Study finds obese women shamed over reproduction
One obese woman’s doctor refused to remove her IUD, telling her that it would be a “disaster” if she got pregnant. Others were told some women just aren’t meant to be mothers.
Canadian researchers say that amid a flurry of press about the dangers of excess fat during pregnancy, overweight and obese women are being made to feel they’re “disgusting” or “bad mothers” for putting their fetuses at risk.
In interviews, women reported dreading prenatal appointments. One was refused fertility treatments until she dropped 60 pounds. Another, sent to a specialist after her doctor suspected a hormonal disorder was at the heart of her infertility, was told bluntly her problem was she was “fat.”
The research was based on interviews with just 24 women in two Canadian cities. But the authors say “fat” women’s experiences around reproductive care suggest a new so-called soft eugenics to keep obese women from reproducing.
Doctors have legitimate reasons to warn women of the complications related to excess maternal weight, the authors said. However, they argue much of the obesity “risk talk” is sensationalized, moralizing and shouldn’t position heavy women as “always-already diseased and dangerous to their child,” they write in the latest issue of Social Science & Medicine.
Larger women, they argue, can have perfectly healthy, incident-free pregnancies and births.
“We’re certainly not trying to say that any of the health-care providers that are referred to in the study is actually a eugenicist,” co-first-author, Andrea Bombak, an assistant professor at Central Michigan University, said in an interview.
“What we’re trying to say is that anytime we refuse care in these areas, or potentially limit people’s care, we could be unintentionally and inadvertently echoing some of these histories that we’ve seen in the past about who is it that society would prefer to reproduce — and who they would prefer to not have reproduce,” she said.
About a third of women in Canada entering pregnancy are overweight or obese.
According to the Society of Obstetricians and Gynaecologists of Canada, obese pregnant women are at risk for miscarriage, high blood pressure and gestational diabetes, while their fetuses are at increased risk of birth defects. Obesity is also one of the biggest drivers of caesarean sections.
“Overweight women do not deliver well,” Dr. Jennifer Blake, the society’s chief executive, told a senate committee studying obesity last year.
In the U.S., obesity is contributing to a doubling and tripling in maternal mortality rates, Blake said.
But Bombak and her colleagues argue the science is conflicting and that some studies show little fetal risk or infant fatness linked with obesity.
The researchers interviewed 24 mostly white, middle-class women in two mid-sized unnamed Canadian cities about their experiences while trying to conceive, while pregnant or while giving birth. The study was a pilot to a larger study now underway.
While many women had positive experiences, others described being made to feel as if they were “disgusting” and that their fatness made them unfit to be mothers. In an earlier paper based on the same interviews, one woman described being told by a fertility doctor, “Gals your size, OK, mortality rates are higher. So I go ahead and intervene, help you get pregnant here. Then you go down to (a birthing ward). And then, boom! Pulmonary embolism.”
The doctor who refused to remove the IUD likely believed it was the medically correct thing to do, said co-first author Deborah McPhail, an assistant professor at the University of Manitoba. (The woman eventually had her IUD removed by a doctor at Planned Parenthood.)
But, overall, women resented being viewed as “bad mothers, or bad potential mothers, because they were taking care of themselves the best they could, the way most pregnant women do,” McPhail said. “They said, ‘But I am exercising as much as I should be; I am trying to be healthy.’ And they felt that wasn’t being taken seriously.”
“There was a real dissonance between the experience they felt they should have had, and the experience they did have. And there was just a lot of anger and a lot of sadness around that.”