Photo: Getty Images
Photo: Getty Images

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Pregnancy fat-shaming terrifies – and stigmatises – women

Pregnant women with high BMIs face humiliating and unhelpful interference from health officials. We shouldn’t ignore this brand of misogyny, says Rebecca Schiller

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By Rebecca Schiller on

Riding unicorns across the fertile fields of public-health officials’ imagination are a troupe of mythical women. Young, but not too young, their cheeks rosy from the folic-acid tablets they’ve been mainlining since puberty, their disdain for alcohol and cigarettes written across their unlined brows. They spend their days doing the required amount of exercise and meditation, while somehow maintaining supportive relationships and jobs with enhanced maternity packages. They plan their impending pregnancies with meticulous attention to detail, ensuring their bodies’ will be the perfect incubators of robust babies who wouldn’t dream of draining NHS resources. Most importantly, these women are slender, wearing their BMI scores of 22 like medals as they skip lightly along.

These women rarely make it out of imagination land. Life happens and it usually isn’t perfect. Pregnancies are unplanned and, planned or not, women’s health and lifestyle choices are based on far broader and more complex social, emotional, cultural, personal and economic factors than whether they think they might find themselves on the midwife’s weighing scales in the future. Yet, pregnancy fat-shaming is increasingly so ingrained in maternity policy and practice that pointing the finger of blame at a woman’s waistline is all too common, while real data and actual risk are often ignored.

Two years after the death of her premature baby son, Hugo, Leigh Kendall attended a fertility appointment during which her doctor informed her that her body and lifestyle choices meant she would not conceive naturally again. He then implied that the rare, life-threatening HELLP syndrome, which led to Hugo’s premature birth and death, was her fault, too. It didn’t matter that there could never be concrete proof of his theory, or that this was a grieving mother, because Leigh had a high BMI and blaming her first is just OK.  

“My doctor had no proof that my fertility issues were tied to BMI, or that my weight had anything to do with developing HELLP,” explains Leigh, who left her appointment in distress, her feelings of trauma and guilt about her baby’s death once more brought to the surface.

Leigh’s experience of shaming without evidence is far from isolated and reflects the current obsession with women’s bodies in a society that treats pregnant people as imperfect vessels to be policed, restricted, monitored and improved. Women are an easy target, and pregnant women whose bodies don’t match the myth the easiest of all.

There is an obsession with women’s bodies in a society that treats pregnant people as imperfect vessels to be policed, restricted, monitored and improved

A recent shame-tool of choice is this study – published in April – from Southampton University, suggesting a future child’s risk of obesity could be closely linked to a mother’s diet, health and lifestyle. In the accompanying press release, Dr Mitrou, of World Cancer Research Fund, makes a giant and unnecessary intellectual leap, telling women that they are responsible for their children developing cancer: “It is incredibly important that expectant mothers make healthy lifestyle choices to prevent childhood obesity, which can put the child at risk of many serious health conditions, including 11 common cancers, in later life.”

At the Policing Pregnancy conference later this month, Clare Murphy will present the results of a BPAS survey of 100 obese women who gave birth in the last year, which demonstrates the effects of this narrative. “The majority of women – 60 per cent – had the risks of obesity in pregnancy discussed with them,” explains Murphy, “but some women reported that risks were raised nearly 30 times. They reported that these discussions, on occasion, made them feel distressed, frightened and humiliated.”

As Amber Marshall (who set up her information and support website, BigBirthas, after her own experiences of pregnancy with high BMI) explains, being obese in pregnancy does have additional risks attached, which can, and should, be explained to women in an unbiased and accurate way. Yet, the evidence that the majority of women still have uncomplicated pregnancies and births is often not discussed. “Many women I have spoken to mistakenly believe that they're almost guaranteed to have problems of one sort or another, and are surprised the hear that the odds are on their side when it comes to having an unproblematic birth,” she says.

Some women give accounts of being stopped from giving birth the way they want, denied access to a birthing pool or birth centre, simply because of their BMI. Others have been told they must attend obesity clinics even if they don’t wish to, or are upset by the patronising telling-off on repeat at every appointment. A midwife acquaintance of mine, who works in an East London hospital with an above-average cohort of obese women, sees the instant, negative impact of this every month as she walks through the corridors after the obesity clinic, scooping up and comforting crying women from the dark back stairs of the hospital. They are distraught, having listened to a litany of terrifying complications and risks they are encouraged to feel responsible for, without any mention that half of them will have completely straightforward births.

The women scooped up by my midwife friend may go on to be the ones BPAS encounters as they consider terminating a future pregnancy because they, once again, can’t face the restrictions, scrutiny and chastisements dealt out to your averagely imperfect woman.

Pregnancy fat-shaming is nothing more than a new chapter in the age-old dummies guide to woman-blaming. But this pernicious 21st-century take on a tried-and-tested approach to undermining women is one we mustn’t be seduced by.

Policing Pregnancy: Who Should Be A Mother? will take place on May 18 and is a collaboration between British Pregnancy Advisory Service (BPAS), the Centre for Parenting Culture Studies (CPCS), Birthrights, and Engaging Sociology at CCCU.

@HackneyDoula

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