I love children. Children love me. I know I want kids, but because I’ve struggled so much over the course of my life with eating disorders and body image issues, I’ve always been concerned about how I would respond to being pregnant. I’ve come a really long way in my recovery journey, but there’s still that part of me that’s afraid that I would freak out about the significant body changes that happen during that time. I wanted to learn more about the REAL pregnancy process from someone who had recently gone through it to get a better sense of what to expect.
Enter my friend Sara Vaughn. Sara is finishing up her OBGYN residency at Cedars-Sinai hospital in Beverly Hills, and will be entering her fellowship at Stanford this summer. When she had a baby of her own I knew she would have an interesting perspective as both a mother and women’s physician, and I also knew she wouldn’t sugar coat her experience. Our friendship has a colorful history, and I’ve come to have a great deal of respect for her, not only as a doctor, and advocate for women’s health, but as a person. She never struggled with eating disorders, but there are certain universal pressures women feel to be thin, and I knew she felt those as much as any of us do. I went to her house while she was still on maternity leave, and we sat down for a no-nonsense conversation about pregnancy, body image, and how pregnancy impacts relationships in ways that often aren’t talked about. I am thankful for her insight, and so I imagine other women will be as well. Here are the highlights of our conversation.
Me: Most women feel so much pressure to be skinny in order to be seen as attractive, and so by society’s standards, we’re essentially forfeiting that when we get pregnant. What was it like to suddenly feel like your body was changing away from those cultural norms of beauty?
Sara: You know, I’m not someone that’s reflected a ton on my body through the years. I mean, I’m a woman, so I certainly did to some extent, but I was a real tomboy growing up. I was tall, I didn’t have breasts, and I didn’t really think about whether or not I was beautiful until probably college. And then in college I started getting more attention, and that was what opened up my eyes to what it means to be attractive. I had a waitressing job, and got hit on a lot, and I discovered the power of beauty. So I’m not naturally someone who reflects a lot on my body image, but what actually did bother me is that when you’re pregnant everyone else starts reflecting on your body image.
Sara: Yeah, I mean before you know it people comment on your body all the time. And there’s no real way for you to stop it. Because it’s not usually offensive, it’s usually the opposite. I was called “cute” more than I’ve ever been called anything in my entire life. Literally every single day for months, I would walk down the hall and 10 people would be like “Oh my god, you look so cute!” “Aw, look at your belly! It popped!” And say these things. Every once in a while I’d get negative comments like “Woah, you got so big!” And it’s like really? Did you really just say that? And it made me strangely aware of my body, and the fact that it was changing in a way that wasn’t really welcome. And then post partum, it’s the same. People say “Oh you just had a baby? Wow! You look so good!” And it’s like stop talking about my body! I’m fine in my own skin! I don’t want to hear your comments about how I look! [laughs]
Me: That’s so bizarre!
Sara: Yeah it’s really strange. Especially in the sense that you’re going through all these pains that are “normal” but that no one talks about and you’re just kind of expected to shrug off. They don’t talk about how you’re going to feel the opposite of cute when you’re being called that all the time, but no one feels cute when your ankles are swollen to twice their normal size. You don’t feel cute when your back hurts because you can’t sleep in a normal position. You are sacrificing your body for something that’s going to be completely worth it, but especially in your first pregnancy it’s really hard to attach the baby with the pregnancy changes because you don’t have a baby. You have a fetus that you can’t see, that looks like an alien on the ultra sound. There are moments when you connect, like when the baby first kicks, and there are moments where you’re like “Oh my gosh, this whole body sacrificing thing is totally worth it!” and you really do feel beautiful, but mostly there are moments when you feel overwhelmed and insecure. And then people call you cute, and you’re just like “could you use any other word? Or just not…at all.”
Me: [laughing] Yeah, we don’t need to hear that!
Sara: And then people also don’t talk about how it’s going to affect your relationship. Everyone just tells you “Sex is good in pregnancy. Have sex.” Which is not always logistically possible.
Me: Like later on in pregnancy? [Secretly crossing my fingers that it isn’t the whole time.]
Sara: Right, later on you may or may not be able to walk up the stairs easily, let alone be able to have crazy rip-roaring sex. You’re having super boring sex if you’re having anything at all. It really does affect your partner, because it’s not just your body that is changing it’s your partner’s partner’s body that’s changing, and they may or may not be into it. And they may or may not be comfortable with it. It can be disorienting for them too, and they’re really not allowed to talk about it. Society tells them “No, no, no, you will tell your pregnant wife that she’s beautiful all the time.” And I don’t know how other pregnant women feel, but I don’t want my partner to say that for the sake of saying that. I want him to say that when he means it.
Me: Was he [your husband] sweet about it though?
