The day after Thanksgiving I went to see the movie Precious; I had head that it was sad, yes, but also that it was uplifting. Unfortunately, I left with feelings of intense dispair for Precious. Although I did not experience the heartwarming ending that other viewers did, I thought that the most touching moments were those involving Precious’ birth and motherhood. Her pregnancy played a huge supporting role throughout the movie and was what propelled much of the plot.
How empowered was Precious when breastfeeding Abdul, and how far had she come from having a mother who gave her own breast to her abusing boyfriend instead of her own child! How beautiful was the one lighthearted moment in the film, with all Precious’ friends in the hospital after her birth flirting with her nurse! How powerful was Precious when she walked away from her only home with her child, and how determined was she to keep both of her children!
I wish they had shown more of Abdul’s birth, but even the little that they did show made me think about how the births of women of size should be managed; are they high risk or low risk? I know it’s not ideal to talk size without talking race, class, gender, and sexuality — especially in the context of Precious — but for now I’m going to focus on fatness.
Women of size are much more vulnerable to various interventions during their pregnancy and birth than thin women. They are almost twice as likely as thin women to have a c-section — about 50% will end up getting the surgery. Although in some cases women of size may be more at risk for complications, what I”ve read indicates that this is often unnecessary and is paired with sub-par care and overblown assumptions about fat women. There were some other interesting facts — for example, having an appropriately sized blood pressure cuff is essential since a cuff that is too small will cause artificially high readings. Since high blood pressure is a common justification for emergency measures, this would make a huge difference in the management of a pregnancy and birth. I also wonder about how to advise women of size on nutrition during pregnancy. It seems like a really bad idea to expect pregnant women of size to gain little or no weight or even suggest that they diet during pregnancy — but that is advice that many women have reported receiving from their providers.
And just like in Precious, I imagine a little support, respect, and dignity goes a long way in preparing women of size for labor.
Some pregnancy and birth resources for women of size and those who assist them: