I was fat-shamed at an Afro-Centric Pregnancy Fair

July 15 2013 | Guest post by Sirius Bonner
The author and her husband. Photo by Jessica Shepard.
The author and her husband. Photo by Jessica Shepard.

The other day, I got fat-shamed. When you get fat-shamed often, like every time you turn on a television, it takes a lot to make an impact. My husband, Chris, and I went to our city's second annual Afro-Centric Pregnancy Fair in Portland, Oregon. I had high hopes of being in a supportive environment of people who care about the unique challenges facing black women as they enter pregnancy, childbirth, and childbearing. I fantasized about talking with midwives, doulas, and new mothers about their amazing experiences and horror stories of hospitals, birth centers, and their living rooms. Instead, I got a major dressing down by a black doctor manning an information table for a clinic.

When Chris and I approached the table and said we are considering starting a family, almost immediately this doctor told me that black women are more likely to face high blood pressure, diabetes, C-sections, and die in childbirth (true). She told me that black babies are more likely to have low birth weight, birth defects, be stillborn, or die (also true). And she said the only thing I could do about these (complex, systemic) issues is lose weight.

Seriously.

The only thing I can do to make sure that I don't die or that my child doesn't die is lose weight — an interesting perspective because, based on my ample research, those things impact black women disproportionately even when controlling for weight. Many argue that this is a logical outcome of systemic, institutional racism and socioeconomic disparity where black women have less access to resources (like good nutrition and healthcare) and deal with the continued physical impacts of racism.

The devastating health disparities that black women experience in pregnancy and childbirth were not the doctor's biggest concerns, however. She continued to tell me that black people don't know anything about health and exercise so it's not surprising that I'm fat and that black people have health problems and her mother was a big girl and she doesn't want anyone to have the terrible life that her mother had. So, whenever she sees a "sista," that's why she stops them and asks "Whatchu doin' 'bout some exercise today?" So before I even think about getting pregnant I need to lose a lot of weight because, otherwise, I'm putting my health at risk, but more importantly I'm risking the life of —

At this point, I stop her and say, "Yes, actually I'm well aware of the health risks associated with obesity and race on pregnancy which is why I've already lost more than 10% of my body weight."

"That's great!" she says. "Obviously, you've got a lot more to go."

That's when I made my awkwardly smiley escape. As Chris and I visited the other tables, rage and shame started boiling in my "obviously" over-large gut. After much discussion with my conflict-averse husband, I decided I wanted to call her out on fat-shaming me, let her know the impact of her words, and tell her not to do that to other people. Which I accomplished… sort of. I did go back, and when I told her that she'd just fat-shamed me and that her words made me feel unworthy of being a mother simply because of my size, she apologized. She got up, looked me in the eyes, sincerely apologized, and hugged me. I thanked her for her apology. It was a beautiful moment of sistahood… except, not really.

This sort of thing happens to me all the time. If I took the time out to have an emotional reaction for every time I experience sizeism, racism, sexism, micro-aggressions, etc., I would cease to function. However, what I wanted to say to that doctor is the same thing I failed to say to another medical professional (and the entire medical profession) the other day. It's that part about not doing this to other people. If I could do either over again, it would go something like this:

As you so smartly deduced and eloquently spoke about, I am fat. Based on my appearance (read: race and size) you may not have assumed that I am relatively well-educated; lead a socially and (mostly) financially stable life; and have ample access to the internet, libraries, and bookstores matched with a desire to learn and college-level researching skills. As such, I am well aware of the health impacts of obesity because I've intentionally sought out that information. Similarly, it's possible that I know more than you do about how to lose weight. I say that because the way you've spoken to me indicates that you have no concept of what it's like to be fat and, further, no concept of the fact that as a fat person, I am constantly bombarded with "guidance, tips, and advice" on how to lose weight. Whether or not I want to be, I am an expert on how to get thin. It's somewhat analogous to the way that white people have no idea that people of color in predominately white communities are experts on whiteness — whether they want to be or not.

Based on my access, ability, and desire to obtain the information, it should follow that I know a great deal about the negative impacts of obesity (and race) on pregnancy and childbirth. One thing comes through loud and clear from my research: Only a portion of obese mothers have these experiences, NOT ALL. It's not a majority, it's not even a large portion. But it happens more with obese women than with "normal" women, so, apparently, you think you have the right — dare I say, duty, even — to scare me into losing weight. You are not educating me. You are not telling me anything I don't know. You are fat-shaming me and patronizing me.

Stop. Please stop doing this to your other patients. Instead, I would urge you to be supportive, thoughtful, and more knowledgeable. You also need to check your bias. Be able to provide resources to your patients like information sources, community resources, and other health (including mental health) support. Keep in mind that you are dealing with other human beings and not just stupid fat blobs with no feelings. Remember that our whole culture is telling this person that ze is fat and therefore disgusting and unworthy. Ask yourself, do you want to be just another voice telling this person that ze's disgusting and unworthy, or do you want to help your patient make some changes?

These are some of the things I wish I had said to these medical professionals. In some ways, the hardest thing about these experiences is that I don't really want to lose weight, but I'm trying to because I want to have a baby and I'm sick of these conversations.

The society and dominant culture in which I live have succeeded in making me very uncomfortable in my fat body. But, stubborn as I am, I cling to my fat as an act of defiance. My fatness runs counter to what is deemed culturally acceptable and is, therefore, a revolutionary act. Unfortunately, the medical establishment sees my revolutionary act of defiance simultaneously as a burden, a cash-cow, and high risk when it comes to pregnancy. For those reasons, I'm much more likely to be highly scrutinized and criticized, required to submit to (possibly unnecessary) medical interventions, and have a C-section.

