial. They are making women feel deeply uneasy in their bodies. They are disturbing women’s eating patterns. They are impacting on how women relate to their physical needs in pregnancy and post-partum, interrupting the focus on bonding with baby in the crucial early months when attachment behaviours are being established (Treasure 2013, Fairburn 1993, Orbach 2003)."
They elaborate on issues including feeding and nurturing babies, the experience of pregnancy, the transition from pregnancy to becoming a mother, bonding and attachment, mothers with body image and eating problems, building baby's secure body image, the case for early intervention, in addition to key information and actions for midwives and health visitors. The report's Executive Summary reads as follows:
- Eating problems of all kinds are on the rise. The most visible and obvious is obesity, which is straining the resources of the NHS. The most hidden is the chaotic eating which doesn’t show but which involves individuals who intermittently restrict and binge while obsessing about their bodies, rarely feeling safe around food.
- Many factors contribute to the current epidemic. Often overlooked is the role of inter- generational transmission of eating problems and the psychological meaning of eating and body difficulties. This is especially powerful between mothers and daughters but it extends to the whole family. We see obesogenic families and families who are vulnerable to eating problems and we see families in which food restraining, fad dieting and extreme exercise are the manifestation of disturbed appetites and fear of food.
- Psychologists, neuroscientists, infant researchers, and public health professionals agree that conception to age 2 is a vitally important time in human development. It lays down patterns for life. It is also a time when attention targeted to parents and babies reaps huge dividends for society.
- Early attachment between mothers and babies creates the foundation for mental health, resilience and flexibility in children. Mothers who are preoccupied with eating and body image problems can inadvertently behave in ways that shape bonding and attachment patterns in damaging ways.
- Midwives and health visitors are crucial in the transmission of public health to mothers and new babies. They are vested with ensuring that the mental and physical health of mother and baby is optimised.
- Midwives and health visitors receive little training on the effect of eating problems on mothers’ relationship with her infant, the feeding relationship and its impact on the baby’s developing body. They also work with significant resource constraints and can be hard-pressed to find time to take on new issues and challenges. Nevertheless, we cannot afford to overlook their potential contribution to supporting women’s body image and healthy eating behaviours at this time.
Both the Royal College of Midwives and The National Childhood Trust have endorsed the report, and various media outlets such as The Guardian, The Telegraph, The Mirror, and The London Evening Standard have covered its release. (See our Press page.)
