The Complex Relationship Between Pregnancy and Body Image Dissatisfaction


Women can be subject to cultural pressures and expectations about how their bodies should look, which can lead to body image dissatisfaction.

During pregnancy, women undergo significant physiological changes, including abdominal growth, weight gain, posture alterations, and changes in the appearance of their hair and skin.

These transformations can be in conflict with Western and global societal ideals of female body appearance, leading to body image dissatisfaction due to the internalization of these expectations. This article delves into the intricate relationship between pregnancy and body image dissatisfaction, exploring the factors that influence how pregnant women perceive their bodies.

The Impact of Pregnancy on Body Image

Pregnancy brings about profound physical changes, including weight gain and alterations in body proportions. These changes can lead to feelings of “feeling fat,” especially in early pregnancy when the abdomen grows, but the pregnancy may not yet be visibly noticeable.

Additionally, the media’s portrayal of pregnant women with unrealistic body standards, often edited to remove imperfections, exacerbates body image dissatisfaction among pregnant women. These depictions create unrealistic expectations, making women feel inadequate in comparison.

However, not all pregnant women experience a decline in body image satisfaction. Some report a more positive body image during pregnancy, possibly because they no longer compare their bodies to the thin ideal. The acceptance of temporary body changes and the focus on the functionality of the body, such as weight gain associated with fetal development and breastfeeding preparation, contribute to improved body image. Furthermore, as pregnancy progresses, women may shift their focus towards the ideals of motherhood, prioritizing the health of the fetus and their new maternal role.

Individual and Methodological Factors

The incongruence in literature regarding pregnancy and body image dissatisfaction may be attributed to individual and methodological factors. Factors such as gravidity (the number of pregnancies), age, pre-pregnancy BMI, gestational weight gain, and mental health status all influence a woman’s body image during pregnancy. Primigravidae, or women in their first pregnancy, tend to have more positive attitudes towards their bodies compared to multigravidae.

Age and body appreciation tend to improve with age, potentially contributing to differences in body image satisfaction between these groups. Moreover, the pre-pregnancy BMI, weight gain from previous pregnancies, and overall body size also play a role in shaping a woman’s perception of her pregnant body.

Study methodology can also impact the outcome. The stage of pregnancy when women are surveyed about their body image can affect the level of body image dissatisfaction reported, as different parts of the body grow at different times during pregnancy. Additionally, different study designs, such as cross-sectional, longitudinal, or retrospective approaches, can yield varying results.

The Impact on Mental Health

Understanding how pregnancy affects body image dissatisfaction is crucial because it has implications for women’s mental health. Pregnancy is a period of heightened risk for mental illness, and body image dissatisfaction can exacerbate this risk. Women experiencing body image dissatisfaction during pregnancy are more likely to exhibit depression and anxiety postnatally and in the long term. These mental health issues can lead to negative outcomes for both the mother and child, affecting emotional, cognitive, and behavioral aspects.

Body image dissatisfaction during pregnancy is also linked to weaker bonds with the fetus, reduced intention to breastfeed, and adverse practices like unhealthy eating, dieting, and fasting. These practices can result in detrimental effects on the fetus, such as low birth weight and premature birth. On the contrary, positive body image is associated with better mental and physical health, including lower symptoms of depression, improved self-esteem, and positive health-related behaviors.


This systematic review and meta-analysis aimed to explore the relationship between body image dissatisfaction in pregnant women and non-pregnant women. By analyzing 17 studies, totaling 5,200 responses from pregnant women and 4,172 responses from non-pregnant women, the study revealed nuanced findings regarding the impact of pregnancy on body image dissatisfaction.

Main Findings

The primary statistical analysis did not indicate a statistically significant difference in body image dissatisfaction between pregnant and non-pregnant women. However, a closer examination of the results demonstrated substantial heterogeneity among the individual studies. Some studies suggested that body image dissatisfaction is lower during pregnancy, while others reported higher dissatisfaction. Additionally, some studies found no significant differences.

Complexities in the Relationship

These conflicting results highlight the complexities of the relationship between pregnancy and body image dissatisfaction. It appears that pregnancy’s impact on body image is highly individualized and not solely determined by the state of pregnancy. Therefore, generalizations across pregnant cohorts should be avoided, as the perinatal experience can vary significantly among individuals.

Several factors could contribute to the observed heterogeneity in the results. One potential explanation lies in the concept of “thin-ideal internalization,” which involves the extent to which individuals internalize societal values and pressures regarding body appearance. While some pregnant women may passively recognize these ideals but not internalize them, others may be more affected. The priority of supporting a healthy pregnancy and a developing fetus may supersede concerns about body image for some women.

The relative importance placed on body functionality versus physical appearance is another factor to consider. Women who focus more on the functionality of their bodies during pregnancy may be less concerned about their appearance. Additionally, the concept of a maternal ideal, which emphasizes the body’s functionality for the fetus, differs from the non-maternal body ideal, further complicating the relationship between pregnancy and body image.

Self-acceptance, or the ability to accept oneself unconditionally despite perceived flaws, also plays a role in body image satisfaction during pregnancy. Pregnancy can affect a woman’s identity and level of self-acceptance, which can fluctuate during this transformative period due to physiological and psychological changes.

Methodological Considerations

The results could be influenced by various methodological factors. Differences in psychosocial, demographic factors, and parental status between pregnant and non-pregnant samples may complicate direct comparisons. Additionally, asking pregnant women to retrospectively recall feelings about their body before pregnancy can be problematic due to the “maturation threat” to their recall. Pregnant individuals may experience changes in their body image over time, especially during pregnancy, making accurate recall challenging.

The analysis of potential moderators that could have provided more insight into the discrepancies in results was limited due to the insufficient number of studies that met all analysis criteria. The lack of detailed reporting and differentiation between gravidity (the number of pregnancies a woman has experienced) is another limitation. Future research into body image dissatisfaction during pregnancy would benefit from investigating the distinctions between first-time and subsequent pregnancies.


This systematic review and meta-analysis demonstrate that the relationship between pregnancy and body image dissatisfaction is intricate and highly individualized. The findings suggest that there is no one-size-fits-all answer to how pregnancy affects body image, as individual experiences, values, and priorities play significant roles.

Understanding the factors that influence body image dissatisfaction during pregnancy is essential for addressing the mental and physical well-being of expectant mothers. Future research should consider the diverse factors and individual differences that contribute to body image dissatisfaction during this transformative phase of a woman’s life. Further investigation into internalization of body ideals, focus on functionality, self-acceptance, and the role of gravidity is warranted to gain a deeper understanding of this complex relationship.

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