TORONTO - When Tina St. John was pregnant with her first child, the doctors told her they were surprised a woman five feet two inches tall who only weighed 80 pounds could conceive so easily.
St. John, 42, said the pregnancy was a constant tug-of-war between her battle with anorexia, a condition she had suffered from since her early teens, and a desire to be a healthy mother for her child.
"When you're chronically ill, your sense of reality around those issues is sort of warped," said St. John, now a mother of four who lives in Ottawa.
"It certainly was a concern, and in hindsight, it was a real threat," she said.
Experts say it's difficult to determine how common eating disorders such as anorexia and bulimia are among pregnant women because those types of statistics are rarely kept due to privacy concerns.
But according to a 2007-2009 Health Canada survey, 0.6 per cent of Canadian women between six and 79 years old reported suffering from at least one form of eating disorder.
In 2009-2010, there were 5,282 hospitalizations related to eating disorders, more than 90 per cent of the patients were women.
Some experts believe unrealistic body images in the media and a celebrity culture have led more women to try to stay thin during pregnancy so they can shed their weight immediately after childbirth.
"Before, pregnancy might have been seen (as) an opportunity to relax into one's body and to experience one's body as it naturally grows," said Merryl Bear, the director of the non-profit National Eating Disorder Information Centre in Toronto.
"But there are more challenges to a pregnant woman's self-perception that are exacerbated by the images and the stories of celebrities who get pregnant, have their babies, and throughout the process … just have their pre-pregnancy body with a bump,” she said.
Dr. Blake Woodside, head of Canada's largest eating disorders treatment program at Toronto General Hospital, said cases of eating disorders in pregnant women _ often referred to in the media as pregorexia _ used to be rare.
Our society, he said, has become "fatophobic and fat discriminatory," even when it relates to expectant mothers.
"When I started to work nearly 30 years ago in this field, a pregnant woman with anorexia would be treated like everybody else," he said. "At this point, they're immediately attached to a high risk pregnancy unit even if their condition isn't that severe.”
Official health guidelines suggest pregnant women should put on between 15 and 40 pounds during their nine-month term. The amount of weight gain varies with one's size prior to pregnancy and whether one is carrying a single fetus, twins or more.
Doctors say starving pregnant women are more likely to develop a number of health problems as are their babies.
The journal Canadian Family Physician warns that women who are anorexic during pregnancy have babies with lower Apgar scores and lower birth weights. The Apgar score assesses the general physical condition of a newborn. Other complications associated with pregorexia include depression, anaemia, hypertension, miscarriage and premature labour.
Fortunately, with a lot of support, St. John’s baby was born at a healthy nine pounds.
Since becoming a midwife three years ago, she has seen other women going through the same struggle of trying to maintain the perfect body shape with a baby growing inside.
People, she said, don't realize that the issues surrounding eating disorders are not just skin-deep.
"There's often other issues that go with it," she said. "When you're dealing with pregnancy and changing bodies and intimate body parts, it's also quite a challenge. It's not enough to just get the eating under control when you're being pulled out of yourself through growth and change."
Bear noted that there is much more awareness today about eating disorders, but said more must be done.
"An eating disorder is not about vanity,” Bear said. “That's really critical to express because there's so much stigmatization and with that stigma, comes discrimination against individuals with eating disorders.”
Bear said the expectant mothers suffering from an eating disorder feel a lot of anxiety and guilt.
“(They) are extremely concerned for the health of their babies," she said.
“It's an extremely difficult struggle for them because physical and emotional changes can actually trigger anxiety ... that they can only manage in disordered eating."
Uma Thurman never publicly commented on her latest pregnancy, and although her rep confirmed that the actress, who most recently appeared on "Smash," and her financier beau, Arpad Busson, <a href="http://www.huffingtonpost.com/2012/07/16/uma-thurman-baby-girl-arpad-busson_n_1676513.html" target="_hplink">welcomed a baby girl on July 15</a>, we still don't know their daughter's name.
It was only after some photos of Neve Campbell sporting a serious baby bump popped up in March 2012 that her rep confirmed the "Scream" actress and her boyfriend J.J. Feild <a href="http://celebritybabies.people.com/2012/03/16/neve-campbell-jj-feild-expecting-baby/" target="_hplink">were expecting a baby</a>. Since then, we've seen a few photos but have not heard much else about their private life.
Reese Witherspoon may be one of Hollywood's most sought-after actresses, but this mama is staying quiet when it comes to her third pregnancy. <em>Us Weekly</em>'s sources <a href="http://www.huffingtonpost.com/2012/03/21/reese-witherspoon-pregnant-third-child_n_1369223.html" target="_hplink">spilled the baby beans in March</a>, but Witherspoon stayed mum until June, when she commented that she was <a href="http://www.huffingtonpost.com/2012/06/24/reese-witherspoon-pregnant_n_1622781.html" target="_hplink">"feeling very round"</a> while at an event in Chicago.
Megan Fox and her husband, Brian Austin Green, haven't confirmed that they are expecting their first child together, but photos of them -- <a href="http://www.huffingtonpost.com/2012/06/26/megan-fox-bikini-pregnant-hawaii_n_1624910.html" target="_hplink">with Fox sporting a very noticeable baby bump</a> -- in Hawaii in June left no doubt that the actress is indeed pregnant.
