Sex and the Fat Girl: You've Got to Fight for Your Rights

Reproductive rights for all U.S. women came under attack this month with the introduction of the "No Taxpayer Funding for Abortion Act" (H.R. 3) by Republican leaders in the House. Once again, a light is shone on the state of women's health in our country today, and it illuminates the situation of women who are routinely denied proper health care, such as fat women. As has been said many times, what makes fat deadly is not the fat itself, but the treatment the fat person receives both from society and from the medical-industrial complex. At every turn, we're told all our problems stem from being fat, we are ridiculed, and forced to accept a lower level of care than a thin person would. As far as our reproductive rights go, well, some people wish we didn't have them, period.

In 2006 the British Fertility Society, which makes recommendations on fertility treatments to the U.K.'s national health service, recommended that "obese" women not be allowed to undergo in-vitro fertilization or participate in any fertility treatments. Their reasoning is that fat women are less likely to get pregnant and more likely to experience complications. I would say the reasoning underlying their official reasoning has more to do with the treatment of fat women as "less than" women, who don't have the same desires and goals for their lives as thin women, or at least shouldn't be helped to fulfill their goals if they have anything to do with creating more potentially fat people. But what keeps fat women trying to conceive unhealthy is less their fat and more the "time lost and poor success of conventional weight loss strategies" cited in an Oxford University study. The "obesity epidemic" is used here to justify not allowing fat women to have the same reproductive rights granted every other woman (at least, for now—and at least, for most other women).

Fat women are either marginalized or ignored in regards to their sexuality and their access to birth control, as well. Hormonal birth control methods don't work as well for fat women, but doctors often don't feel the need to inform fat women of this and advise them to use a backup method of contraception. This contributes to unintended pregnancies, and also poor prenatal care because unfortunately, some fat women don't know they're pregnant until they deliver—especially if they think they're in the clear because they're on birth control. And if you do find out you're pregnant and decide to have an abortion, you may have an experience like this woman's—told she was too fat to be administered anesthesia during the procedure. I've had a D&C (dilation and curettage, one method of abortion) without anesthesia and it is a level of hell I wouldn't advise anyone to enter. But apparently above a certain BMI fat smothers nerve cells and prevents them from transmitting pain!

Joking aside, these situations should spur us into action to protect reproductive rights for all women and demand a level of care that is equal across the board. H.R.3 is bringing the fragility of women's abortion rights to the fore once again, and it's an opportunity to also bring to the fore the mistreatment so many marginalized women still receive when attempting to exercise their reproductive rights.

Comments

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but...?

There are alot more complications to an obese woman (there is a HUGE difference between fat and obese) being pregnant and carrying to full term. Especially if she is given a fertility treatment and has more than one. Heart failure is just one one many.

How is there a difference

How is there a difference between fat and obese? Fat women are obese. Obese women are fat.

There's a difference, Sista

Noooo. There's even a difference between obese and "overweight." Obese is defined as "weighing more than 20% (for men) or 25% (for women) over their ideal weight determined by height and build." In order to be fat you don't even have to be overweight, you can be fat and be well within the "acceptable" body weight. It's a matter of your build, your body and how fat distributes itself on it. Most fat women aren't obese.

I would disagree. What (in

I would disagree. What (in America anyway) our culture sees as fat is about size fourteen and over. Most plus size people are over a size 14. nearly all plus size people are 'obese'. As a size 18 I am on the smaller size on the plus size scale, and I am obese. Woman bigger than me are 'obese'. So yeah, I would say most fat women are, in fact, obese.

But note, the bmi is ridiculous and should not note be used to measure health.

But hey, whateves, YMMV

peace,
Zoe

"What (in America anyway) our

"What (in America anyway) our culture sees as fat is about size fourteen and over."

Not necessarily, it doesn't depend on a clothing size, but rather a shape.

