At my 10-week booking appointment, the midwife told me that my history of anorexia meant I was more likely to get postnatal depression. She could see that I’d last been under psychiatric care less than a decade ago, two years after my last hospitalisation. She apologised that she had to note it down on my maternity records. She and I were both tangibly relieved the serious health issue being discussed had nothing to do with my baby. No one ever mentioned it to me again.

Anorexia never leaves you, even after treatment. Relapse is common. Thought patterns and eating habits become engrained – physically, emotionally and psychologically. By the time I became pregnant, I’d been “recovered” for a few years and “in recovery” for several before that. But pregnancy was the first time in 15 years I felt hungry. During pregnancy, our bodies need more fuel and water – creating a baby is physically laborious. Having trained myself as a teenager to ignore the sensation, I did not recognise it at first. Eventually I came to remember the feeling, and that eating helped.

In a way, pregnancy was an antidote to anorexia. Having been through IVF, with so much time to mentally prepare and so much at stake, I relished my growing bump and everything it symbolised. My body was supposed to look different. I knew the foetus was reliant on what I ate. I desperately wanted to do right by my child. Eating correctly would ensure that my blood, and then my milk, could sustain him.

But postnatally, I faced the biggest threat to my recovery in a decade. Old thought patterns resurfaced. It wasn’t simply the perpetual “baby body” chat. When I looked back, the ingredients for my near-relapse were amassed during pregnancy. Enforced eating habits had been normalised again. I’m supposed to stick within normal limits for the first two trimesters and increase my calorie intake by 200 in the last? No problem. As someone who spent a decade punishing myself if I ate one too many peas, I can perform a calorie-related maths challenge with aplomb. Then there are the foods to avoid. The list on the NHS website is exhaustive and exhausting. The pregnancy apps provide a “helpful” food tip each time you log on.

Postnatally, those threads unravelled. The pressure was similar to puberty, when, as for many sufferers, I exerted what little power I had through ordered starvation, bingeing and purging. Like puberty, my postnatal body was new, my knowledge of it limited. I had spent so long focusing on childbirth that I’d forgotten I’d spend weeks bleeding afterwards, or that my breasts would take a couple of months to settle into their new role. The hormones made my face puffier.Just as this settled down, my hair started falling out.

Meanwhile, I was responsible for the care of a human being, the reality of which no number of books or parenting classes can prepare you for. Not reverting to old patterns took more control than I’d ever had to exert. If I hadn’t been breastfeeding, I don’t know that I would have managed it. Breastfeeding meant my body was still responsible for nourishing my son; it was an excuse to continue to eat when hungry.

My experience isn’t uncommon. In one online forum, three new mothers with a history of eating disorders reached out for support with weaning; they received dozens of replies, all with the common refrain that breastfeeding delayed an inevitable struggle. Across the UK, eating disorders are increasing. As reported last week, hospitalisations are at their highest in nine years and sharply rising. The charity Beat received 30,000 calls to its helpline in 2018-19. This is the sharp end of it. Beat estimates there are well over a million people with an eating disorder in the UK, three quarters of whom are women.

The Nice guidelines for pregnancy are so concerned with obesity they don’t consider those of us with anorexia and other eating disorders. My midwife was clearly aware of some of the risks. And if I hadn’t been made aware at that first appointment, I wonder whether the outcome might have been worse. As it was, I had a support network, resources and a community – not to mention years of therapy – to help me stumble through.

The fact is, the perinatal period poses a serious threat of relapse to anorexia sufferers. The medical establishment barely acknowledges this, and often makes things worse. Nice guidelines must acknowledge all eating disorders, whether or not there is a current diagnosis. It should also revisit whether its focus on obesity masks the risks of other forms of disordered eating. Midwives and doctors should know how to support those of us who struggle.

• Ché Ramsden was diagnosed with disordered eating as a teenager. She had a postnatal relapse of the psychological symptoms of anorexia