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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.

plus size pregnant woman in a hospital

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

IT IS ABOUT THE AMAZING THINGS YOUR BODY IS DOING.

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.

However, I’ll tell you like I tell my friends, INTERVIEW YOUR PROVIDER, YOU ARE HIRING THEM FOR A VERY IMPORTANT JOB AND IT’S NOT ALWAYS THE RIGHT FIT.

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. This year she along with her dear friend Mellisa Reeves founded Motherbirth, a podcast and community for women to share their stories of transitioning into Mothers.

She loves coffee, cooking, traveling and talking about Women's Reproductive Rights.

When she's not working as an Labor and Delivery nurse you can find her laughing with friends over a meal, dancing in grocery stores aisles and listening to Podcasts.

“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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Theresa v

Wednesday 28th of December 2022

As a plus size mom and currently preggo with baby number 2 your article is one that I keep coming back to for inspiration after dr. Appointments that I feel unhappy with. The hospital closest too me (30 mins away) has new restrictions on woman with higher BMI and it’s makes me so frustrated. I am right on the cusp and only in my 19th week. So if I gain any weight I will have to most likely travel over 3 hours away to the next closet hospital that doesn’t have a BMI restriction. Almost 3 years ago when I had my baby girl in the hospital that is 30 mins away I had an unmediated vaginal delivery with no complications what so ever. A Ten hour labor with a need for antibiotics for strep B, Just jaundice but that had nothing to do with my size. It was my baby girl banging her head on my pelvis while coming down the canal. The only obgyn near me at said hospital 30 mins away is sadly my only option and a lot of the drs there look at you as if you are a number not a person. But with my area being the way it is I have no other options, so I am stuck and trying my hardest not to go past the cut off of BMI (50-55) I’m at 48 right now, in fear that I will be sent away if I go there when I am actually in labor. Having my baby on the side of the road is not an option that I see being viable. I see these restrictions causing major issues.

Maddi

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.

Courtney

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 PA.gov.

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.

Kate

Friday 26th of March 2021

As a plus size mom, I lucked out with an OB who never made me feel like I was less than because I was obese. That being said, she did recommend that I get induced and I *did* have a big baby - he was 9lbs, and developed shoulder dystocia during birth. They got him out safely without any injury but it was touch and go there for awhile. Not *every* recommendation for an induction due to gestational size is BS. Just sayin'!

plussizebirth

Friday 26th of March 2021

Thanks for sharing your story, Kate. I'm so glad everything worked out okay for your son!