Dr Kerryn Phelps, AMA President - 'Today', Channel Nine

Nora Ready is one expectant mum who's given us an insight into her pregnancy and the way she feels about her changing figure.

READY: I'm 38 weeks pregnant - I've got two weeks to go. I'm looking forward to the birth of my baby. About four and a half months, you notice that your waist starts expanding, so nothing in your wardrobe fits any more. So, it's time to go shopping for maternity clothes. I've been very fortunate - I have my own business. I own maternity stores, so I was able to go and choose whatever I wanted from the store.

Some people come in and they just love being pregnant and that's…it's a pleasure to serve them. And, more women have a very negative attitude towards being pregnant - they enjoy being pregnant, but they don't want their body shape to change.

I have a few friends who've put on an awful lot of weight during their pregnancy and obviously, after spending time with them, I've realised that the reason why they've put on so much weight, is that they eat a lot and, a lot of food that's not good for them - that's really high in fat.

So, I think, if you overeat, you're definitely going to put on a lot of weight. And I felt that if I watched my diet and had a healthy - a good healthy, normal diet, that I wouldn't put on an excessive amount of weight. So, then, I wouldn't end up being depressed after my pregnancy, having to lose it all.

GRIMSHAW: Well, while Nora's experience is highly positive, sadly it's not so for many expectant, or new mothers. To tell us more, we're joined by Today's Health Editor, Dr Kerryn Phelps.

Morning, Kerryn.

PHELPS: Good morning, Tracey.

GRIMSHAW: Is this concern over body image among pregnant women a spin-off from the sort of Hollywood starvation fad we're seeing, at the moment? Or, have pregnant women always had these concerns?

PHELPS: Well, there's no question that thin is in, but it has been for quite some time. What I think is different, is that we are increasingly recognising that eating disorders are not just a problem for teenage girls. It's a problem, obviously, for teenage girls and boys, but it also can persist into older age groups and, we are seeing a greater awareness that pregnancy is one of the times when we can see a resurgence of eating disorders in women who are really having problems adjusting to the change in their bodies.

GRIMSHAW: And are you saying you're seeing this in women who have perhaps had a history of eating disorders? Or, is pregnancy enough to trigger a disorder?

PHELPS: I think both things can happen. Certainly there's no question that pregnancy can…it changes the body and the emotions so rapidly that a lot of women do have problems adjusting to that. But they have problems adjusting not only to their own bodies and their own…the way they're feeling I guess - hormonally - but also that leads later on to how they feel in terms of self-esteem and confidence, after they have the baby.

I think that a lot of the cases that we're seeing of post-natal depression are related to that trouble in adjusting and that loss of confidence and self-esteem. And, I think, the big message here is that pregnant women and their partners, their loved ones and their doctors, need to be aware of the warning signs that somebody might be developing an eating disorder, or working towards post-natal depression.

GRIMSHAW: I guess, the trouble is that just as there's no standard model for a body, there's no standard model for a pregnant woman. Some women will puff up a little bit when they're pregnant, others are just all baby. Who's job is it to tell women that they needn't worry about conforming - that they don't have to look to the pregnant woman next to them for an image?

PHELPS: Well, there is a healthy amount of weight that you gain during a pregnancy and some women, as we heard in the film clip earlier, do eat too much. I mean, we hear about the old 'eating for two'. Well, you don't have to eat for two adults - you eat for yourself and the growing baby. And your metabolic rate does increase markedly during pregnancy and you can…you do actually have to eat more, in order to provide the nutrition for the baby. But, the key is healthy eating and low fat eating and not eating enormous amounts of just about anything, because you're going to put the weight on, anyway. And so, a lot of that is about education around nutrition, about how you need to eat very well-balanced, nutritious meals, as a pregnant woman, to make sure that the baby is getting all of the nutrition that the baby needs. But also, so that you are gaining weight at a healthy rate and not too much and weight is certainly one of the things that we do monitor during a woman's pregnancy.

GRIMSHAW: Sure. You mentioned post-natal depression and that some of it may be a result of physical changes - body changes. But also, sleep deprivation, I believe, is another factor?

PHELPS: Yes. So many women who've had a history of depression in the past will be more likely to get post-natal depression with their first and subsequent pregnancies. But, there's also a great deal of adjustment that needs to be made and one of the adjustments that's very hard to overcome, particularly in the early months, is lack of sleep. And we know that sleep deprivation has been used during wartime as a torture for prisoners of war and, a lot of women feel as though they're being tortured by sleep deprivation when they have a baby who's very young.

GRIMSHAW: What's the answer? What can you do if you can't afford a nanny - what on earth can you do?

PHELPS: Well, we do have mothercraft nurses and Tresillian Centres and places like that, you can give people advice, either as an outpatient, or as an in-patient with their baby, to help them establish a sleep pattern. There are ways of going about adjusting the way a baby is fed, so that they're more likely to sleep during the night. There are techniques like controlled crying, as the baby gets older. It's much more difficult when they're very young. And of course, I think people need to have the trust of a GP that they can go to, to make sure that there's nothing wrong with the baby that's causing it to be so fussy and irritable, like a problem with reflux…

GRIMSHAW: Okay.

PHELPS: …So, I guess the really important thing is communication and awareness that these problems can occur, that adjustment is very difficult and that having a GP, a doctor that you can talk to, is very important.

GRIMSHAW: Alright. We'll leave it there. Thanks, Kerryn.

PHELPS: Thanks, Tracey.

Ends