Fat Women’s Access to and Experiences of Reproductive Care

The word “fat” has been re-appropriated as a non-derogatory term by the fat activism movement to which University of Manitoba community health Prof. Deborah McPhail belongs. The word “fat” is preferred because “obesity” now has judgmental connotations of disease and health problems. McPhail told seminar participants at Robson Hall on October 9, 2019, that she uses the word “fat” in her research. She discussed the results of a research project in which she interviewed 25 fat women to explore their conception, pregnancy and birthing experiences.

Existing research appears to have normalized terms such as “maternal obesity” for the medicalized combination of pregnancy and fatness, and fat women are treated as potential “bad mothers” for putting a fetus at risk for ailments transferred from mother to child.

Conception care is typically sought where assistance is needed to get pregnant or in cases where a person has difficulty conceiving. Health professionals communicating with fat women trying to conceive tend to overemphasize the risks purportedly associated with fatness in a stigmatizing manner. Some of the perceived risks include gestational diabetes, cardiac dysfunction during pregnancy, high blood pressure, postpartum haemorrhage and birth defects. There is disagreement within biomedical research on the risks of fatness but medical professionals make them sound definitive when communicating with fat women seeking conception care. This discrimination interlocks with other existing systems of domination such as racism and sexism.

McPhail’s research found communication of risks created stress for most of the participants and medicalized fatness and pregnancy. Indigenous participants expressed fat oppression in the frame of ongoing colonial violence, and for a few participants, it re-triggered their eating disorder. Participants of the study were either denied or deferred conception support. In cases where conception was not outrightly denied, health professionals used risk discourse to subtly discourage women from becoming pregnant.

Indigenous bodies are medicalized, particularly with respect to diabetes. This medicalization of Indigenous bodies fails to consider factors such as colonial histories and intergenerational trauma. McPhail pointed to the example of an Indigenous woman with gestational diabetes who was told she was at risk of “squishing” her baby. Even in cases where conception support was offered, weight loss was strongly emphasized. The emphasis on fatness conveniently leaves out other explanations for fertility problems and implies that “not only should fat people not have children, they cannot have children,” she said.

Slides

Questions

Can you speak a little bit about denial of care and resistance against medicalization?

This involves a movement against the medical establishment’s emphasis on pregnancy as some form of disease that requires constant medical monitoring, especially in fat women.

Is there any movement to include weight discrimination in human rights legislation?

Graduate student research assistant Lindsey Mazur said there was an unsuccessful attempt in 2016 to include weight discrimination in the Manitoban Human Rights Code. There are groups still advocating for this inclusion.

Are there countries that have included weight discrimination in human rights laws?

Mazur is aware of weight discrimination laws in Israel, Iceland, one state in Australia and Michigan.

Listen to podcasts from other seminars in this series.

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