The real world implications of bigotry create unnecessary stress on my body and will for my baby. Stress during pregnancy is strongly linked to high blood-pressure, diabetes, maternal death, low birth weight, premature birth, birth defects, stillbirth, and infant death (truth). Funny how that works.

  1. That is awful! I hope she heard you and makes a real effort to change how she talks to people and what assumption she makes.

    A friend of mine runs http://plussizebirth.com/ and is fighting for the medical community to provide respectful, appropriate care for plus size women based on their actual medical history, not assumptions based on their weight.

  2. Big hug, soon to be mama! I gave birth at over 300 pounds twice. no diabetes, or high BP, and conceived easily. We found a size-positive doc and I remember the nurse weighed me once and said "perfect!" I told her no one had ever said that to me before. 🙂

  3. Upon discovering I was pregnant with my first child in early 2003, I chose a doctor and eagerly looked forward to my first appointment. It was a disaster. My doctor (who, half-way through my pregnancy, sold her practice and moved away) informed me that I was fat and proceeded to put me on a diet. I had no sign of diabetes, high blood pressure, or high cholesterol. I weighed just over 200 pounds. A couple of months later, she said was "concerned" for the health of my child because I wasn't gaining enough weight.

      • Everything turned out okay, but my son was born small (just over 5 pounds). Thankfully, he was/is healthy. Through that entire pregnancy, I gained a grand total of 15 pounds, and they could not figure out if that was good or bad. I am so sorry that you were shamed at the fair, and I thank you for speaking out on this.

    • Hey, Sumayyah! (It's me!)

      I had the opposite happen, sorta. When I fou d out I was preg with my son, I was 204. As my preg progressed, I LOST weight. My doctor was telling me he was going to prescribe me Ensure. I told him no, and he threatened to call Child services on me for not taking care of myself. This wasn't even my first pregnancy, and i knew I was fine. My son was born with no complications, but two weeks overdue. Needless to say after I gave him a piece of my mind, he no longer tried to threaten me.

  4. Yes. YES TO THIS! I had a wonderfully healthy and problem-free pregnancy and natural delivery, for which I am truly grateful. The only negative experiences I had were with the number of doctors and midwives (the practice I went with was huge, so I saw a lot of both) who wouldn't stop making a big deal out of my weight. They were so certain I'd have diabetes, have an unusually large baby, have hypertension… none of which actually happened to me.

    If only we all could keep ourselves composed and erudite and say exactly what you wish you'd said when confronted with bias such as this. The problem is, shaming makes you feel ashamed! So all I could do, every time, is look at my shoes and say nothing.

  5. Shame on her. I had a similar experience while pregnant with my third daughter at thirty. I'm overweight and developed high blood pressure after week 17. My OB/GYN, who I adored, refused to believe that I've never had the condition…based on the number on a scale. I also had a C-Section because the baby was face up and I'd had a couple fainting spells due to the anxiety of starting an induction, which I was pressured into and not wanting to experience for the THIRD time. C-Section recovery was not a good experience for me in comparison to my previous two deliveries. Everyone at the hospital was WONDERFUL. Don't let anyone lump you into a category based on your weight – our bodies were made to create and sustain life. After delivering my (perfectly healthy)child I stopped taking my blood pressure medicine…and once again it reads perfect. I wanted to head straight up to his practice and tell him to kiss my entire fat ass.

    • Honey, I find your doctor's ignorance even more terrifying because a high blood pressure at that time of pregnancy can indicate so many other underlying problems, like degredation of the placenta, which could have killed both you and the baby (it's happened in my family) – the fact that he blamed your weight and didn't look further for any other pregnancy complications scares me! Arse-kissing on his part is definitely in order!

  6. i'm so sorry this happened to you. i think sometimes people in healthcare forget that when a patient/prospective client comes to them, it is not for the professional's personal opinion or personal crusade. It is for medical advice and services. I have only worked in healthcare for a few years but am often surprised at others' inability to separate what they think is right and what would be right for a particular patient and/or family.

    while i have not had to suffer under judgement for weight, i have had my ability to make decisions for myself while pregnant scrutinized because i wanted a VBAC (which i was successful in). i found my experiences with the healthcare team to be filled with worry and concern because i felt that they were pushing for me to do what they would do or what would be easiest for them, and not considering that this was my experience and my body-only i would be able to make the right decision for me. i hope you are able to find supportive medical providers because pregnancy is in itself enough to worry about.

  7. Please please please start reading DancesWithFat.com – a great blog about fat activism, anti-fat shaming, scientific research on obesity (vs. perpetuated medical myths), and the concept of Healthy At Every Size.

    Also, when you do get pregnant, find a provider that does not use BMI as an indicator of health (instead using blood pressure, physicals, and blood tests as accurate measurements)! Find a provider who will treat you as high risk ONLY of you are truly high risk, not simply because you are obese. The two are separate issues and being obese does not automatically make you a high risk pregnancy. I am currently 7 months pregnant, and my midwife hasn't brought up my weight once- because I lead a healthy lifestyle of nutritional eating and moderate excessive and my blood work is absolutely perfect. You rock, mama and don't let society tell you otherwise.

