“This isn’t a high-risk body”: Reframing Risk and Reducing Weight Stigma in Midwifery Practice
Katie M. Cook, MA, Andrea LaMarre, PhD, Carla Rice, PhD, and May Friedman, PhD
This article investigates the standards of care for fat recipients of midwifery care through a lens that questions common risk-focused narratives related to fat pregnant bodies. Throughout this article, we use the term "fat" rather than "obese" or "overweight". We avoid the language of obese/overweight because these medicalized terms are used to stigmatize fat people. Working from a fat liberation standpoint involves reclaiming the word “fat” as a morally-neutral descriptive term for larger bodies. Drawing on data from a research project exploring weight stigma during pregnancy care, we present findings from eleven interviews with fat parents including those who identify as women or transmen who accessed midwifery care during their pregnancy and/or childbirth experiences. Participants had both positive and negative experiences with midwives, often within the same care relationship. Related to weight specifically, many participants reported that midwives focused on the risk factors often associated with being fat while pregnant, even when their clients did not display signs of these risks. We discuss how practitioners—particularly midwives—might shift away from an anti-obesity, risk-based narrative. Instead, practitioners might acknowledge the potential risks of fatness during pregnancy while simultaneously honouring fat individuals' embodied realities and treating fat clients with respect to facilitate positive pregnancy and birthing experiences.
midwifery, pregnancy, standards of care, weight stigma