Of course, one of the biggest things doctors can do is scare women of size out of having a pregnancy in the first place.
One of the best ways to do that is to tell them that they will die if they dare to have a pregnancy at their size, to imply that "obesity" in pregnancy is practically a death sentence.
I remember the first story like this I heard. I did not save the email, alas (this was early in my internet days), but this mother basically was told that if she went into labor, she would have a heart attack and "die on the table." I remember that phrase specifically, all these years later....because, you know, obese people are all walking time bombs and will keel over from a heart attack at any kind of stress, so of course labor would kill us.
Funny how I went through labor FOUR times and am still here to talk about it, then.
Anyhow, here are some excerpts from stories I have read, slightly edited for grammar/spelling or to take out identifying details:
- "I went to see a doctor today...He basically made me feel my baby is a death sentence...In his "honest opinion" I am going to die during labor/delivery or recovery."
- "I used to go to a really Fat phobic doctor; he was so awful he told me that I couldn't even consider the idea of having another baby or I would die for sure (due to my weight)."
- "[My doctor] was appalled when she heard I was not on any form of BCP [birth control pills] and said that "at your age and with your size" that either the baby or I would die."
- "According to him I'm probably going to die of a heart attack sometime during my pregnancy or shortly after."
- "That's when she hits me a barrage of insults, the selfish speech, and that I will be dead in 15 years therefore I am not even responsible enough to have kids because I won't be there for them or my husband. The baby could be at risk because (a list was rattled off)...[and] I could die trying to have a baby."
- "After scolding me for even allowing myself to get pregnant at my weight, he told me that even if I could carry the pregnancy, he had doubts about my ability to deliver or survive a c-section!"
To me, this is one of the most monstrous kinds of fat bias. I wonder how many fat women have been scared out of having a baby at all because of treatment like this. I know that many fat women have been scared into Weight Loss Surgery with arguments like these, and that many others simply decided long ago not to even consider having children.
I also think that this has to do with doctors trying to become the gatekeepers of who they think should procreate and who should not. If they don't think you "deserve" to have a baby or if they don't want to see your fat genes passed along to future generations, they subtly or overtly discourage you from children.
Barring that, they pressure you constantly to have your tubes tied during that cesarean you are "destined" to have, or try to make your birth experience so awful that you decide not to have more children. [Oh no, that's not just hyperbole; I have stories like that in my collection.]
Most of the time, fat-phobic behavior from doctors and other healthcare providers is more subtle. Most fat women don't hear the "you're going to die if you try to have a baby" speech. But it's important to document that this kind of egregious treatment DOES exist and to roundly condemn it.