  8. Weight and how it relates to health is a complex and controversial topic. Some overweight people can be healthy, just like "normal" weight people can be unhealthy. Size doesn't always correlate with health. I know a lot of people in the medical community who all have different opinions on weight and how it relates to health. It's sometimes hard for doctors to be able to distinguish these groups- which overweight people will get healthier if they lose weight and which people for whom it might not matter. Because losing weight works for some of their patients to improve their health, they recommend it to many. Some overweight women have to lose some weight to get pregnant, but certainly not all! There are some things you can't get around…like it's just more difficult to do certain types of surgeries on obese people than it is thinner people. And it can be more difficult to treat patients with coexisting conditions related to weight, but these coexisting conditions aren't always 100% due to weight.

    So my point is that you can't claim that weight doesn't matter at ALL, and doctors have reasons for considering it. HOWEVER, health care professionals should treat the WHOLE PERSON they see in front of them, not some future possibly thinner person. A healthcare professional would never look at 1 number for a person of normal weight to determine their health, they look at ALL the numbers (cholesterol, BP, etc). So a healthcare professional should NEVER look at a person's weight – 1 number – and stop there. They should look at all the numbers and other factors to determine if that person is healthy. And if your doctor responds to "I have an ear ache" with "You need to lose weight," you should find another doctor. They need to address your primary concern, then maybe later address other things related to your health.

    And certainly there are SOOOO many more factors than what the scale says that determine if you should try and get pregnant. Hopefully by going back and saying something to the woman at the fair, you made her more aware of the complexities of the issue. Keep spreading your information and fight back against assumptions!

  9. First: I'm so sorry, if not surprised, that this happened to you. Being fat in public is seen as an open invitation to comment, judge, and shame. I'm sorry that a space that you hoped would be welcoming and supportive ended up not being that way.
    The relationship between fat people and the medical establishment is so broken at this point, and we are suffering because of it. I completely understand that feeling of wishing you had said something right away, and wishing you could be as eloquent in the moment as you are later. It's difficult anyways, and throw in an authority figure like a doctor and it gets so much harder.
    I second the recommendation for Dances with Fat, and there really are a lot of awesome fat activists running blogs and tumblrs that can be wonderful support. I really like Living ~400lbs (http://living400lbs.wordpress.com/).
    For pregnancy stuff I really recommend http://wellroundedmama.blogspot.com/. Her website not only has real women's stories, pictures, and info, it pulls together research, debunks a lot of the common shaming/scaring arguments, and analyzes studies.
    I also really really recommend the Fat Friendly Health Professionals List (at http://www.cat-and-dragon.com/stef/fat/ffp.html). It has lists by state and country and all the entries are either by fat people who have had these professionals and found them to be fat friendly, or by the professionals themselves. Even though I haven't always been able to find someone in the small towns I live in, there really are a lot of providers, including midwives and OBs, listed and it's nice to know there are some out there either way.
    Good luck with your journey to/through pregnancy and childbirth!

  10. Good for you for having a voice and getting it out there.
    I've been fat all my life. I do my best to be healthy, and I'm always working on ways to be more so. And almost every day, someone comments on my weight. Sometimes it's veiled under my boss talking about standing up from my desk while I'm on the phone, and sometimes it's a guy at the grocery store who talks says "Damn! That's a big girl there!" And I want to have a child as some point, and I've done all the research, but I'm worried that when the time comes, I won't be able to find a practitioner who will accept the person I am.
    I'd never found a way to be extra active that worked well for me so that's always been a struggle, but now I go to Fat Yoga where just being the person that I am is enough. My yoga class is the best part of my week because I don't have to hide or feel bad. I don't have to think about if what I'm wearing is going to hide enough to not be commented on. I don't have to worry about being sweaty and not looking put together.
    But when I finish my class, I have to go back out into the world and face what I've always faced.
    You keep fighting the good fight and don't let anyone tell you that you can't have what you want to have. Thank you for letting us all know that we're not alone.

    • Sort of off topic, but Fat Yoga sounds like a brilliant idea.

      While I don't have personal experience in the matter, a supportive, non-judgmental exercise environment seems like a much more productive way to help people who are over weight be active than badgering them about it.

      • I've never heard of it, but I think that's awesome. It's hard to get a good workout when you feel self-conscious. (That goes for anyone of any size.)

        I know people who found a supportive community with Zumba classes. It probably varies by location, so if you try it one place and hate the atmosphere, maybe try a different location before writing it off.

  11. I am also fat and was TERRIFIED that I'd never be able conceive based on some books I read. My kind doctor finally told me that heavy women conceive everyday. My body gives me so many signs that I am fertile and none of them are numbers on a scale. The only thing in my life that was a barrier to conception was the stress of trying to lose weight or worrying that I wasn't.

    I conceived almost immediately.

    I also received fantastic care at the Providence Maternal Care Clinic in Portland. They ran some extra tests for gestational diabetes that I was at risk for because of my weight and age. But it was all very matter-of-factly discussed with no shaming involved.

    • We loved our midwives at Alma Midwifery (Portland). They are not weight-obsessed at all – I didn't even have to be weighed at my appointments if I didn't want (i ended up gaining 70lbs which are still with me). I also recently had a consultation with our lead midwife because we are thinking of having another child and I wanted to discuss my weight and my age as risk factors. She was not concerned. AND they didn't charge for the appointment!!! Love them!

      • I'm with Kaiser now… that's a different topic for a different day. I think I may be able to switch to providence when open enrollment opens up at work. That switch would also allow us to have more options outside of hospitals.
        The Birthing Center at Alma is my absolute dream. I've even got my room picked out there. But I'm sooo worried about being rejected because of my size or being considered a "high risk" pregnancy and rejected for that. Did you use their birth center or a home birth with one of their midwives?

        • I used their birth center which was awesome. We opted to stay the whole two days to get a handle on breastfeeding, but it was also really nice to be taken care of during that time. Oh and the massage on day 2 was wonderful!

          About insurance: At our first appointment they gave us a list of insurance providers categorized by their (Alma's) ability to work with them – some providers are easier than others for them to work with. But there are some providers that don't cover out-of-hospital birth at all (maybe Kaiser?). That being said – they (at least in 2011 when we delivered) are not in any provider's "network", so it really is all about what your out-of-network coverage is. The first time around we had Providence and out of pocket for us was something like $2200 (prenatal care, birth center delivery, and 6 weeks of postpartum care for me and the babe). Alma has certain benchmarks you have to meet paying your out of pocket cost, like $250 at your initial appointment $1000 by a certain number of weeks (28?) and the balance by 36 weeks but I think I remember reading that they might be able to work with financial issues. We went with a self-imposed payment plan that split that out-of-pocket cost evenly over 8 months which ended up satisfying those benchmarks. We were lucky that was not too big of an issue for us, but next time around we will have Cigna and our out of pocket cost will be just under 5k. I approached my husband about the possibility of a home birth to cut that number down but it didn't fly. We'll have to see how we can make that work – however that happens it would be totally worth it to us. Barring anything illegal 😉

          About risk: I am reasonably certain that weight alone would not be the sole factor in deeming your case high risk (unless maybe you were like 700 pounds?). There are certain conditions they wouldn't handle and would refer you out, but for others they really are all about informed risk. They want to make sure you understand all the risks associated with delivering whatever way with whatever situation may come up and then it's up to you. I would really recommend scheduling a pre-conception consultation with them and then you can discuss exactly under what conditions they would refer you out for risk and what they would be looking for in the way numbers or whatever to have that not happen (if and where possible). Then if that doesn't happen to be the case at the moment you can be moving toward that in pre-conception.

          Some insurance companies require you work with a CNM (ours did) but I'm glad that was the case because we love Kori!

          Whoa – sorry for the super long comment, but I hope the information is helpful to you and hopefully not redundant.

  12. I just want to thank you so much for writing this! It is so hard to articulate this stuff. As a fat person myself, it happens so much that it seems exhausting to even try and address it with people. So sometimes I just swallow it, and feel the shame and doubt my own intelligence/sanity…and that's not cool.

  13. "those things impact black women disproportionately even when controlling for weight" Yes, yes, YES! I am so impressed with this piece, and so glad that the author went back and called the doctor out. We rightfully tend to assume that doctors are up on the latest research on health issues, but they rarely are. Right now there is a huge divide between the medical community trying to call obesity a disease, and the research indicating that it's not. But even if it were a disease or an indicator of poor health, what right does that give people to shame others? Repeated shaming is more likely to lead to poor self-esteem which discourages self-care, rather than encouraging self-care.

  14. Wow, first of all I'm so sorry you had this experience, especially going into a venue that is supposed to be a place of support and acceptance for ALL Black women. Sounds like (in the way she brought her mother into the convo) that your presence triggered this doctor, and if she's doing this to her "sistas" all the time as she indicated, she really needs to seek a therapist. I grew up with an overweight fat-shaming mother, and I'm still working to undo the damage (the way she spoke of her body, the bodies of myself and my sister, people on the street) that caused in the way I view myself and others. Thank you for sharing your story and for speaking up, it's helping women of all shapes and sizes to check themselves and to heal.

    • This. So much this. I also agree that I must have triggered her deeply. I do hope that she reexamines her connections to and experience of blackness and fatness.

  15. Great piece!

    I'm so sick of people being condescending towards others when it comes to decisions and changes regarding their own lifestyles.

    I've never been fat myself, which I'd put down to genetics and habits formed before I was old enough to be aware of what was going on. Having tried to make some positive changes for my own health, I can't imagine how incredibly difficult it must be to lose any weight, let alone a significant proportion of your body weight, no matter how significant the potential benefits.

    I simply don't understand how someone could look at another person, and decide they're worthy of being patronised on the basis of their size and race.

  16. Thank you for writing this. I am new to the fat activism scene, but I have been fat my whole life. I was fat in Kindergarten.

    Anyway I just wanted to say I have had 3, beautiful, healthy pregnancies and babies, one at my highest weight of 370 lbs. I chose a midwife and homebirth specifically for the reasons you talk about in your article. I wasn't fat shamed by my homebirth midwife. She asked me to keep a food journal (as she does all her patients) And actually told me to replace some "low fat" things in my diet with real food. She said if I am being nourished by real food, I'll be healthier, and left it at that!

    I hope that if and when you decide to have your baby, you look into practitioners with a more wholistic type approach (mind/body connection) because they KNOW that fat shaming only hurts and hinders a new mom.

    Much love to you in this place. I feel like we are kindred!

  17. I love OBB, but I think this just won for my favorite post in the whole empire ever.

    You might already know the Shapely Prose archive, but for anyone reading this who doesn't (and anyone reading who might be tempted to talk about how fat really is unhealthy and correlation = causation) this is my favorite post for jumping off into other articles about what is known about fat and what isn't.

    http://kateharding.net/faq/but-dont-you-realize-fat-is-unhealthy/

  18. I love this! I am a very slender girl- I hear all the time "you're so skinny!" or " you have to go eat a cheeseburger". Body shaming as a whole needs to stop! We are born with the bodies we are born with! My oldest sister is 300 lbs, I am 110. Our whole life she was trying to lose weight while telling me I looked like a boy. I was wishing for her breasts(even half of 'em!) and she wanted my waistline. Now, as adult women, she is happy in her skin and I am happy in mine. But it still hurts when I hear "skinny bitch"!
    We all need to look beyond color, shape, size, dress- people are all so beautiful!

