Pregnancy and Nutrition #2 - Eating intuitively when pregnant

I’ve been feeling inspired recently to write about nutrition advice and recommendations in pregnancy, firstly because I’m currently 5 months pregnant and also because there’s a lot of information thrown at you when you’re pregnant. There’s so many ‘shoulds’ and ‘should nots’ during this time, which can be pretty confusing at an already somewhat intense time in your life. Intuitive eating provides the perfect set of tools to equipt you for this crazy and exciting time and to help build self-compassion and respect for how incredible your body is that it can grow a whole tiny human by itself. If you're looking for more information on specific advice for what to eat during pregnancy check out the first part of this series on pregnancy here. Otherwise if you're curious about how intuitive eating and the non-diet approach can be helpful during pregnancy, read on.

Weight as a proxy for health

I entered my first ever midwife appointment, early on in my first trimester, with a mixture of excitement and nerves, but actually ended up feeling a little disappointed. My midwife was so kind and lovely but when we started talking about health she brightly  exclaimed “I can tell just by looking at you that you’re healthy!” Now as a person with thin-privilege I've heard this before, but when you take a second to think objectively, it just couldn't be true that you can tell a person's health status just by looking at them; I mean unless you’re lying on the floor covered in blood, then your outer image might give an indication of poor health. But to really get to grips with someone’s health you need measures of the following: 

Blood pressure, fasting blood glucose, blood lipid profile, blood mineral status (e.g. iron, calcium), electrolyte balance, tests of kidney and liver function, disease history, smoking status, sleeping history, alcohol and drug use, recent and historic eating patterns, activity levels, mental health and stress levels… and so on.

And yet all of this so often gets boiled down to weight or BMI - as someone with a 'normal' BMI I'm assumed to be healthy just by being looked at. Our healthcare system is weight-centric which means it uses weight as a measure of health and desires everyone to be within a ‘normal’ weight range. This really is insanity though and harms everyone along the weight spectrum as those in bigger bodies are automatically assumed unhealthy and told to lose weight (which might not actually improve health and for most is very difficult, if not impossible, to achieve) and those in smaller bodies are told they’re healthy so more often miss out on tests and conversations about their health, which would likely benefit them.

Don't eat for two

From my own experience I feel this weight-centric messaging plays out in pregnancy, from a very early stage. At my first visit to the Maternity Hospital there were murals all over the walls warning about the dangers of over-eating and reminders to ignore the old saying of “you’re eating for 2 now!” This is in an effort to minimise weight gain during pregnancy beyond what the NHS deems 'normal'. This messaging really is everywhere. Where I live we get given a maternity app with helpful tips and information about your baby’s stage of growth. On one week I saw the line ‘You might be feeling hungrier, but you don’t need to eat more’. This is the go-to line from the NHS and speaks to the weight-centric directioning of our healthcare system. So we’re literally telling our pregnant people that their body signals (reminder: it's totally normal to feel hungrier than normal at many stages of pregnancy) are wrong and not to listen to them.

This is a demonstration of where healthcare messaging goes awry as we’re compounding the belief that our bodies can’t be trusted, especially when it comes to hunger and fullness. But this information is so valuable and important, which is why I advocate for intuitive eating where we learn to tune back into these signals and trust that our body knows what it’s doing. For thousands of years humans didn’t question their appetite or beat themselves up for being hungry. This is a recent phenomenon and has no place during pregnancy when our body is giving us all sorts of useful information about what it might need at different stages as we grow a whole new life within them.

Intuitive eating in pregnancy

I wanted to share my experiences so far as someone who’s been an intuitive eater for several years now and who is also currently 5 months pregnant (as I write this). I’ve been very lucky with this pregnancy and since around 12 weeks I’ve been feeling very normal and although more tired than usual my eating habits have been back to basically what they were before conceiving. However, this wasn’t the case for a lot of my first trimester and for a few weeks it was pretty tough going. This really wasn’t something I’d expected as I knew morning sickness was a thing but didn’t know quite how rough you could feel and how debilitating it can be. There really should be more public awareness about how much the first trimester can suck!

Because of intuitive eating I have somewhat of a heightened awareness of what’s going on inside my body (termed interoceptive awareness, which we work to become sensitised to through intuitive eating). But pregnancy (along with a bunch of other phases and states e.g. stress, sleep, illnesses etc) can get in the way of our body signals and make things confusing. Although for the most part I could cope, for a couple of weeks I felt nauseous from the second I woke up to the second I went to bed, and on some days found it really hard getting out of bed. 

During those days choosing what to eat and finding things that didn't make me feel worse was really hard. For a while there I would also stress out about putting certain foods (e.g. kimchi, sauerkraut, coffee, peanut butter which I usually eat tonnes of) in my mouth. I knew if I ate it the taste would be fine, but thinking about it was extremely unappetising and made the nausea worse. This is what I found difficult, as an intuitive eater I know I usually love these foods and that they make me feel good (if I don’t have them my toilet habits change, a lot!) so having to reconcile this with my physical reaction was a challenge. Looking back I think I’d developed some slight food phobias, probably related to the nausea. 

But I also found that the huge amounts of self-compassion you have to constantly cultivate and apply through the approach of intuitive eating really helped. When you feel nauseous or sick in pregnancy the idea is that you eat whatever you can cope with and don’t worry about not getting the exact right balance of nutrients. But this can lead to worry that you're not eating a perfectly balanced diet. It's important to remember that your baby is somewhat of a parasite though and will take from your own stores what it needs, so for the most part, you don’t need to worry. 

Intuitive eating trains you to realise that it’s okay not to be able to eat exactly how you usually would sometimes. It’s important not to stress out about only being able to survive off tea, plain cereal and small bites of dinner because stress and worry only makes things worse. Just because your body signals are telling you that what feels right isn’t what you might consider ‘balanced’ in regular times doesn’t mean they aren’t to be trusted. This is a temporary state, whether it lasts for a couple of weeks or your whole pregnancy. Being an intuitive eater helps guide you to the right foods which will suit what you need at the time and accept that this will likely change over time, if you let your body lead you.

The same also goes with dropping other usual expectations of what you should do to take care of yourself, like taking part in regular exercise. If you try to drag your sickness-laden bum out of bed to move your body you’re probably going to make yourself feel worse. When your body tells you that rest, naps and bed is all it wants trying to ‘force’ it to do otherwise isn’t good self-care and isn’t listening to your body; no matter how many people tell you taking a walk will help. But if getting some fresh air does feel right, then by all means go for it, but when you’re ready, not when someone else tells you you are.

Forgetting the past and the future and working out what will feel good right now, in this moment is key. Because the present moment is really all that matters when it comes to feeling satisfied and nourished when we're not feeling our best. Dropping expectations of perfect eating (during pregnancy AND all the time!) can help us to manage the constant challenges and changes that life throws at us. If you find your self-talk around food includes ‘shoulds’ and ‘should nots’, maybe take a second to question this - are you trying to live up to someone else’s imposed expectations of eating?

Pregnancy is quite the ride and even as an experienced intuitive eater there have been moments when I've felt confused and unsure about my food choices; this is normal especially when going through something for the first time. But whether you're pregnant or not, intuitive eating and learning how to eat flexibly can be so beneficial for promoting a sustainable, enjoyable relationship with food.