by Ann Douglas

Feeling good about yourself is the key to making the most of the childbearing year. A woman who feels good about herself will celebrate the changes that her body experiences during pregnancy, look forward to the challenge of giving birth, and willingly accept the physical and emotional changes of the postpartum period.

Unfortunately, not all women embark on pregnancy with a healthy self-image. Feeling good about themselves as their bodies experience extraordinary changes can be extremely difficult for these women, and they may require a great deal of support from friends and family during this challenging year in their lives.

Prenatal

Women tend to fall into one of two camps during their pregnancies, says midwife Mary Hunking, those who feel very negatively, and those who feel very positively.

"For some women, it's just the changing weight," says Hunking. "Many young women in our culture have real love-hate relationships with their bodies. There's such a strong pressure in our culture to be young and slim and active and vital, and for some women, when they're pregnant, that doesn't happen. They're always tired, weight gets put on, and they struggle with body changes they don't really have any control over. In a sense, there is a loss of control.

"For other women, it's a really positive thing. They're the healthiest they've ever been, they feel good about their bodies, and the fact that their bodies have life growing within them. Some women talk about when they were pregnant being the best time in their lives."

It is normal, says Hunking, for a woman's self-image to fluctuate over the course of her pregnancy. It is hard to feel particularly healthy or vital while you are bending over a toilet throwing up, but you may feel entirely different about your changing body by the time you've moved into the second trimester, when you may be awed by your baby's movements. Then, once the breathlessness and difficulty sleeping so characteristic of the third trimester kick in, you may find yourself feeling considerably less than enthusiastic about the entire business of being pregnant. It is during this final trimester when many women start to feel negatively towards their pregnant bodies, says author Carl Jones in his book After the Baby is Born. "Many expectant mothers see themselves as misshapen, awkward, and even ugly during the later prenatal months."

For Margaret Allan of Calgary, Alberta, it was during her second pregnancy that she experienced the most difficulty with her body image. Her two sons, Gordon and Andrew, were born 17 months apart, and she recalls that the spacing of her two pregnancies left her feeling "like I was pregnant for two years." Gordon was born six weeks prematurely, while Andrew was a full-term baby, and, because of the differences in her two pregnancies, Allan remembers feeling much larger and bulkier during the final weeks of her second pregnancy: "The second time I felt absolutely enormous!" she exclaims. She feels that the support and interest that her husband Drew took in her pregnancies was instrumental in allowing her to continue to feel good about herself.

The partner is not the only person who can have a significant impact on a pregnant woman's body image, however. Family and friends also have a significant role to play. "I think it's important for women to have a lot of positive support around pregnancy," says Hunking, but, unfortunately, many pregnant women are subjected to "very subtle remarks that can be very insensitive." In an attempt to counteract these potentially hurtful remarks, many of which focus on the pregnant woman's size, Hunking and her midwifery partner, Kelly Sexsmith, make a concerted effort to reassure their clients that all babies are carried differently. For example, a woman pregnant with her first baby will carry differently than a woman carrying her fourth child, and a woman with a large frame may carry differently than a woman with a petite one.

Not only do pregnant women find themselves being subjected to insensitive remarks about their size; they may feel that their entire private lives have become public property and that what matters to everyone is not they themselves, but rather their childbearing function. Author Sheila Kitzinger writes in The Experience of Childbirth, "Suddenly [she] is somebody different - an expectant mother - a subject of interest and concern to society - her life seems to be no longer intimate and apart, but something anybody can talk about. They even know when her last period was, whether she is being sick in the morning, and whether her nipples are the "right" shape." Trying to measure up to everyone's expectations of the perfect mother-to-be can have a devastating effect on a woman's self-esteem.

Preparing for Birth

Having a positive self-image and confidence in her own body is crucial for the woman who is approaching delivery. Unfortunately, in our society, many women approach the birth of their child with tremendous anxiety and a sense that they are not quite up to the task at hand.

"There is so much fear about childbirth in our culture," says Hunking, "because the birth stories aren't getting passed on anymore. Grandmothers and mothers traditionally passed on birth stories in a way that we don't anymore because there's a whole generation there - our mothers - who totally lost control of what happened to them, and don't have memories. All those memories are erased, and when you don't have the memories, what replaces them is fear.

Women are then left with a sense that "somebody else has to control it; somebody else has to do the delivery because that person knows what's going on."