    • So true. There is way to much body hostility going around period. But I think this is because so many people are very critical of their own bodies. They have a constant negative interior dialogue about their shape, and because it is always on their minds they feel compelled to comment on other people's shapes as well; whether it is because they feel that others are too fat, skinny, short, busty, leggy, etc. Personally, I don't feel that any of us are "entitled" to an opinion about how others look, regardless of what they are wearing or how they choose to present themselves, and that a little bit of self-love could help ease the desire to voice these negative feelings. One of my favorite websites for fat activism and body positivity is http://www.everydayfeminism.com

  19. Thank you all for the kind words, responses, and feedback! I am aware of most of the resources shared, but hopefully someone will learn something new from them.
    It's difficult to share such an embarrassing experience in such a public way, but I hope that my story will make fat-shamers reconsider and maybe change things for those at risk of being fat-shamed.

  20. I went into my pregnancy overweight, though I had tried to slim down (ended pu losing around 30 lbs to get pregnant) and asked my midwives EVERY appointment how I was doing on the weight gain. They all said I was okay, doing fine, seemed healthy, until the LAST midwife (it's a rotation) who said "ideally we would have had you stop at 20lbs (I had gained 40)," and it PISSED ME OFF. I had tried to be super conscientious the whole time, asked about cravings, tried to eat moderately and to be slammed in the last few weeks felt super hurtful and overwhelming. And now, 19 months postpartum I still haven't lost the baby weight because I am still breastfeeding. I've gotten nothing but flak from medical professionals, though in very passive aggressive ways (like just writing it in my discharge papers, without talking to me about it). Running, eating healthy, and still can't lose the last bit of weight, but all they see is FAT.
    I'm glad you wrote this essay because I don't think any woman should have to endure that kind of hatefulness.

    Hugs.

  21. Thanks for writing this! Isn't it funny that the people who concern troll those of us fat women about our health couldn't seem to give a damn about our MENTAL HEALTH?

    I had a baby just over a year ago and was absolutely blessed with an ob who never said anything negative about my weight. Every single technician that took my blood pressure or gave me an ultrasound assumed that I had gestational diabetes (not even close, suckers).

    And this sounds super cheesy but after I gave birth I felt better about my body than I have in my entire life. My body made a baby and pushed it out and I was AMAZING.

    As an ending note, here's a great blog with tons of information: http://wellroundedmama.blogspot.com/

  22. I am so sorry you had that experience, but thank you so much for sharing it and for speaking up! It's so important that people know that you can be a "well-rounded mama" and still be healthy. We all need to focus our energy on healthy behaviors like exercise and eating whole foods, not numbers on a scale. Thank you again!

  23. Fat shaming during pregnancy can happen to white people too. One of my coworkers (currently on maternity leave) came to work near tears one day. She said that after getting a growth ultrasound at the hospital, the doctor snapped at her "you better lose weight after this baby is born or you'll never see your daughter get married." I couldn't believe anyone would say something like that to anyone, much less someone who was pregnant. Besides, this doctor didn't know that she was dieting before concieving and didn't bother to say "your weight gain is on track for someone your size" considering she had only gained 10 lbs at that point. It seemed to me all she saw was some poor fatty pregnant rather than a person trying to have a healthy baby.

    • This writer was speaking to a very personal situation that happened to her that is rooted in deep systemic racism. She never said that it ONLY happened to black women and I'm sure she is well aware that white women also experience this discrimination. It's not a dang competition and fatness has different roots and experience for women of various identities.
      Your first sentence is just super frustrating.

  24. I am conflicted about this. Your piece is beautiful and well written. The doctor is obviously completely uneducated on what actually motivates people to make the major life changes necessary to change themselves: acceptance for who and what they are right now. This is why interventions don't work and many smart addiction counselors advise against them, when you make someone feel wrong for who they are it IS NOT a long-term motivator for self-improvement. People grow when they feel good about who they are and understand they are powerful enough to improve themselves.

    I am conflicted because I feel for you and think this doctor was an idiot. However, I disagree with the idea that it's "okay" to be obese. I agree that our country has absurd ideas about beauty and that most of the people we see on TV are not actually healthy. Weight is relative to many things and beauty comes in all sizes (personally I'm a fan of females having curves). But I think it is no better to avoid the scientific fact that obesity is a huge strain on the body and isn't a healthy way to live.

    I don't know what the answer is, but I think it lies somewhere in the middle and definitely doesn't come from making a woman feel bad about herself. I'm truly sorry you had to go through that.

    • I am also conflicted. I know people who work in various medical professions, and they see patients every day who have health complications linked to weight. Obesity complicates things. It's another factor to consider among other complicated diseases, so of course doctors would like to simplify things and remove one of the factors that can actually be changed to give you better care. For example, it might be worth it to lose some weight before undergoing risky back surgery for back pain. You can't change your genes, but you can change your weight (to a certain extent, and no it's not easy for everyone).

      HOWEVER, that doesn't mean that doctors can assume certain things about obese people without even looking at their medical history and chart. (And there is no need for technicians or nurses or the asshole in the grocery store to make a "diagnosis" that you should change your body.)

      But if AFTER your doctor looks at your history and numbers, and they give a concrete example like "you lost 25 pounds, and your high blood pressure went down," I think that is perfectly ok for them to suggest you lose more weight. It just means that you are one of those people for whom weight makes a difference. That's why it is so important for doctors to NOT fat-shame people, actually look at the evidence, and also for the patient to be receptive to the doctor's advice. The doctor should approach weight as the complex issue it is- genetic, environment, and mental health. It's more complicated than drugs or smoking because you need to eat- you can't avoid food entirely. And that's why a lot of the scare tactics doctors sometimes use with smoking will not work with weight.

