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.”
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“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.
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.
You are a beautiful woman and you and your husband will make wonderful parents. I’m just sayin’ 🙂
Thank you!
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.
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!
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). 🙂
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 🙂
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!
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.
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.
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.
Are you also in Portland, OR?
I’m located in Denver, CO but my business is online so I’m everywhere 🙂
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.
I lost my work-sponsored Kaiser Permanente in my second trimester and had a much better experience with the provider I got with medicaid. That could just be because KP sucks.
So much suck. Ugh.
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.
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!
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.
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.
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.
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.
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.
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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