Reproducing stigma: Interpreting “overweight” and “obese” women's experiences of weight-based discrimination in reproductive healthcare

• Published in: Social science & medicine (1982) 2016-10, Vol.166, p.94-101
• Main Authors: Bombak, Andrea E., McPhail, Deborah, Ward, Pamela
• Format: Article
• Language: English
• Subjects: Adult; Attitude of Health Personnel; Body Weight; Canada; Discrimination; Evidence-based practice; Female; Females; Health care; Health problems; Health services; Humans; Medical research; Medicine; Mothers; Obesity; Obesity - psychology; Overweight - psychology; Professional-Patient Relations; Qualitative analysis; Qualitative Research; Reproductive health; Reproductive healthcare; Social Discrimination - psychology; Social Stigma; Stigma; Women's health; Womens health
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2016.08.015

Amidst a barrage of policy documents, bio-medical research, and press items concerned with the “crisis” of obesity, a growing scholarship is concerned with what has come to be known as “obesity stigma.” This scholarship hails from a range of sources including critical obesity scholars who problematize the idea of obesity as a health concern, as well as from “mainstream” organizations and researchers who, while maintaining obesity is a world-wide health problem, also argue that “obese” people are the targets of discrimination. In this paper, we analyze both interpretations of obesity stigma, particularly as that stigma applies to obese women's experiences of accessing and receiving reproductive care. We describe a qualitative study conducted with 24 overweight and obese women in 2 Canadian cities. Participants related overt and covert experiences of stigma when accessing reproductive care founded in healthcare practitioners' focus on fetal risk and “mother-blame” which, though partially evidence-based, was interpreted by participants as discriminatory. As such, we maintain that any true interruption of obesity stigma in the reproductive healthcare interaction requires a bridge between critical and mainstream scholarship, and careful attention to the risk-based foci in clinical settings which can be interpreted by clients as moralizing. •Women labelled obese described experiencing stigma in Canadian reproductive contexts.•Weight stigma in reproductive contexts is based on a view of obese bodies as ‘risky’.•Risk of maternal obesity framed as extending to mothers, fetuses, and providers.•Reducing stigma requires disrupting risk discourse and pathologizing of body size.