You Are Not Too Fat To Give Birth

For those of us who have been stigmatized by the medical system for our weight, it can be really embarrassing to go to a regular obstetrical provider once you find out you are pregnant. Some providers assume you already have health complications and some will be vocal about the pregnancy complications “you will have since your BMI is higher.” Some providers will tell you that you need a c-section at your first appointment because they assume you aren’t able to push your baby out vaginally.

Let’s chat about BMI for a second. Body Mass Index (or BMI) is a measurement used by healthcare professionals. Research has shown that in certain populations, BMI can be inaccurate as a measure of body fatness. BMI does not distinguish between fat, muscle, or bone mass and it does not provide any indication of the distribution of fat among people. Additionally, there are many factors that can influence the relationship between BMI and body fat including age, sex, ethnicity, and muscle mass.

While it is true that [in theory] you are at a higher risk for certain diseases such as heart disease, high blood pressure, type II diabetes, breathing problems, and gallstones with a higher BMI, this measurement alone can not predict a pregnancy complication.

What does the actual evidence on pregnancy and higher BMI say? Check it out here.

It is no secret that the medical system fails plus-size parents regularly. So what can you do?

The Single Most Important Decision You Can Make In Pregnancy

The most important decision you can make as a pregnant person is choosing your care provider. Trust, rapport, and an absence of bias and fatphobia lead to better birth outcomes because providers trust that pregnant people can make the best decisions for themselves…even in a larger body.

How To Identify and Find a Fat-Friendly Provider

Fat-friendly providers understand that pregnant people in larger bodies are no different than pregnant people with smaller bodies. All providers should practice holistic and patient-centered care by:

Providing individualized, compassionate care
Treating plus-size patients with dignity
Not categorizing patients as “high risk” solely based on their BMI
Not making assumptions about a person’s nutrition or level of physical activity
Having the appropriate room set-up to accommodate people with larger bodies
Being aware of their own personal biases and addressing them [we ALL have biases]

Finding a maternity care provider who is not fatphobic can be really difficult. I’m an advocate of finding a provider by word of mouth. Pop into your local parent’s Facebook groups and ask if someone has had a positive experience as a plus-size pregnant person.

If you don’t have any luck there, I’m here to make it easy for you! I have listed the few (but wonderful) plus-size friendly care providers in the Raleigh area below: