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Dear Plus Size Mom: A Letter From A Labor And Delivery Nurse

Dear Plus Size Mom,

Welcome; well, at least I hope you feel that way.

I know that at some point in your pregnancy you have felt unwelcome.

Like you didn’t “fit” in.

Whether it was beginning each appointment with your provider on the scale, watching and waiting for a bump to show off or the countless amount of times you have been called high-risk.

I want to say I am sorry and I am guilty.

I am guilty of judging you by your BMI (how is that even a THING IN PREGNANCY)?!!?!

I am guilty of dreading our time together doing fetal monitoring.

I am guilty for thinking about your weight before thinking about your pregnancy.

And I am sorry.

Dear Plus Size Mom

Your pregnancy and birth is not about BMI, Maternal Fetal Medicine Consults, Gestational Diabetes Screens or Fetal Heart Monitoring.


I tell all of my patient’s that it is my job to help you cope with and experience your birth while keeping you and your baby safe.

It is also my job with every Mom to help her believe in herself and her body’s capabilities.

A pregnant woman has super powers (a common phrase in my handbook).

So, if you are here today to give birth, think about everything you have already done. Your body has shown you it is capable of greatness already.

For many plus size Moms the road to your pregnancy wasn’t easy. So, look at your courage and strength.

For your time here on Labor and Delivery there will be things that are not made for you. Beds, tubs, gowns, monitor straps that haven’t taken into account the Plus Size Mom.

Don’t let that phase you – you are used to it and today isn’t about that. If that angers you advocate for it!

Your provider most likely wants you to be induced—you probably have a big baby—question that.

Your provider most likely wants you to be continuously monitored because you are high risk—question that.

Your provider may have told you a list of things that are more complicated due to your BMI—question that.

If you haven’t hired a plus size friendly provider it is never too late to ask for another opinion.


There are things we must do as nurses; you may always say no. There are things I must say, protocols, recommendations; you can engage and question.

We are a team and my goal is for you to rock this.

Birth, especially in a hospital, is public to an extent.

This may be the first time in a while you are naked in front of strangers or intermittently exposing your body and parts of you that in the past have been private.

A plus size Mom I took care of once said to me: “I have never let anyone look at my stomach before my pregnancy, not even my husband. Now you have all been staring at it and poking it and prodding it all night – it’s surreal because I don’t care.”

This might just be transformative for you – like any woman, you get to do something MAGICAL with YOUR body.

You get to believe it will do something right and good for your baby.

You can have a vaginal birth, you can have an un-medicated birth and you can have a healthy pregnancy and delivery.

I may not be the kind of nurse you have – you may have the one I admitted I have been. Judgmental, put out or concerned about your weight in this process. Working to manage your labor because of your weight.

Dissipate that energy and be you in this.

As a plus size woman you know that life can be harder for you than it is for some but I am here to say your birth does not have to be.

It can be a normal, beautiful experience and you have the choice to believe that and hopefully, those with you are there to remind you. You are already ahead – you have found this community of women to support you and cheer you along the way.

Love and Support from a Labor Nurse,
Laura Rice

Motherbirth Podcast

Laura is a labor and delivery nurse and childbirth doula who lives in Portland, OR. She is currently pursuing her Doctorate in Nurse Midwifery. Laura and her dear friend Mellisa Reeves founded Motherbirth, a podcast and community for women to share their stories of transitioning into Mothers.

“I have always cared deeply about women expressing themselves fully and supporting them as they pursue their dreams. It was not until I saw my first birth that I understood that this was my calling, to be in this space with women. “-Laura

Jen McLellan, CBE
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Friday 15th of March 2024

Thank you so much for sharing this. I had a horrible time during my pregnancy because I was plus sized. Much more from the doctors than the nurses. I means a lot to hear someone in the medical field share these words.


Tuesday 26th of December 2023

Jen, I want to thank you for sharing Laura's letter.

I am a big girl and gave birth at 39, 3 mos before I turned 40. For my age alone, I was considered high risk; at the time, the literal diagnosis (for billing) said elderly primigravida, talk about making you feel incredibly old. I was also morbidly obese, have two genetic mutations that put my babies and my life at risk, serious risk, and have a list of mental health diagnoses that means I search for every worst possible outcome so I can "prepare" for...which, by the way, is impossible. My husband and I tried for 5 years, between the beginning of our attempts and the birth of our perfect Rainbow Baby, and when we stopped trying when he was 5, I have had over 40 chemical pregnancies and 1 nine-week miscarriage. When we got and stayed pregnant with R.B., we were over the moon.

Based on all my Other issues, I knew I'd have to be an MFM patient. There is 1 MFM practice in my area without having to drive nearly 2 hours. High-Risk pregnancy means there is no way I'm driving 2+ hours for labor and delivery. So, we went to the closest, 8 MFM OBs and 4 MFM NPs, and I don't even know how many nurses there are. The one thing about all my appointments that stayed the same was my nurse, Heather.

Now, I learned at age 18 I had to advocate for myself. I have PCOS but wasn't diagnosed until age 31. Every doctor from family medicine, internist, OG/GYN, and on and on, told me there was nothing wrong with me that the pill and some mental health care wouldn't fix. Now, please understand that one of my gene mutations means that taking the pill could cause blood clots, yes, multiple to form and kill me.... so no, thank you, educated Dr. who should know this; I gave you my and my family med history. I fought to find doctors who would actually listen. Once I found her, I wasn't giving her up.

So yes, I advocate for myself, but Will never forget what Heather did for me. Every visit I saw a different doctor, none of them made me feel at all bad about my weight, in fact, I was constantly cnongratulated on my healthy pregancy, same as they did for "normal" size ladies.

But there was one, he came into my exam room took one look at me, walked out, brought an intern back in with him and proceeded to give a lecture on why I would have to have a c-section, lifted my belly to show where the incision would be and ignore me. I was laying there in tears, when he lifted my belly, I tried to stop him, he told me that should be grateful that as I was way to fat to have a normal delivery it had to be a c-section. I was screaming at him when Heather came in and forced him put of the room yelling the entire time. It was then, the doctor I was supposed to see came into my exam room apologizing for the other doctor's arrogance. Before I could even ask, Heather had him banned from my case.

The day I was admitted, I was sent upstairs at the hospital to be induced due to a sudden and unexpected hike in my BP. Even though it wasn't her job, Heather stayed with me and made sure I didn't even have to look at or talk to a size-biased doctor. The plan all along was for me to have normal labor and delivery but fate had other plans. I was induced and in labor for about 60 hours when the docs from my group canged. The new doc came in and started apologizing for thne previous one not seeing me. After a lengthy discussion we, together, decided I needed a c-section, labor had lasted to long without sufficient change.

My c-section which becaime an emergency, post op for 2 days and mother/baby care is another story and one of weight bias. But I wanted Heathers story, care and worry know. Without her, I don't know what I would have done. And I am a self-advocator.. but she, tiny little Heather wou,d stand up to md's twice her size to protect her patients.


Monday 14th of June 2021

It hurt a lot to read this letter. I honestly had never thought about my care providers judging me and ‘dreading’ having to care for me because I’m overweight… until I came across this ‘apology.’ I recognize the fact that you ‘own’ it and are changing, but I could have done without reading this at all. Reading this has given me anxiety about my very first pregnancy that otherwise would not have been there :( I work in healthcare, and maybe it’s because I am plus size, but I have never felt ‘dread’ when treating someone else who is plus size. This letter made me feel about the size of a pea. I’m hoping with all my heart that my healthcare team embraces me and lifts me up throughout my first pregnancy, because this letter just made me lose a lot of hope and excitement for my upcoming journey. We as humans need to do better and lift each other up, always, and in every setting! Do better.

Alana jones

Tuesday 18th of July 2023

@Maddi, I totally agree with you. I’m feel very self conscious about my upcoming delivery.


Tuesday 8th of June 2021

As a plus size mama for the second time, thank you. This made me tear up for sure. I was fortunate to have an AMAZING team of nurses with my first born in Pittsburgh, but the doctors? They were often less than compassionate or comforting. It was my nurses that sang to me during my anxiety attack while getting an epidural just to complete cervical exams after my doctor told me it would be "quite difficult since you're obese" to find the right location and ensure the epidural would work. It was my nurses who came to watch HGTV with me while I was sitting awake and alone at 1am, scared and emotional. It was my nurses who snuck me into the NICU to see my baby. It was my nurses who held me and rubbed my back when the doctors would say ABC would be difficult because I was big. I thank God every day for my nursing team, and I pray that I get some more angels this time around as well. <3

Jodi Rose

Friday 26th of March 2021

I would like to second the recommendation that Ender made - that nurses and medical staff need to all be informed about this fat shaming in this area.

Perhaps the author can please consider writing or emailing or calling the medical publications around the country and have an article or series of articles about this topic to be published in them.

It has been 16 years since I have been pregnant, so I am a long ways away now from knowing what resources are available and things. But I imagine there are other blogs, magazines, newsletters, medical web boards, Facebook groups for medical providers, podcasts, maybe even radio show hosts, local tv networks, medical shows, female script writers who write for medical shows who can write plots to popular tv shows and movies .... all of this would help move thought in the right direction on this issue.

I was interviewed about a medical issue by an out of state medical journal a few months ago. It will be in a journal for the PA medical folks to read. It's through

Also, I want to mention that I wasn't a plus sized mom. I have always been curvy. I have never been skinny. I am definitely plus sized now, but as a pregnant woman, I wasn't. I gained close to 100 lbs with my first child. Took off most of the weight then got pregnant again. Holy cow. That's been quite the journey!

Anyway, my first child was born at almost 10 lbs. I gave birth at home with a certified nurse-midwife and a doula, with only my partner and step-mom in attendance during labor and delivery. I gave birth at home a second time with my second child and had an aqua doula to help during labor.

My first child came out and wasn't breathing and the midwife and doula used an oxygen tank and got him breathing. It all worked out. I just find it hard to believe that someone who is overweight is chronically shamed because "their baby may be big and they may have issues." Well, I was in a normal range and my baby was definitely big and had some issues. And it was handled with grace by a nurse-midwife and doula. No doctor in attendance. At home.

I hope this blog post gets widely shared by everyone and not just by folks it applies to. Everyone - let's share the dickens out of this and raise awareness of this issue to help out of our friends who deal with fat-shaming ALL THE TIME.

Thank you for this blog post.