Sarah Michelle Gellar
Actress Sarah Michelle Gellar is expecting Baby No. 2 this year, but don't expect this mom to start blabbing about her pregnancy. <a href="http://www.huffingtonpost.com/2012/04/26/sarah-michelle-gellar-pregnant-second-baby-report_n_1457659.html" target="_hplink">Sources leaked her happy news to the press in April</a>, but while we've seen her -- and her growing baby bump -- out and about, she has yet to comment.
Is she or isn't she? Sources <em>swear</em> Gisele Bundchen and her football star husband Tom Brady are gearing up for another baby, but the model, seen here in early June 2012, isn't talking -- yet.
Drew Barrymore made headlines for her engagement in January, but it's photos of her <a href="http://www.tmz.com/2012/02/21/drew-barrymore-pregnant-sonogram-fiance/#.T0QF8EzLyEs" target="_hplink">carrying what looks like a sonogram</a> that had everyone talking. Though<a href="http://www.huffingtonpost.com/2012/06/06/drew-barrymore-married-st_n_1573927.html" target="_hplink"> her <em>People</em> cover story about her wedding</a> mentioned she was expecting, she hasn't spoken publicly about her bundle of joy.
While promoting their film, "Kung Fu Panda," at the Cannes Film Festival in 2008, Jack Black accidentally told the world that Angelina Jolie was pregnant with twins. Oops!
Man, exes always seem to ruin everything! In 2007, actor and choreographer Cris Judd confirmed to both <em>Us Weekly</em> and <em>People</em> that his ex-wife Jennifer Lopez was expecting her first child with then-husband Marc Anthony. Lopez and Anthony welcomed twins Max and Emme in February 2008.
Actress <a href="http://gawker.com/5675047/did-thandie-newton-out-mariah-careys-pregnancy-on-the-view" target="_hplink">Thandie Newton spilled the beans</a> during an Oct. 27, 2010, appearance on "The View" when she let it be known that she had gotten her role in "For Colored Girls" because of Mariah Carey's pregnancy. Carey <a href="http://www.reuters.com/article/2010/10/28/us-mariahcarey-idUSTRE69R2ZD20101028" target="_hplink">officially announced her pregnancy</a> the next day on the "Today" show.
In 2007, the <em>National Enquirer</em> broke the news that Edwards had fathered a daughter with his former campaign videographer. But it wasn't until 2010 that Edwards publicly admitted that <a href="http://voices.washingtonpost.com/44/2010/01/john-edwards-admits-paternity.html" target="_hplink">he was baby Quinn's father</a>.
Let's call this the most secretive pregnancy in Hollywood history. Just two weeks after going public with their romance, E! News revealed that Jeffrey Dean Morgan and "One Tree Hill" star Hilarie Burton also welcomed a baby boy. In 2009, Burton wasn't photographed for nine months. Now that's some serious secrecy.
In 2011, former California Gov. Schwarzenegger acknowledged that he fathered a child with a member of his household staff after the <a href="http://www.latimes.com/news/nationworld/nation/la-me-0517-arnold-20110517,0,312678.story" target="_hplink"><em>Los Angeles Times</em> broke the story</a>. For at least 10 years, Schwarzenegger managed to keep his secret safe.
Before Pink announced her pregnancy on "The Ellen Degeneres Show," her baby news was spoiled by someone else. "Hey, Pink, I'm sooooo happy for you lady!!! Congrats on baby!!" wrote "Good Day L.A." co-host <a href="http://twitter.com/#!/askjillian" target="_hplink">Jillian Barberie Reynolds on her Twitter page.</a> "Ps. You know your man whispered it to us at dinner. See I CAN keep a secret!!" Actually, Jillian, it looks like you couldn't keep a secret.
Leave it to Liv to spoil her own family's secret. Liv grew up thinking that rock star Todd Rundgren was her father. But rocker Steven Tyler began dropping by to visit, and Liv noticed that his daughter, Mia Tyler, looked enough like her to be her twin. She then confronted her mother, and was told the truth, and by the time she was 12, she had taken Tyler's last name. Not even Nancy Drew is that good!
Salma Hayek married her very wealthy husband, François-Henri Pinault, in 2009. But around the time they met in 2006, Pinault was also seeing model Linda Evangelista--and he ended up fathering both Hayek's and Evangelista's children--who both happen to be 4 years old. Awkward.
Isla Fisher and husband Sacha Baron Cohen can certainly keep a secret. The couple had their second baby in August 2010, and chose not to reveal what they named the little girl. However, <a href="http://www.usmagazine.com/momsbabies/news/revealed-find-out-the-name-of-isla-fishers-baby-2011103" target="_hplink"><em>Us Weekly</em> ended up unearthing the name</a>: Elula Lottie Miriam Cohen.
After many months of speculation, Katie Holmes and Tom Cruise finally announced they were expecting their first child together, though they kept their due date quiet and waited several months before they <a href="http://www.vanityfair.com/culture/features/2006/10/suri_portfolio0610#slide=1" target="_hplink">showed her off in the pages of <em>Vanity Fair</em>.</a>
Jennifer Garner welcomed her third child with Ben Affleck in 2012, but she wasn't quick to talk about the news she was expecting. In fact, it was only after many photos of her sporting a baby bump popped up that they finally confirmed it.