Sara: You know, it was hard for him. He has always been attracted to thin women, and you’re not supposed to feel that way with a pregnant wife, but that just isn’t realistic, and I knew that. And it was also hard for him to see me going from being capable to seeing me being less capable—needing to have things carried for me, and all of that. He likes to take care of me, but he didn’t like seeing me not being able to take care of myself. So I don’t know what works for most people, but I encouraged him to be really honest the whole time, and share his experiences, and that was what was best for us. Then when he said stuff that was really beautiful, I didn’t have to question whether or not it was true. When we went through the experience of labor, and we cried, it was this really powerful moment, and I knew that everything wonderful he was saying wasn’t just to make me feel better. Honesty is the most important thing for me in a relationship before sensitivity.
Me: I can definitely relate to that.
Sara: When I first delivered, like a couple of days after, everything hurt. Your vagina tears, and gets sewed up, your breasts are sore from a little person gnawing on them and not knowing how to do it, and I said to him “everything that was ever sexy about me hurts.” And he looked at me and said “Well, does your brain hurt?” and because of that trust we established, I knew that he wasn’t saying it for brownie points. Then thinking about all of the people who said I looked beautiful when they probably didn’t mean it, it kind of made up for the whole thing.
Me: Aw, I love that! That’s really cute.
Sara: [Smiles ear to ear] Yeah that was good.
Me: Something I’ve thought a lot about, because I have been more body conscious, and I’d be curious to hear your perspective, is how all of a sudden your body becomes almost utilitarian. I mean, there are parts of our bodies that serve a very specific biological function. I wonder what it’s like to actually see that purpose being realized, and experience those parts of our bodies being used as they’re designed to be used.
Sara: So now that [the baby] is here, that seems very real. I can’t say that the pregnancy process for me felt very utilitarian. It really just felt like I was being destroyed from the inside out [laughs]. But now that he’s here, I am so in love with him that I would pretty much destroy anything in my life for him, and I don’t feel uncomfortable in my body now like I did at the end of pregnancy. It really is a totally different way of experiencing your body.
Me: I can see that. Yeah I think a lot of us spend our earlier years working out a lot, and doing whatever we do to try to “stay hot” because society tells us that’s how we find a good partner, and we’ve been conditioned to treat ourselves as objects in a way. So there’s this really real separation between what our bodies are for in terms of reproduction, and how we relate to them.
Sara: I think that pressure doesn’t just go away once you’ve had a baby, and you realize that your boobs were really meant to grow a person, and your belly was meant to be stretched out and look a little floppy for a while. Those things don’t go away, and that outside world doesn’t go away, and you have to deal with the balance of both. Also, after you deliver a baby there’s this total shift in relationships where you have to balance what your body means to your partner, and what it means to your baby, and what it means to you. Then you also have to balance the fact that your time tremendously shifts. I think men go through a lot of withdrawal when the new baby shows up, because they used to have this woman all to themselves, and then it’s like they suddenly have to share. And it’s not jealousy, in a traditional sense, but there is an adjustment period for sure while they get used to your body and your time being needed by someone else in a way they’ve never experienced. But even if you have a baby and you’re single, a lot of those time and body pressures are still there. And I know a lot of women feel like they have to get back to their pre-pregnancy weight right away.
Me: Right? It’s like every tabloid you see is some celebrity with a headline of “How she got her body back after baby!” People are obsessed with that.
Sara: Yeah, celebrities make it look like they have their body back at day 1, and the reality is that it takes a while. And it really should. You shouldn’t become drastically different within a few weeks. That’s not healthy for your body. And it’s not healthy for your baby to be exercising in extremes or restricting calories during pregnancy either, but that’s kind of what the celebrity mentality is.
Me: Well, I’m glad you brought that up because I was going to ask you. Where you work I imagine you see a lot of actresses and the stereotypical Beverly Hills Housewives types coming through. Are these new moms under a lot of pressure to get plastic surgery after?
Sara: I don’t know about surgery after, since I deal with deliveries, but I do know that pressure to stay thin, even during pregnancy is higher in Beverly Hills than it is pretty much anywhere else. I’ve seen actresses come in after overdoing it in exercise class feeling awful, because they’ve been told they need to stay thin. It’s sad because no one tells them “hey, it’s OK to feel crazy because you’re not living up to these societal pressures for a while. You’re growing a person, and you’re not going to look the same right now, but it’s going to be so worth it.” It’s sad, because people just aren’t being honest with them about how their lives and bodies are going to change, especially in this neighborhood, so I try to be as real with them as possible.
Me: Well how do you mitigate that? I know you’re someone who will present things as they are, and you’re not just telling people what they want to hear, but you’re seeing expecting mothers all the time. How do you help them get through all of the changes?