    • I would encourage you to check your bias (https://implicit.harvard.edu/implicit/selectatest.html) and to do some research on healthism (http://www.tumblr.com/tagged/healthism) and concern trolling (http://fatheffalump.wordpress.com/2012/01/04/genuine-concern-vs-concern-trolling/).
      Based on your comments, I'm not sure you've read or understood my whole piece. I would ask that you take another look at the part about what I wish I had said, especially this sentence "Ask yourself, do you want to be just another voice telling this person that ze's disgusting and unworthy, or do you want to help your patient make some changes?" Similarly, you should check out some of the comments made on the post.

    • There are a lot of things that are common in our culture and are a huge strain on our bodies and not a healthy way to live. Sitting at a desk 8+ hours a day, eating highly processed foods, extreme diets, high stress, etc. But when thin people do those things, they're not shamed for it or discriminated against. Obesity CAN be an indicator of other issues, but treating it as a visible confirmation of otherwise unconfirmed medical issues, or the assumed cause of medical issues rather than caused by medical issues, is fat shaming, not scientific.

    • Something else to consider: is it "okay" to have cerebral palsy? Is it "okay" to live with cancer? Is it "okay" to have Down Syndrome? Is it "okay" to have a broken leg? Are people in those situations allowed to love their bodies, receive appropriate medical treatment for their specific issues, and not be shamed by strangers on the street?

      If your answer is yes, you're not talking about physical health. You're talking about fat shaming.

    • The science around obesity is actually still kind of shady. We know that it's correlated with lots of stuff, but also that lots of stuff can cause obesity. For instance: I have an intestinal disorder. Probably Crohn's. Even though Crohn's is generally understood as a wasting disorder, I gained weight during a major flare up. As soon as I got treatment, I lost a whole bunch of weight very quickly. This is actually fairly common amongst inflammation disorders. Diabetes can also cause weight gain. There's a lot of chicken/egg issues. And then, of course, high weight can also be caused by genetics (the women in my family are all fat going back several generations–they also tend to die in their late 80's), environmental factors (like pollution), a history of weight cycling, and, of course, food and activity levels. Many of these things are bad for you independent of weight gain (though not all are bad for you), some of them are controllable, and many of them are not. So is it "OK" to be fat? How do you know what's causing it for a particular person? Is it OK in certain situations and not others? How do you make that call? Health is personal, and even if someone IS fat because they are sedentary and eat lots of junk food, you don't know the situations that cause them to take those actions.

    • It's not okay to be obese. This was not and is not the right pregnancy expo for you. You should have chosen a place more conducive to your chosen way a life which is not afrocentric.

  25. I cannot THIS this enough! Lifelong fat girl right here. When I became pregnant I knew my risks, I read every piece of information I could get my hands on and ended up terrified! In the end all my doctors called me a 'poster child's for healthy pregnancy for anyone of any weight. I have always exercised and eaten well, this is just my body and I rock it. You can be healthy and happy and a big girl and more women need to know it. Thank you for putting yourself out there. And please never back down, everyone needs someone like you to advocate for them.

    • Agreed!!!!!!!! Being plus size does not mean you are automatically going to have a high risk pregnancy. I too am a lifelong fat girl and I had a perfectly normal and healthy pregnancy and natural childbirth.

  26. I'm so sorry that happened to you. Don't give up the search for a great doctor or midwife who has a clue about health education and patient relationships. There are some truly excellent clinicians in Portland and in general, it is a great place to have a baby.

  27. Sadly, this happens on both sides of the spectrum. It's like as soon as you announce that you want to be a mother or get pregnant, the world thinks they have the right to judge you more harshly because they're looking out for "the health of your baby."

    I was told by a midwife that if I failed to gain (near the final weeks of my pregnancy), we would need to talk about inducing! He arrived on his own, perfectly healthy, but small compared to the average baby. Now at six month people bulge their eyes when we reveal his age. He was initially small so that my body could handle the birth and my body has continued to nourish him into a healthy (larger than average) baby. Everyone is different. It's tough, but trust your heart and trust your body. At the end of the day no one else can tell you what's best.
    I definitely second finding a supportive team!

  28. I feel like I have a lot to say in one tiny comment! First, I really hate that this happened to you, because I know what it's like and it sucks. Good for you for telling her to check herself! Too many of us just let it go thinking that we are indeed fat and thus made of fail, so we deserve whatever a doctor is going to throw at us. I'm fortunate in that I found a good physician and an OB several years ago, so I don't dread the doctor anymore. On the subject of pregnancy, being a tubby girl myself (good grief I hate the term "obese", but there you have it) and I always have been, and have two amazing, healthy kids: one about to turn 13, and one 6 months old. With the first, I had a few minor complications and gained way too much weight, but with the second I had an especially really health pregnancy, and I feel that it's probably because I eat better and exercise better now than I did 13 years ago- fact! My OB was super supportive and mentioned gently the things I knew about elevated risks up front, then went out of her way to reassure us that all was well and she had no reason to believe it was going to be otherwise. And it was! At any rate, I wish you the best of luck and support, and hope you find fantastic medical support for your future baby(ies). 🙂

