September 1, 2016

the HAES® files: Keeping the Faith: Maintaining Body Trust during Pregnancy

by Health At Every Size® Blog

by Lindsey Schuhmacher, MA

When I was younger, I had a vague, fearful notion of birth that looked something like the scene in Monty Python’s Meaning of Life with a woman lying flat on her back, feet up in stirrups, and John Cleese as a pompous, disinterested doctor yelling for the machine that goes “PING!” I imagined being one of those angry pregnant ladies in the movies screaming “Give me drugs!” and shaking my fist at my husband, “You did this to me!”

As I got older, and seriously considered creating a baby, I became more interested in learning about the process of childbirth and how women’s bodies work. I read books by Ina May Gaskin and Michel Odent. Eventually I was won over by the midwifery model, and by the time I was pregnant with my first baby, I had decided on a homebirth, as long as my pregnancy wasn’t “high risk.”

Midwifery care often uses language about trusting the body – trusting that it knows what to do, that it was created to give birth. In the meantime, I learned of the Health at Every Size™ (HAES) philosophy and stopped pursuing that most unproductive project of my twenties – forcing my body into a certain size and weight, only to gain it back and start over again (and again, and again). By the time I actually was pregnant, I had given up dieting and settled at a weight that felt comfortable and healthy despite putting me in the “obese” range on the BMI –something I fought tooth and nail against when I was younger, convinced it meant something terrible to inch above that number.

These two paths of trust – trusting my body to choose its own weight and trusting my body to make and birth a baby – came together to create a lovely pregnancy and birth experience with my son, despite the horrifying language around fat that mainstream pregnancy websites employ to make women fear their bodies. In a quick Google search, potential fat mamas will find language like this: “Going into your pregnancy overweight means you could put your own health and your baby’s health at risk, and potentially set your child up for a lifetime of health issues.” [i]

Goodness gracious! So just being me, just living in my large body, makes me “high risk” and could ruin my child’s life before it even starts? The same website says “Studies link being overweight to a list of pregnancy complications, including miscarriage, stillbirth, and birth defects such as spina bifida. Too many pounds also makes it harder for you to conceive in the first place. You’re also more likely to develop problems during your pregnancy, including high blood pressure (preeclampsia) and gestational diabetes.”

This is not the language of body trust. This is the language of stigma and fear, and feels a lot like bullying to a concerned, first time mama. Reading on, you find “Research suggests that overweight mothers are programming babies in utero to be overweight themselves and to have long-term problems with obesity and childhood diabetes.”

So if I have a baby, I am programming it (a word that seems to imply intent) to have long-term problems with obesity and childhood diabetes? Well, what if I’m okay with my child being fat? What if my fat child eats well and is active, and never develops childhood diabetes? What if my fat child goes on to win a Nobel Prize? What if he or she becomes a great artist? Or what if he or she just becomes a happy, well-adjusted human who trusts and takes pride in his or her body? Wouldn’t any of those things be a great accomplishment?

It felt amazing to fly in the face of all of that negativity and give birth to a beautiful, healthy boy in my living room.

Then came my second pregnancy. As of writing this, I am 37 weeks pregnant and could be going into labor with my baby girl at any time (sooner rather than later, I hope!). I chose midwifery care this time around, too. However, I was diagnosed around 28 weeks with Gestational Diabetes. My diagnosis was based on being only a few points over the test, and it’s been easy to control with diet by making small changes to the healthy diet that I already eat. But the diagnosis shook that precious trust I had built and threatened to undermine the healthy relationship I have with my size and body. I found myself resistant to telling people about the GD. When I asked myself honestly why that was, it was that I feared the judgment in their eyes – “Oh, the fat woman has GD – big surprise!”

I found the act of keeping a food journal and checking my blood sugar after each meal triggering. Waiting for the glucometer to tell me whether I was “good” or “bad” based on a number felt very familiar, having been an obsessive calorie counter in my twenties. As I grappled with these feelings, I began to feel my sense of confidence slip away. I found myself Googling area hospitals and reading fear-based birth stories about gigantic babies getting their shoulders stuck in the birth canal and excesses of amniotic fluid causing cord problems when the waters broke. While these rare medical conditions do exist and should be taken seriously, they are certainly not the fate of most babies born to mamas with GD, especially diet-controlled GD like mine. Lots of people get GD, just like lots of people get type 2 diabetes later in life. Correlation is not causation, and GD is not a “lifestyle disease.”

I wouldn’t judge another fat mama based on a diagnosis of GD. I know that looking at someone does not tell me much about their health. I know that many fat people are metabolically healthy, eat well, and exercise. I also know that many thin people are not and don’t. However, thin GD mamas, while I’m sure they also struggle with their diagnoses, aren’t subject to the same scrutiny as fat mamas who are blamed for “programming” their babies to be fat and sick. In the long run, it’s the internalized bias, shame, and doubt that is the hardest to shake. It gets in the way of the much more productive knowledge, respect, and confidence that are required to be able to trust my body.

To be safe, I recently visited a Perinatologist (a high risk maternal-fetal medicine specialist) to check on the baby and make sure that she is free from any risks that would necessitate a hospital birth. After a long visit, the kindly older gentleman (who looked nothing like John Cleese) complimented me on my control over my sugars and overall good health. He said there was no reason to think that there was any elevated risk in an out-of-hospital birth. He said that despite the mild GD, I had a “textbook” pregnancy and my baby was thriving.

In the end, my body hasn’t let me down after all, even after I failed to trust it the way that I know I should. It has provided a beautiful gift – a healthy, beautiful little girl, and a sister for my son. I hope that she will grow up trusting her body and delighting in the amazing things it can do, regardless of its shape, size, or weight.

[i] Watson, Stephanie. Trying to Conceive? Lose Extra Weight First. WebMD Magazine. Retrieved from http://www.webmd.com/baby/features/pregnancy-obesity

 


Lindsey Schuhmacher is an aspiring writer and an English and Humanities Instructor. She teaches the Portland State University capstone “Every Body Matters: Embracing Size Diversity,” a service learning course that looks closely at size discrimination and public health issues surrounding fat phobia. She is passionate about promoting body positivity and the principles of the Health at Every Size™ (HAES) paradigm. Lindsey also teaches English at Clark College in Vancouver, WA. Her academic interests are writing, art, literature, science fiction, media studies, rhetoric, philosophy, and fat studies. Lindsey has a B.S. in Philosophy, an M.A. in English, and is completing an M.F.A. in Creative Writing, where her focus is on writing for young people. She hopes to write science fiction and fantasy for young adults and teens. She loves to work with students, watch Star Trek, and spend time with her family and pets (though usually not all at the same time).

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