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Friday, December 18, 2009

Pregnorexia: A cry for help....

In consulting with a new mother-to-be, I asked her what her concerns were. To my surprise, her calm exterior dissolved into a torrent of scalding tears. As I comforted her, and prepared a cup of tea, I braced myself for the worst: is her husband abusive? is she concerned about finances? maybe she doesn't have any food or clothing...

The problem was revealed through hiccups. "I gained ten pounds! I am so fat, I will never lose this weight!" This set off a red flag in my head. It is normal to have some concern over weight, and in this country of weight consciousness, somewhat acceptable. The warning to me was of the utter hysterics posed by the idea of losing her perfect figure for even a few months.

To this client, gaining weight was the negative of pregnancy, and she fought every step of the way to keep slender: she exercised for an hour a day, she drank slim and non-fat milk, she tightly regulated her snacks and was rigid on her portion controls. Any deviation from her plan(one pound a month) made her desperate. She spent hours on the internet, researching low-calorie foods that she could eat and looking for tips of the trade on how to keep her weight down.

When she calmed down somewhat, I asked her when her next appointment was with her OB/GYN, and asked permission to accompany her, along with a professional friend of mine. She agreed.

At the next appointment, I and my friend, who is a psychiatrist, showed up. We listened as the client told the doctor how everything was fine, she was eating "loads and loads" and she nodded vigourously as the doctor admonished her to eat nutritious meals in order to have a healthy baby. Again, the client agreed.

There was a short pause. I gently said, "Is there something which you want to share with Dr._________? A concern that you raised with me?" The client stared at me, a mixture of fear and anger on her face. She denied vehemently that she had something to add.

I again said gently, "Don't you know that if your health or the health of the baby is in jeopardy, I cannot stay quiet?" At this point, Dr.__________ let the client know that I had sent a report, indicating that there might be some trouble regarding eating, and that I was very concerned with her nutritional balance.

The client was, to say the least, not happy.

This is when the doctor took over and asked if the client wanted to continue with my services. Livid,...well, we can all picture what happened next.

Would I change it again, perhaps hinted and prayed that the client would come to her senses? Surely I could use the retainer fee, especially in this season of Our Lord's birth, and hardly anything in the house. I could have just shrugged and let it pass from my eyes.

I could not, and cannot. This woman needed help, and I, as San Jose's Community Doula, could not turn my back on that fact, no matter what the consequences....

1 comment:

  1. GOOD FOR YOU!!!

    I would have done exactly the same thing. Even if it meant losing a client, and even having to return the money they had already given me, I would do it in a heartbeat. There is a fine line between client confidentiality and then clients starving themselves and their babies.