  29. I was just entering the "obese" category, BMI wise, when I got pregnant with my youngest. I gained 65 pounds during my pregnancy. My midwife never gave me a hard time over weight gain – what she said was "As long as the numbers are still good and you're healthy, I don't really care what you gain." My blood pressure, pulse, etc were always great. In fact, she told me that I was born for birthing babies. I gave birth, at home, at 263 pounds. My daughter was 10 1/2 pounds and almost 23 inches long and I didn't even need stitches. Overweight and obese women can ABSOLUTELY have wonderful, healthy pregnancies and fantastic births, and I hope that you do, and continue to share your story with us 🙂

  30. What an ordeal!
    Something about pregnancy makes everyone an "expert" (read: judgmental know-it-all), isn't it true?! Sure, you have some different risks than I do (I'm average weight, white, had a c/s then a vbac, now hoping for another vbac), but each of us has risks and shame on anyone for making you feel like you're the only one. I know plenty of super skinny white girls who had gestational diabetes, several women who had their first baby at 37 or older, and fat women who have had perfectly healthy pregnancies and babies.
    I learned in a Bradley (natural childbirth) class that the food you eat during pregnancy is much more important than the weight you gain or lose. So it's normal and can be healthy for an overweight woman to lose weight during pregnancy, as long as she is eating right (and what a good reason for eating well!). And I've always thought that doctors and midwives should ask "what have you been eating?" At visits rather than put you on the scale right away. Much more indicative of mother's and baby's health!

  31. As a Women's Health medical provider, I am heartbroken that you received such a horrific response to your proactive query and am astounded at that provider's inability to really see and hear you until you called her out.
    As an obese woman who just recently gave birth to my healthy first born son after a relatively uneventful pregnancy, I am reminded that it must be appreciated that pregnancy is subjective and there are so many factors that can impact one's health, pregnancy and delivery.

  32. Bookmarking this, so I can read it all the time.
    In fact, with your blessing, I may steal some of what you wished you'd said and take it with me in my purse, so I can whip it out whenever someone feels like it's OK for them to judge me.
    Because maybe if I have the guts to stick up for myself, then someone else who doesn't have the courage or the words to do it might not have to.
    My fiancee has been instrumental in reminding me that my weight does not mean I am unhealthy. And as long as I eat the foods my body needs & move (in fun ways!), then I can be 60kgs or I can be 160kgs. It's not anyone else's business.
    I'm lucky to have this supportive person in my life, and maybe it's time for me to speak up on behalf of me and all the other 'overweight' people I know who can't/won't speak up.
    I still remember going to my GP for a rash under my arms that I kept getting when I used deodorant. Apparently rather than being an allergy (my thoughts), it was because I'm fat. He came to this conclusion after glancing at me (not my underarm…me), and without doing any tests.
    The only way to avoid underarm rashes is to lose weight.
    Given how proud I was of being healthy (all my blood work is perfect, and my BP is always good), that was enough to crush me.
    And I just sat there and took it. Because that's what fat people are supposed to do, right? The GP knows best. Skinny people know best. Everyone except the person in the situation knows best.

    • Please steal my words. Use them as a jumping off point. Whatever! We all need to stand up for ourselves more, so whatever it takes to get there, I'm down.

  33. Sirius, I can completely identify with your story as a woman of size. When I found out I was pregnant I was nearly 300 lbs. All I read online was how I was going to have a bunch of complications and end up with a c-section. I was heartbroken. 8 months later ROCKED 16 hours of natural childbirth and gave birth on my KNEES! Was it a miracle? No! I ate right, stayed, active and most importantly hired a size friendly provider. MOST plus size women have perfectly normal and healthy pregnancies. My birth experience changed me so deeply that I wanted to make sure all plus size women have access to POSITIVE information about plus size pregnancy. I have photo galleries full of women who are pregnant, giving birth, breastfeeding, and babywearing. I'm currently about to roll out childbirth educational classes specifically for plus size women. To help all women find their voice as you have!!! Your body is amazing Sirius. Your body is not broken! Best wishes with your TTC journey.

  34. Oh come on. This is a ridiculous way to talk to people. What the hell was wrong with that doctor?

    Incidentally, I also ran into constant talk from doctors about how I would absolutely have a c-section because I was 35 lbs overweight. No options. It would just happen. I was lucky as hell to find the birth center where Soren was born, after 8 hours of unmedicated labor, the only complication being slightly higher than average blood loss. My race never worked against me, but my socio-economic status came into play as much as my weight did. I was unmarried, and well below poverty level (and on Medicaid). I was consistently treated as if I were an uneducated idiot who should have kept her legs shut, with no idea of what was happening to my body, physiology, what standard procedures and their risks, benefits, and associated statistics were, and what my rights consisted of as a patient. Medicaid = stupid to far too many doctors and even CNMs. I can only imagine how much worse my already horrible experiences would have been if I were not white. I felt grateful to find the midwives that I did; the sad part is that I shouldn't have.

    This should not be standard. For black women, for overweight women, or for low income women.

    There should not be higher c-section rates for minority and low income women, even when controlled for risk status. There should not be higher rates of intervention. This should not be normal.

  35. Well you know this is going to happen again, so I hope you've memorized this speech for those (unfortunately inevitable) occasions. Maybe you should circulate it around the fat acceptance community, so others can have it on hand when they have this horrendously common experience.

