Interoceptive sensibility and body satisfaction in pregnant and non-pregnant women with and without children

Abstract

Pregnancy is a time of great physical and psychological change. As well as prominent changes in the external appearance of the body, such as the baby bump, there are also substantial changes taking place within the body. Our awareness of, and attention towards, internal bodily signals (interoception) is thought to have a direct impact on how we feel about our bodies. Therefore, understanding how our experience of these interoceptive signals might change during pregnancy may have important implications for maternal wellbeing. This study examined body satisfaction and interoceptive sensibility (subjective experience of interoception) in pregnant and non-pregnant women with and without children. Feelings towards pregnancy-specific changes in body satisfaction and interoceptive sensibility were also examined in women in their first pregnancy (primigravida) and subsequent pregnancies (multigravida). It was found that pregnancy did not directly impact levels of body satisfaction, instead pregnant and non-pregnant women with children reported less satisfaction with their bodies compared to those without children. Primigravida women were more satisfied with the appearance of pregnancy specific bodily changes compared to multigravida women. Interestingly, these differences in body satisfaction in those with children (pregnant and non-pregnant) were mediated by the extent to which women trusted their bodies (measure of interoceptive sensibility). All other pregnancy related changes in interoceptive sensibility and body satisfaction were either non-significant or had small effect sizes. These results may suggest body trust as an important factor to support during the transition to parenthood in order to improve body satisfaction in mothers.

Comparing body image dissatisfaction between pregnant women and non-pregnant women: a systematic review and meta-analysis

“…One notable participant variable that was hypothesised to affect body image dissatisfaction in pregnancy is gravidity. However, only three studies analysed the effect of gravidity [ 31 , 55 , 64 ]; two of these studies found that women in their first pregnancy (primigravidae) have lower body dissatisfaction than multigravidae (M = 5.76 / 6.01 [ 31 ] and M = 139.2 / 143.8 [ 55 ] for primigravidae and multigravidae, respectively), whereas the third study [ 64 ] found primigravidae had slightly higher body dissatisfaction (M = 9.61) than multigravidae (M = 7.01). Due to the other fourteen studies not reporting separate means for gravidity (N=8; [ 12 , 14 , 56 – 58 , 62 , 65 – 67 ]), not reporting gravidity (N=3; [ 36 , 59 , 63 ]), or only testing primigravidae (N=3; [ 60 , 61 , 70 ]) no statistical analysis was possible within this meta analysis.…”

“…This systematic review and meta-analysis of 17 studies compared body image dissatisfaction in pregnant women (total 5200 responses) to women who were not pregnant (total 4172 responses), across 13 between participant design studies [ 14 , 36 , 55 , 57 – 60 , 62 , 63 , 65 – 67 , 70 ] and 4 within participant design studies [ 12 , 31 , 56 , 64 ]. The main statistical analysis on a group level showed that women’s body image dissatisfaction was not statistically different during pregnancy compared with when not pregnant.…”

“…Agreement was very high (99.1%), and any disagreements were discussed by the reviewers (0.9%); full agreement was reached after discussion and closer inspection of the papers, so it was not necessary to involve a third reviewer at either stage. Thirty-five papers were fully assessed for eligibility, of which 17 studies met all inclusion criteria [ 12 , 14 , 31 , 36 , 55 – 67 ]; Table 3 ). This process is shown in the PRISMA diagram, Fig.…”

“… Was appropriate statistical analysis used? Chan et al (2020) [ 31 ] High High N/A N/A High High High High Clark and Ogden (1999) [ 60 ] High High N/A N/A Unclear Unclear High High Crossland et al (2022) [ 55 ] High Unclear N/A N/A High High High High Davies and Wardle (1994) [ 57 ] Low High N/A N/A High High High High Duncombe et al (2008) [ 56 ] Unclear High N/A N/A Low Low High High Fuller-Tyszkiewicz et al (2020) [ 65 ] Low High N/A N/A Unclear Low Unclear High Gough (1998)* [ 64 ] High …”

“…In cases of multiple results, justification of which were chosen and why Authors Quality rating Measures taken Measure used for analysis Justification Data collection point Chan et al (2020) [ 31 ] High Body dissatisfaction (BD) subscale of EDI (Eating Disorder Inventory; [ 71 ]; 4 questions developed for this study Body Dissatisfaction subscale from EDI Validated measure, including measuring discontentment with the overall shape and size of 10 body regions. Drive for thinness may not apply during pregnancy as pregnancy contravenes thin ideals Retrospective measure of 6 months pre-pregnancy (T0; collected at T1), Trimester 1 (T1)*, Trimester 2 (T2), Trimester 3 (T3)*, Postnatally (6 weeks postpartum)* (T4) Clark and Ogden (1999) [ 60 ] High Restrained eating subscale of Dutch Eating Behaviour Questionnaire [ 72 ]; 8 item version of Body Shape Questionnaire [ 73 ] Body Shape questionnaire Measures concerned with body image dissatisfaction – more relevant than restrained eating behaviours Retrospective measure of 3 months pre-pregnancy, Trimester 2, Non-pregnant control asked their average body image over last 7 months Crossland et al (2022) [ 55 ] High Body Cathexis scale [ 74 ]; Body Understanding Measure in Pregnancy Scale (BUMPS; [ 42 ] Body Cathexis scale BUMPS is only relevant to pregnant women and therefore does not provide a comparison for non-pregnant women All trimesters mixed to form the pregnant sample (8% in trimester 1, 38% in trimester 2, and 54% in trimester 3), Non-pregnant control Davies and Wardle (1994) [ 57 ] High Drive for thinness (DT) subscale and Body dissatisfaction (BD) subscale of EDI [ 71 ]; Dutch Eating Behaviour Questionnaire [ 72 ]; Other scales developed for the study …”