Pregnancy is one of the most transformative and vulnerable times in a woman’s life. Hormones shift, bodies change and alongside these physical demands come emotional uncertainties that can feel overwhelming.
While public conversations about fertility anxiety and postpartum depression have become more common in recent years, mental health struggles during pregnancy often remain overlooked. Yet many women experience symptoms of anxiety, depression or disordered eating as early as the first trimester, long before the baby bump appears. Research suggests that up to around 15 percent of pregnant women likely have had an eating disorder at some point, and about 5 percent experience an eating disorder during pregnancy. These behaviors can include food restriction, bingeing, over-exercising or obsessive body checking—often exacerbated by hormonal changes, body image concerns and the pressure to maintain a “healthy” pregnancy.
Food, feelings and prenatal experience
During pregnancy, women attend between 10 and 20 medical appointments. At nearly every visit, their weight is monitored. They may be given broad, well-meaning guidance about what to eat, and then face the stress of passing the gestational diabetes screening.
However, OBs are not dietitians. While they play a vital role in maternal care, they typically aren’t trained to offer individualized, evidence-based nutrition counseling that addresses the mental and emotional layers surrounding food and body image. And referrals to registered dietitians during pregnancy remain rare. Why? A mix of factors contributes: limited nutrition training in medical school, time-strapped appointments, lack of insurance reimbursement and inconsistent referral systems. As a result, many OBs simply aren’t equipped—or incentivized—to screen for disordered eating or provide holistic nutritional guidance, leaving a critical gap in care at a time when patients are especially vulnerable.
At the same time, expectant mothers must navigate the influence of social media, where curated bump updates and seemingly effortless pregnancies fuel comparison, envy and self-doubt. The cultural pressure to “do pregnancy right” can be relentless. Many women also carry longstanding insecurities about their bodies and eating habits, ones that pregnancy may amplify. Natural prenatal changes such as weight gain, stretch marks and swelling can stir up shame or anxiety that has little to do with the pregnancy itself.
It’s no surprise, then, that 9 out of 10 women report feeling judged during pregnancy, often believing they’ve failed before even giving birth. These feelings don’t just fade postpartum, they can evolve into chronic stress, anxiety or depressive symptoms that linger well into motherhood.
The overlooked connection: nutrition and mental health
Pregnancy is exhausting, physically and emotionally. In the whirlwind of appointments and to-do lists and lifestyle changes, many women are encouraged to focus on their baby’s health but to deprioritize their own. But what is frequently missed is the critical link between mental and nutritional health.
Emerging research shows that diet can influence mood, while restrictive eating behaviors or poor nutrition can raise the risk of perinatal mood and anxiety disorders. Despite this data, it’s not yet standard practice for pregnant women to see a dietitian or maternal health specialist. It should be.
Registered dietitians trained in prenatal nutrition can provide compassionate, personalized support that addresses both physical and emotional needs. From identifying food fears and body image concerns to planning nourishing postpartum meals, this kind of care can be a game-changer for maternal well-being.
But despite the clear need, access to this support remains uneven. Insurance barriers, rushed OB visits and a shortage of prenatal-trained dietitians all contribute to a system where nutrition care is often siloed—if offered at all. These gaps are even wider for low-income, rural and BIPOC women, who face disproportionate barriers to both nutrition and mental health services during pregnancy—but it doesn’t have to be this way. When nutrition care is integrated into prenatal care, it supports not just healthier pregnancies but also healthier mothers.
Supporting mothers benefits everyone
Prioritizing mental and physical health during pregnancy isn’t a luxury. If you’re navigating pregnancy and feel like something’s missing from your care, trust that instinct. Ask your OB about a referral to a registered dietitian—especially one trained in prenatal nutrition or disordered eating.
A mother’s well-being isn’t optional. It’s a form of essential care that helps mothers feel stronger, more resilient and more prepared during pregnancy, postpartum and beyond. Whether you’re expecting, postpartum or anywhere in between, mental and physical health are not tangential, they are foundational. It’s not self-care, it’s essential care. When mothers are supported, emotionally and nutritionally, everyone benefits.