  36. Thank you so much for writing this. As an averaged sized white woman who grew up in and continues to live in a mostly white community I really appreciate the chance to gain a new perspective and get a quick glimpse into the realities of people in different situations. I'm so sorry that you are so constantly bombarded with such bull shit! At 25 I am considered by most to be very young to have a 4-year-old and am (thank god) dealing with less and less ageist comments all the time now that I'm starting to look closer in age to the other moms around. I sure had to deal with A LOT of it during my first pregnancy though. Pretty well all doctors, nurses, etc that we dealt with treated us as if we knew nothing about pregnancy and parenting when in fact we were probably considerably more informed than you're average 30-year-old having her first baby in small town Ontario. I had an OB once ask me if I wanted to bleed to death when I asked one little question about their policy to automatically give a Pitocin shot to help expel the afterbirth whether there were signs of any issues or not. "No, Queen of All Birthing, my preference is not to bleed to death but rather to die in the midst of KICKING YOUR ASS!"

    During my second pregnancy we did find some really lovely midwives who were incredibly respectful though so hopefully you'll find some great health care pros right off the bat!

  37. Thanks for sharing your experience, and high-five for being able to tell that lady how she impacted you!

    My first doctor wouldn't help me until I lost a certain amount of weight- She even said things like "You've just got weight to deal with- at least you aren't a bitch!" Which in my head was like: So do you tell them to stop being bitches before you help them get pregnant?

    I spent a whole year feeling awful about myself thinking that I wasn't good enough or deserving of a baby… finally once I regrouped I was able to find another doctor who has been supportive and has helped us work towards reaching our goal of a family and doesn't seem to think my weight has anything to do with anything.

  38. Wanted to second the person who mentioned Health At Every Size (R). In this approach, the emphasis is on healthy habits, rather than numbers on a scale. Some people lose a little weight when they focus on habits, some don't. But the focus on habits rather than the scale means that many people keep the habits longer, since so many people give up exercising or healthy eating when the weight yo-yo's back up after a diet.

    You can find links to more information about Health At Every Size by googling it. ASDAH's blog is a good source. My blog has links as well. Thanks to those who have recommended it.

    Everyone gets to choose what works best for their bodies, so for those who wish to pursue weight loss that's fine. But it's important to know that there is another choice besides being unhealthy or pursuing weight loss yet again. You can focus on positive health habits instead. Research shows better health with this approach and longer-lasting changes than ones associated with dieting and weight loss. See http://www.ncbi.nlm.nih.gov/pubmed/15942543

    And yes, you can be fat and have healthy pregnancies and babies. I've had four. I'm glad you are being proactive about looking for a size-friendly care provider. That's absolutely KEY.

  39. I had a BMI of 33 going into this pregnancy (currently 38 weeks) and the midwives made a huge fuss that if I went over 35 I'd have to be put on the special 'too fat' plan, that would involve lots of extra scans and monitoring that would limit my already very limited labour options. Then I developed hyperemesis gravidarum (severe morning sickness) which they refused to treat as it would "do me good". I'd lost 6kg (13lbs) at my lowest point and by 36 weeks I'd only gained 4kg (8lbs) on my starting weight, taking me to a BMI of 34. Despite this they've continued to treat me as if I were over the limit. I've had to listen to several speeches about cutting back on junk food (I cook 90% of our meals from scratch) even whilst vomiting into the bin in the midwives office. I passed the gestational diabetes test but was told that because of my weight I was still likely to have a large baby and so they haven't been monitoring his growth properly. We've now found out, much to late to do anything about it, that he's at a low weight and much smaller than expected. All because they focused on my weight at the start and not on anything that happened afterwards.

  40. While the statistics on black mothers may be true, they are also linked to the poverty stricken and the ill educated. There are similar studies that say those same statistics are the true with whites in poverty. All of which happens because we under fund education in poverty stricken areas, especially minority neighborhoods. I know plenty of overweight women who have had successful and healthy pregnancy's. Also it is possible to be over weight and healthy. By the way you look beautiful and sound cleaver, whatever doctor you pick they should make you feel that way.

  41. I'm curious as to why you would attend an Afro Centric Pregnancy in the first place. By the looks of your mate, you choose not to create an African child. Second, it's shameful that you would tarnish the name and occasion of this event because of one encounter that you had. I'm sorry that you don't want to hear the truth about obesity and don't want to face the facts that you're obese. If you don't want to hear the truth, stay away from doctors and health practitioners. If you're a doctor, you're obligated to tell your patient information that will improve your health. If you smoked cigarettes and was happy with that, the doctor would still have to tell you that cigarettes cause cancer because that is the truth. Perhaps you would make a post about "cigarette" shaming and your "right" to be respected as a smoker. If you want to be fat, that's your prerogative. Eat to your heart's content.

  42. I have no experience with pregnancy as a fat woman but I have a heap of experience being medically fat shamed. I have back problems. Really painful ones. I've had pain and problems for years. Every doctor I went to told me (some without even examining me) that my only recourse was extreme weight loss. They went on long diatribes about how because I am fat I must have high blood pressure, high cholesterol, diabetes, etc. Some doctors have even re-ordered my blood work assuming that the lab was mistaken when my LDL cholesterol levels came back so low they didn't register on the machines used in the lab, that surely my A1C couldn't be so… normal. It got to the point that I would have a speech prepared for a new doctor "Hi. I recognize that I am considered morbidly obese and I know you will insist on telling me how dangerous it is to be fat. However when you finish that I hope you will be able to look past that to help me solve the issues I am having." One doctor simply told me he couldn't. Finally I found a doctor who actually did not mention my weight until my third visit. She waited until after she had examined me and received MRI results before diagnosing my back problems. When I got my results all I wanted to do was go back to each and every doctor and show them my results. I could have been saved years of unnecessary pain if any of the previous doctors had bothered to really take me seriously. If they did they would have found that I have osteoarthritis in my spine, spinal stenosis, and 4 herniated discs each pressing on nerves. They could have possibly even prevented it from getting as bad as it is.

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