I’ve been pregnant with anorexia before. This isn’t my first rodeo.

Almost three years ago, I was pregnant with my son and in the early stages of recovery from an eating disorder. I had spent months in residential treatment, and then conceived, with a bit of assistance from medical science, later that year. 

They say it can take up to a full decade to recover from an eating disorder like anorexia . . . to truly quiet down the inner voices that sing your inadequacies like a Greek chorus and to automatically respond to situations with a better coping mechanism than starvation.

So a handful of months being symptom-free was perhaps not the best foundation on which to grow a healthy baby . . . but, as we all do, as all mothers do . . . grow a healthy baby I did. Because I had to. Because there was no choice, you see. My son in my womb became, the instant I saw a pink line on that pee-soaked test, the top priority. I no longer had the luxury to think about myself and myself alone.

And, sure, the weight gain was rough. Those voices got loud at times, lamenting my changing body, lamenting the loss of control, and the temptation to return to that former life was strong at times. But I had a great support system, a talented therapist, and maternal love on my side. So I stayed nourished, practiced self-care, and delivered a not-quite-full-term-but-that’s-an-unrelated-story baby who remains the best single motivation to take care of my body and my mind. I recovered from the C-section, lost most of the baby weight, and resumed life as my little boy’s mom.

So, here we are at the present moment, and . . . YAY! Pregnant again! Little sister is due in October, and I cannot begin to describe the ecstasy that was seeing the “positive” on the pregnancy test, this one digital, this one in the bathroom at work, reflecting back on the unlikelihood of falling pregnant without really trying, but absolutely delighted baby # 2 would come into existence without fertility help.

Only this time, it feels different.

This time, being pregnant is triggering my anorexia, in remission now for a few years, but always there, dormant, sleeping, under the surface, anxious to find an escape back into the forefront of my brain.

This pregnancy, I am carrying completely differently than the first time around. I’m NOT gaining a lot of weight; my baby bump is rather small, even six months in. I’m NOT breaking out like a teenager this pregnancy (thank you again, my darling son, for the hormonal acne scars from your gestation). I’m much more tired, much less moody, and only one of my feet is grotesquely swollen now.

And, of course, I’m much sicker.

The nausea is pervasive, the queasiness is omnipresent, and the food aversions are strong. While my experience is nothing like those women who fight through hyperemesis gravidarum, I can’t help but be jealous of all the women who feel an improvement their second trimester.

In fact, for several weeks in the middle, I was losing weight. And that’s what did it.

Losing weight for an anorexic is like a drug; there’s a reason it’s called a relapse when a former patient falls back into his or her eating disorder. It awakens the anorexia, soothes you like an old friend, as comfortable as a down comforter on a cold night and as impossible to resist as a newborn’s cries.

The desire to give in to old symptoms grows the more weight you lose, and even as I was on the scale at the doctor’s office, even as I rested my hands on my abdomen and pictured my daughter, even as I was blown away by the force of my love for a little girl I’ve never even met . . . I was hoping to see I had lost even more weight since the month before.

THAT is cognitive dissonance.

It is possible, somehow, for those two thoughts to co-exist. While they should be mutually exclusive, while the baby should take precedence, while the disease should be quieted through sheer strength of will, while the old familiar pull of anorexia should be that much less in the face of the baby growing in my womb . . . they are nonetheless existing side-by-side in my inner monologue, and I’m getting tired of their argument.

I have about four more months of pregnancy, and I would be lying if I said I didn’t anticipate these feelings continuing to be an issue. But if there’s one thing I have learned, it’s that being honest about your state of mind and state of health is far better than the alternative. I’ve learned that you’re only as sick as your secrets, and your secrets keep you sick. 

So I’m reaching out, to my support system, to my old therapist; to strangers, I suppose, by putting this down on paper. But it’s because I love my daughter so much that I do, because she is owed that much. She is owed the absolute best I can provide for her, even in light of my own struggles. Because, just like with my first, I am her mom. There is no other choice. And I know deep down that what I want, even more than sharp hip bones, is a healthy baby girl.

Shannon Frost Greenstein

Shannon Frost Greenstein resides in Philadelphia with her husband and son, who keep things from descending into cat-lady territory. She comes up when you Google her.