Weight Stigma Even in Pregnancy? Really?

Honestly, this one is hard to wrap our heads around. A new study in Health Psychology tells us that weight stigma during pregnancy and right after birth may be increasing the risk of depression, excess weight gain, and weight retention. Angela Incollingo Rodriguez was lead author on the study.

Prospective Observations

This prospective observational study followed 214 women through pregnancy. In addition, researchers collected data for a year after birth. They looked at measures of depression, weight, and markers of maternal stress.

Even after adjusting for covariates, they found that everyday weight discrimination predicted more weight gain, weight retention, and depression.

Rodriguez called these findings “really troubling” because postpartum depression can be quite serious. It affects both mother and child, sometimes profoundly. She said:

We really need to be thinking about how family members, friends, doctors, and even society treat pregnant women regarding their weight.

Stigmatizing Healthcare

To understand how this feels, consider the experience that a new mom relates about her first pregnancy visit. Without her knowledge or consent, her obstetrics provider directed here into an program for pregnancies in women with obesity.

I was looking forward to hearing the baby’s heartbeat, but the OB didn’t even check it. She didn’t even touch me. She just talked about how bigger ladies have more problems.

This is neither empathetic care nor a model for shared decision-making. Unfortunately though, health professionals often assume that women with obesity “don’t take good care of themselves.” Some OB/GYNs have even gone so far as refusing to care for pregnant women with obesity.

We cannot comprehend such cruelty from a healthcare provider. Fortunately, late last year ACOG adopted new ethical standards to combat weight bias in women’s care. It’s a good start on important work to be done.

Click here for the study and here for more reporting on it. For other research on weight bias in maternity care, click here.

Kiss, photograph © Jack Fussell / flickr

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February 26, 2019