Sara: Now I feel like I can tell them my own experience. I think that’s the best way to relate. For me, if I had to do it over again, I think the best way to get through the body change is to just focus on creating healthy behaviors, like eating healthfully and doing things that are good for you. And that could mean throwing out all of the mirrors in your house if it doesn’t add to your day. Just do things that make you feel good. I didn’t want to buy any maternity clothes, I mean I went to Pea in a Pod and left almost offended by the prices and the unflattering choices, but then I went to Sephora and spent $400 on makeup and I felt great about it. I’ve never actually worn makeup, but that was just what I needed, and I ended up using it for my fellowship interviews. It’s more about being healthy, balanced and treating yourself well, and empowering yourself to accept that these changes are happening for a reason. And accepting that you’re going to feel gross sometimes, and that’s OK.
Me: So was that something you experienced? Feelings like “Oh my god, I look gross?”
Sara: Yes, of course. I definitely did.
Me: And that wasn’t something you had really dealt with before, right? Or maybe we all do to some degree…
Sara: Yeah, I mean I went through some weight changes in college. When I first went to college I actually lost a ton of weight. I was a vegetarian, and then I moved to Texas and there was no food for me, and I was desperately trying to live off of salad and granola. I actually lost my period, and I didn’t look attractive–I looked unhealthy, and it was even a little scary, because I felt like there was something wrong. But my mother said to me “Oh my gosh, you look so beautiful, we should be getting you into a modeling agency…”
Me: Oh god. [face palm]
Sara: I remember being really angry, because I didn’t think she should say those things, but at the same time there was a part of me that wondered if maybe it was a good thing. But the part of me that knew better changed my diet, and I gained a lot of weight—even more than I had lost, and I do remember being effected by it.
Me: Well in our culture we’re kind of damned if we do, damned if we don’t in a way, when it comes to weight. There was a time for me too when I was exercising excessively, and I controlled everything I ate, and I got to be really underweight as well, and people close to me were like “Wow, you look so great! What are you doing?” I was just thinking “NO! You don’t want to be doing what I’m doing!” But of course I didn’t say that at the time, because on some level I was enjoying the praise.
Sara: I think the difference with pregnancy…well, it’s just such a different thing. You’re going to gain weight, and you’re going to lose weight after, and that’s the process. As I doctor I used to tell patients about our guidelines, which are entirely based on your BMI (body mass index). But now that I’ve been pregnant I realize the guidelines aren’t that precise. We tell a 5’ tall woman and a 6’ tall woman to gain the same amount of weight if they have the same BMI, which doesn’t really make sense. Now I explain to my patients that the baby, extra fluid, placenta, increased blood volume, breast tissue, etc. is about 25 lbs. Some woman need a little more if they start low, and some women need a little less if they start high, but generally I focus on healthy eating, and realistic expectations. And I’m very cognizant of how damaging it is to say “you’re gaining too much weight” and it’s much better for patients to assess whether they are living a healthy lifestyle. And also some women can exercise, others can’t.
Me: Could you?
Sara: Well I’m on my feet all day, and I was working 14 hour days for my residency during the first trimester, so by the time I got done I just wanted to sleep. And I was super nauseated. Then by the second and third trimesters I hadn’t worked out in a while, and felt overwhelmed by the idea of restarting. But I think just taking care to eat and exercise—not to lose weight or change your body—but just enough to where you feel like you’re taking care of your body is important.
Me: Absolutely. And that makes me wonder: what has your relationship with food been like since you’ve had the baby?
Sara: It’s actually never been easier for me to eat healthy in my life. I am not restricting to lose baby weight, because I think that can be emotionally injurious, but I’m just hyper aware that everything I’m putting in my body is going directly to him. So if my friends want to go get ice cream, I’ll absolutely have some, but I’m also aware that if I’m eating ice cream every day, he’s eating it every day too. So it has changed my perspective on food and eating, as well.
Me: That makes so much sense. It’s like you’re accountable to more than just yourself.
Sara: Exactly. So I’ve been drinking a ton of water and eating a lot of vegetables, not because I necessarily feel like I have to, but because I want him to be getting healthy milk.
The recording of our conversation got cut short, so I will just leave you guys with something beautiful Sara wrote a bit later on Facebook:
“It wasn’t until I lost my body that I truly learned to appreciate it. It metamorphosed multiple times, overtaken by a small creature we now lovingly refer to as the ‘milk monster.’ It wasn’t until I lost my body that I realized it was never really mine to begin with. Maybe I’ll have it all to myself for some moments for some period of time in the future. Other times it will have other jobs to do, other people to help, other lives to grow. I am thankful for this body. And my brain, bathed in oxytocin, is exhaustingly happy in love.”
So the truth is, I still don’t know how I will respond to being pregnant. There’s no way to know until it happens. I do feel reassured that no matter what it’s like for me, I have women like Sara in my life that I can talk to about it openly. And like everything else, anything I feel will be temporary, and the gift of life on the other side will make it all worthwhile.
Happy Mother’s Day!