Bad Nutritional Advice to Pregnant Women of Size

I get so tired of all the assumption around the nutrition of people of size.  Care providers often assume we eat nothing but junk food, fast food, and sugar, or don't believe those of us who say we eat reasonably.

With the hysteria over restricted weight gain in pregnancy in fat women, these assumptions run particularly rampant when you are pregnant. Here are a few examples from My OB Said What?!?.

• “Well, I don’t know how you’ve gotten to the size you are if you don’t like sugar?” – Midwife to mother who wanted to avoid the glucose drink for gestational diabetes testing and offered to track her blood sugar with finger prick testing instead. Very sugary foods typically caused her to not feel well for days. (entry found here) 

• “Well, you are bigger than you should be… You obviously like to eat.” – Midwife to mother who was a large woman.  (entry found here) 

• “Great! Now, no more snacks. No eating between meals at all. You should only be eating at mealtimes.” – Midwife to mother who had suffered from morning sickness but was now feeling a bit better. The mother was a larger woman.  (entry found here)

Many times providers will suggest that women eliminate or drastically reduce certain food groups in their diet (beyond just the usual sugar or white flour).  Here are a few examples of that:

• “If you don’t eat fruit, your baby won’t be fat.” – OB to mother worried about a large baby due to the family history of large babies, including both the mother and father weighing over 9 pounds.  (entry found here)

• “Never eat a whole piece of fruit in one sitting.” – OB to mother while discussing weight gain during pregnancy. (entry found here)

• “Lay off the carbs!” – OB to mother whose pregnancy weight gain was two pounds higher than the standard.  (entry found here)

• “You need to do Phase 1 of the South Beach Diet and cut out carbs.” - OB to mother who was extremely swollen and had a large weight gain and later was diagnosed with preeclampsia at 38 weeks.   (entry found here) 

• “Your weight looks great, good job! … But you should eat nothing but vegetables for the rest of the pregnancy.” – Midwife to a mother at a 20 week prenatal appointment.  (entry found here)

Come on! The pressure over prenatal weight gain restriction in women of size has gone too far when women are being told to completely eliminate fruit from their diet or to eat nothing but vegetables for the rest of pregnancy.

And even when women comply with these ridiculous restrictions, their care providers often don't believe them.  In the care providers' eyes, if you are "obese," then OBVIOUSLY you are overeating, mainlining ice cream and bread, and consume a TON of sugar.  And if you don't admit to it, well, then obviously you are lying.

Or there's the old saw that more prenatal weight gain leads to soft tissue dystocia (translation: fat vagina trapping the baby inside) and cesareans:

“Whoa there! You’d better slow down on that weight gain! I totally understand though, I like to sit down and eat ice cream for dinner too, but I don’t have to push it out of my vagina afterwards.” – Midwife to mother at a prenatal visit. She had gained 2.5 lbs. in the previous two appointments, after having had SEVERE morning sickness earlier in the pregnancy, and had gained only 17 lbs. total in pregnancy. She had NOT been eating ice cream. The midwife became convinced she'd have a big baby and a cesarean, but the mother gave birth vaginally to her 7 lb. infant anyhow

And still another one along those lines here:

“Nothing tastes as good as pushing for one hour less feels!” – Midwife to mother who started out at a higher weight than normal. Midwife was suggesting that the mother was eating too much.

I'm sorry, but it's nonsense that prenatal weight gain goes straight to the vagina, not to mention the stupid but pervasive myth that a fat woman has so much fat around her vagina that she cannot possibly push out her baby.  What nonsense.

And that last quote, "Nothing tastes as good as...." is a saying from the pro-anorexia movement!  How twisted is it to quote that to a pregnant mother!

I understand care providers' concerns over potentially excessive weight gain in women of size because there are risks associated with that. I know they think they are doing women a favor by cautioning them to keep their weight gain down.

But it's not reasonable to ask women to gain virtually NO weight in pregnancy, it's frustrating when people make wrongful assumptions about what you eat based only on your weight, it's hurtful when they assume you are lying about what you eat, and it's absolutely wrong to give advice that leans in the direction of promoting eating disorders.  

Providers, giving reasonable nutritional advice to your clients is fine, since excellent nutrition is the backbone of a healthy pregnancy. However, forbidding entire food groups or telling women to only eat vegetables is NOT reasonable nutritional advice, and borders on promoting eating disorders.  And this whole "fat vagina" myth has got to just STOP.  Ugh!