A Woman Your Size Has No Business Being Pregnant

Although this past year's Turkey Awards went to ignorance around PCOS, we have to give a Dishonorable Mention Turkey Award to a recent entry at My OB Said What?!?:

“Why are you crying? It’s not like you lost anything. A woman your size has no business being pregnant anyway.” -ER nurse to an overweight woman suffering the miscarriage of her third child

Really? REALLY?!?!

It's hard to believe a healthcare worker would say say something this insensitive and unprofessional to any woman in the middle of losing her baby, but sometimes they do. Healthcare professionals are human like anyone else, of course, and have rough days where they find it hard to be empathetic....but even in the middle of a bad day, they need to remember the wisdom of silence when you can't quite muster up empathy.

There is nothing quite so tender as a miscarriage or stillbirth. Medical professionals need to remember that just because a miscarriage is early doesn't mean it's not still a loss. Even if an early miscarriage doesn't seem like a loss to them, they need to honor the fact that it feels like a loss to THAT patient.

And telling someone not to cry when they are in the middle of losing someone precious to them shows a tremendous lack of empathy. Most likely it comes from the fact that the person's grief is making the medical professional uncomfortable and they don't know how to deal with it, so they belittle the person's pain and tell them to just get over it.

But it's not supposed to be about caregiver's comfort level, it's about the PATIENT'S comfort level and needs, and they need to remember that in their dealings with patients. You don't have to feel things the same as your patients, but you need to be respectful of the patient's feelings, even if you don't agree with them, aren't what you personally would feel, or make you uncomfortable.

But the thing that bothers me the most about this entry is the idea that women of size "have no business being pregnant."

That's absolute nonsense, yet it's a very common feeling among many medical professionals, due to the hyperbole around risks in women of size. Some have been taught that fat women are at SUCH a high risk that they have come to believe that fat women can't possibly have a healthy pregnancy or a healthy baby, and that's simply not true.

Many of us DO have healthy pregnancies and healthy babies, and it is NOT an irresponsible act to have a baby at a larger size.

Yes, women of size are at increased risk for some complications, but being at increased risk does not mean that complications will happen, nor does facing potential risk disqualify you from motherhood.

All kinds of women are at increased risk for complications due to various factors (age, family history, racial or ethnic status, various health conditions) but usually are not told that they have "no business being pregnant." Their risk status is acknowledged and counseling toward risk mitigation is given. The same can be done for women of size.

In dealing with women with risk factors, the focus should be on helping them have the healthiest pregnancy possible, even while acknowledging possible complications. Many caregivers are mature enough to recognize that plenty of women will have perfectly fine pregnancies and healthy babies despite having risk factors.

And in those who do experience complications, mature caregivers realize that the emphasis should be on kind and empathetic care in helping the woman towards the best possible outcome, not on scolding and judgment.

Although I'm sure there are women with various other risk factors who have faced reproductive policing, most of the time these days it's considered wrong to question a woman's basic right to motherhood, even in a mother at risk for complications. Yet reproductive policing and shaming seems to be considered acceptable behavior in the medical community towards "obese" women.

Sorry, but NO ONE has the right to forbid reproduction. The government, medical authorities......history has shown time and again that these people should NOT be the gatekeepers of reproduction. Whether to have a baby is a decision for the woman and her partner to make and no one else.

Couples should be counseled (with compassion, not scare tactics) about their risk status and possible complications, yes, but if they decide to move ahead anyhow, they should be treated with respect.

The ability to reproduce is one of the basic rights of people in society; the state and/or medical caregivers have NO business trying to govern that. 

Nor should women be subject to shaming or scolding for the simple act of wanting to have a family. 

That applies just as much to women of size as well as to women in any other group.