As DTI works to be inclusive of all birthing people, we realized we had a gap when it came to supporting plus size birthing people. Our society is inching along, trying to be more body positive, but it’s the work of several tireless people who continue to shift our culture. We first met Jen McLellan of Plus Size Birth at the Birth Without Fear Conference several years ago and were smitten with her work. Jen has a magnetic and friendly personality, too. We reached out to Jen again, to ask some questions, and we’re so glad we did! We learned a lot, and hope it informs how you support your clients going forward.
The obstacles of being plus size and pregnant start with the simple difficulty of finding affordable maternity clothes. This may seem superficial, but it’s really not. Feeling as though you have nothing to wear has a significant impact. For example, many plus size people can’t walk into their local Target and find maternity options that will fit since their clothing line only goes to size 2XL. (http://plussizebirth.com/plus-size-maternity-apparel/)
Then there are the emotional challenges of having to wait a lot longer than an average size person to appear visibility pregnant. Not just that though, they also wait longer to feel their baby flutter.
It’s also not uncommon for people to have a belly that looks more like a “B” than the traditional “D” looking belly (http://plussizebirth.com/whats-a-b-belly/). It can be painful when you’re waiting for your big, beautiful bump to “pop” and it seems as though it will never look smooth and round like you think it should.
Beyond those frustrations, we live in a society where it’s still socially acceptable to shame people because of their size. Sadly, the medical community is not immune to this poor behavior.
A lot of the work I do is helping people who are pregnant to connect with size friendly care providers. (http://plussizebirth.com/size-friendly-care-providers/)
A size friendly care provider practices evidence-based, compassionate care. This is not too much to ask for, I promise!
I’ve found that when a pregnant person connects with a size friendly care provider, be it an OB-GYN or midwife, they often have a more positive experience regardless of their birth outcome.
The reality is that people of size face increased risks during pregnancy as well as a high cesarean birth rate. Yet, if they are able to connect with someone who doesn’t make assumptions based upon their weight, they are able to receive great individualized care throughout their pregnancy journey.
Absolutely! The language we use when talking about people’s bodies matters.
I surveyed 100 people who self-identify as being of size and only 2 of the 100 said they were okay with being called “obese”. Yet, obese is still the word that many care providers use.
Most people responded positively to “plus size”.
I always tell birth professionals that it’s importance to listen to the language people use when talking about their own bodies and then reflecting those same words back to them. In the end, there’s nothing wrong with simply asking people what language they’d prefer.
I think it’s really important that doulas become educated about slight differences in care that plus size people face during pregnancy. For example, people of size are often tested twice for gestational diabetes. The first time happens very early-on in pregnancy to assess if someone is already pre-diabetic or diabetic. Then a second test occurs, if the first one is passed, around the 24 week – 28 week mark when most people are tested.
With this said, it’s alarming if a care provider is suggesting someone should be tested monthly for gestational diabetes. Or if assumptions are being made that someone will develop gestational diabetes based only upon their BMI.
Another example is that it’s not uncommon for people of size to be told they should have a late-term ultrasound. This might sound like a red flag to some; however, it can be harder for care providers to accurately palpate a larger pregnant belly to know the exact positioning of the baby.
Knowing these nuances will help the doula to support the pregnant person and let them know that everything they are experiencing is normal and/or to assess for true issues that indicate their care provider might not be size friendly.
To learn more about increased risks plus size pregnant people face, and how to reduce them, checkout the My Plus Size Pregnancy Online Course (http://learn-plussizebirth.com/). Use code DTI30 to receive 30% off the two hour long video course. While the intended audience for this course is someone who is trying to conceive or pregnant, you’ll learn an incredible amount of information to support your plus size clients! You’ll also receive an 89 page e-book that you can add to your lending library.
I think it’s wonderful when birth workers clearly state that they work with people of all sizes and/or state that they are “size friendly” and I encourage you to do so if you truly are competent and caring with people of size.
I even have a size friendly doula directory on my website (http://plussizebirth.com/douladirectory/) for families to connect to doulas. The purpose of this list is to help alleviate possible apprehensions a plus size person might have inviting a stranger to be part of their birth. A family will know, by contacting someone on this list, that their prospective doula is size friendly and will treat them with dignity.
Part of being size friendly is being aware of your personal biases when it comes to people of size. I highly recommend this resource as a way to assess your own comforts/discomforts – http://www.obesity.org/obesity/resources/facts-about-obesity/bias-stigmatization
When I talk to pregnant people about connecting with size friendly providers or doulas, I suggest they ask the following question; “What is your experience working with people of size?” So I’d recommend you ask yourself that question and listen to the way you answer it.
Ultimately, the fact that you’re reading this article means to me that you’re interested in learning how to best support people of size. So I thank you for your time and encourage you to explore the plussizebirth.com website for even more resources for you and your clients.
Thank you, Jen, for teaching us and inspiring us to be better!
Jen McLellan is a published author and certified childbirth educator who advocates for plus size people. She promotes positive information to empower healthy decision making during pregnancy. Within her blog, Plus Size Birth, she helps people navigate the world of plus size pregnancy, shares tips for embracing your body, and laughs along with the adventures of parenthood. Her work has been featured in major publications such as Yahoo Shine, Huffington Post, Everyday Feminism, and International Doula. She co-authored the Amazon bestseller, The Peachie Moms Guide to Body Love for Moms and authored My Plus Size Pregnancy Guide. Jen is also a skilled patient advocate, professional speaker, wife, and mother to a charismatic 6 year old.