Your logic just really isn't sound because women's bodies range so much in shape and height that clothing size really isn't a good indicator (and on top of it, inconsistent clothing sizes).

As an American Woman living

As an American Woman living the United States I found this article offensive. Doctors only want the best for their patients and would never discriminate against anyone especially some one of larger size. This article was very bias towards the medical practice and the compassion doctors and nurses have towards their patients. Everyone has the same opportunities to raise a family and have children. Doctors are the most concerned about the safety of the mother and someone who is unhealthy could be putting themselves as well as their unborn child in danger.


 

Spam?

This isn't a real comment, is it? Mods? It's not biased towards the medical practice. Not everyone has the same opportunities to raise a family and have children. Not in the slightest! Fat does not equal unhealthy. (again, not in the slightest!)

I'm in the middle of reading

I'm in the middle of reading Rethinking Thin, a very interesting book about the diet industry and the history of obesity research. Doctors miss treating their fat patients is actually common.

Bull SHIT. I am the daughter

Bull SHIT. I am the daughter of a doctor and I am a doula who works with doctors regularly, and you're right, most doctors are wonderful people who want the best for their patients. But just because you don't HATE fat people doesn't mean you are serving them in a way that best meets their needs. Discrimination comes in so, so many forms. First thing that comes to mind: blood pressure cuffs. As a fat woman, I require a larger blood pressure cuff to accurately obtain a reading. I know this because I have so much experience in the medical field. Yet when I request a larger cuff, nurses frequently look startled and have to search for one that will fit me. I can't imagine other obese patients are aware of this. Especially in pregnancy, bp readings are so, so important... but this is one of the simplest ways that health care providers fall down on the job with fat patients.

Also, I'd like to note that once you're pregnant, that's it. You can't lose weight while pregnant and maintain your health and your child's health. So, even if being fat is putting yourself or your child in danger(newsflash: it ain't.) there is nothing you can do about it. So doctors who talk about mothers' weight negatively are simply stressing out moms for no reason. (By negatively, I mean more than stating, "Because you're overweight, these risk factors need to be watched for more carefully.")

Doctors are people too, and as such, as prone to racism, sexism and discrimination just as much as anyone else. I have nothing but respect for the vast majority of doctors, but respect does not mean blind adoration.

Okay, this is one of those

Okay, this is one of those times where the articles here on Bitch have made me go, "Huh?" Women who are obese do experience more issues when it comes to pregnancy, that's just a fact! Sorry, if it rubs anyone the wrong way, but it is what it is. I hate these articles where it seems people are in lala-land. No, being fat isn't disgusting or something vile, but c'mon! My asthma is a direct result of me being overweight, there isn't anything sexy about not being able to breathe!

"Their reasoning is that fat women are less likely to get pregnant and more likely to experience complications. I would say the reasoning underlying their official reasoning has more to do with the treatment of fat women as "less than" women"

I can't speak on why Britain is doing this because I live here in the U.S. All I can say to that is that it was a recommendation, not an order. And, I will say, I understand the recommendation.

I am currently going into the practicum portion of my Masters program, and the insurance I have to get as a practicum student is ridiculous! I can't make a diagnosis, and I prescribe anything as a practicum student. I am still having to purchase high malpractice insurance. Why do I mention this you might ask? Well, there is research linking obesity and health issues. It's out there, it's been proven reliable and valid; therefore, I have to let you (the patient) know this so you can make an informed decision. If I don't, then the hospital/clinic/organization and I can be sued. Even if I read the research and there was less than a one percent chance of obese women developing heart failure as a result of pregnancy, I'd still have to inform any obese pregnant mothers because what if they fell into that less than one percent? If one of the mothers and/or the children dies, it's on me (as a healthcare provider)!

Also, I don't know what doctors you've been going to or hearing of, but all the doctors I've seen have treated me with the utmost respect and care. Yes, I've been told to lose weight by every last one of them, but I think it has a lot more to do with the fact that I can't run five blocks without feeling like my lungs are going to collapse, and less to do with how "Oh so disgusting!" being fat is.

Responsibilities

You're right, it's true that doctors ultimately bear the responsibility for informing their patients about risks. That being said, obese women really get the short end of the stick in maternity care. They're most likely to be encouraged to restrict their eating during pregnancy, for example.

I'd also like to point out that fat and fit are not opposites; I wager that your asthma and your weight are at most symptoms of the same problem, rather than the weight causing the asthma. I'm 230 lbs, 5'8", and I regularly run 5 and 10Ks with no more issues than any of the other runners have. Your doctors telling you to "lose weight" is about as helpful as if they told you to "breathe better"; there are a lot of ways you could remove weight without being even a little bit healthier, and that very feasibly might cause you to be even worse off. The only doctors who have ever told me to lose weight have been treating me for problems that were utterly unrelated to my weight. I think that says something about them.

Anyway, to sum: Just because something is your experience, does not mean it is everyone's experience. (Much like my fatty fat fat running.) But it's important to give precedence to the people who are being hurt by prejudice, instead of denying it. Yes, informing women of risks they need to be aware of is good medicine. It is also good medicine to do so in a nonjudgmental way, while supporting them in healthy, life-affirming choices. Most fat women cringe at the idea of going to the doctor, being weighed and receiving yet another lecture on their weight. Especially in pregnancy, going to the doctor should be a good thing; it should be a space where they feel safe and taken care of. It's unfortunate that that is so remarkably rare for many women.

Hello from the UK

Healthcare resorces are rationed in the UK as theres only so much free IVF to go around. This may appear heartless but tough choices have to be made. There is criteria in each health trust to give fertility treatment where it will be most effective, e.g. if you are very old, you are smoker or you are very fat then you will be the back of the queue as medical experts have deemed that your treatment is less likely to work. I don't know if this is true or not, there seems to be enough obese people getting pregnant naturally in the UK to cause a fuss about money being spent there.

If patients want to go private in UK or abroad they can have whatever treatment they want, and sometimes do, causing outrage amongst the moral majority.

As a non-fat woman (in my eyes by some peoples standards I would be a fatty I suppose) I see FA as simply treating people with respect. Don't be an arsehole to people cos they are different from you! Bit sad this has to be said in 2011 but there you go.

I feel fat people have become a scapegoat in the UK for a slow news day e.g.here is an example of a recent story - "fat people need bigger ambulances! And guess what you are paying for them!" Personally I feel there are much bigger issues in this country and this world but why report that, might require some work.

Hopefully I haven't bored you with my British ramblings : )

Fat Dr. Daughter

Ok guys, here's how I see it...

as the daughter of a doctor, I know first hand the prejudices the medical profession has against fat people. Let us not forget the studies funded by diet pills that state that overweight individuals are more likely to die of all sorts of horrendous things but also the studies that state having extra fat on your body can prevent these things. There is very little actual scientific consensus on the matter but doctors like to have one, and they go with that fat = bad because when it comes down to it, that's the mainstream idea. (and also the most profitable one.)

Now, I realize that obese women have more difficulties in pregnancy, however, more obese women than small women are likely to have health problems caused sometimes by the lifestyle that can lead to being obese. In the case of not allowing IVF to obese individuals, I find that to be so discriminatory because it's the lifestyle that causes the health problems, not the obesity in the majority of the cases. There are healthy obese individuals who probably have a better chance of having a healthy baby than a skinny person, to discriminate solely on the fact that they are obese without looking into the medical history and making an informed decision on a case by case basis, is flawed.

That being said, if fat women have more complications during pregnancy, shouldn't we be doing everything we can to allow fat women to still have children in a safer and more controlled manner? Shouldn't the medical profession be searching for ways to allow fat women to carry healthy children to term rather than discouraging them from becoming pregnant in the first place?

/rant.