Seeing Beyond Size

“I felt very invisible when I became pregnant because I just didn’t see anybody who looked like me.” Mia O’Malley of Plus Size BabyWearing is certainly not alone when expressing her feelings about being excluded from the world of pregnancy information. This is understandable when you realize the products and marketing out there are nearly void of women in bigger bodies like hers.

“I was just so desperate to find myself somewhere in this. To know what I would look like and all of that.” People assume that every woman who’s happily pregnant will relish in the attention of others pulling out chairs, opening doors, and giving up seats for them. But, for plus-size women, that is simply not the case and they are looking for change.

I spoke to three prominent voices in the plus size pregnancy world, Jen McLellan, Mia O’Malley, and Erica Edwards Mason, to learn how that change could start. They all said the issue of inclusion in plus size pregnancy is yet another way people of size are marginalized. It’s only thanks to Instagram that plus-size women can now see themselves pregnant and nursing or pumping and wearing their babies. Currently, there are more than 81,000 photos when you follow the hashtag #plussizepregnancy. But, when it comes to mainstream media, or even their own doctor’s office, plus size women will be hard-pressed to see themselves represented or fully understood.

Feeling seen

Jen McLellan, founder of PlusSizeBirth and the Plus Mommy podcast, was the first to establish a place for plus-size women to prepare themselves for pregnancy with evidence-based information on her leading blog about the subject. In fact, her work is so thorough, she was approached by the National Institutes of Health to help create their initiative called Pregnancy for Every Body. Jen notes, “It was amazing when the National Institutes of Health came to me because they wanted to create something that was more inclusive and approachable and empowering…” for plus-size women.

Jen remembers, “I got pregnant forever ago, in 2010, and there really weren’t a lot of resources at all for plus size people, there wasn’t much of anything… I remember finding one store in person where I could actually find extended sizes. I just felt like I wasn’t included and I didn’t have options that would work for my body. So it kind of sets you up to feel like there’s something wrong with you or your body is incapable of having a healthy outcome because of your size.”

In fact, nothing could be further from the truth. Plus-size model, Erica Edwards Mason or, as her fans know her on Instagram, @ericathegreatish, actually used Plus Size Birth to get information when she was trying to conceive. Erica is a woman of color and a brand new mom to twins who were born during the pandemic. She says her biggest complaint navigating plus size pregnancy was, “seeing that there was only one website that had any information. It was kind of disappointing because if you’re able to get pregnant, most of the time, it doesn’t matter what size you are.”

According to the National Institutes of Health, “plus-size women are at higher risk for certain health problems during pregnancy. But most plus-size pregnant women have healthy pregnancies, especially if they manage their weight gain, get regular prenatal care, and have a birthing plan in place for their labor and delivery.”

Feeling heard

In fact, it’s so hard to find size-friendly pregnancy resources, Mia told me that there are actual “whisper networks” that exist for plus-size women to help each other find pregnancy resources. A whisper network is “an informal chain of information passed privately between women.” These whisper networks help plus size women find “medical care that will be supportive or fertility clinics that will have you, birth centers that will have you or lactation consultants that understand larger breasts and larger bodies,” adds Mia.

Mia says that’s how she started her pregnancy journey. Once she had her son, though, she couldn’t find any support for finding the best baby carrier that would fit her body. That’s why she started PlusSizeBabyWearing.

“Most new parents usually find a baby carrier through registries or someone recommending a random carrier that might have worked for them. Unless you’re really connected to the babywearing world, new plus-size parents are not going to see a lot of carriers that would work for their bodies. It’s definitely getting better, but certainly not when I was pregnant in 2018.”

Mia continues, “I had one carrier that worked for me but I needed a new one because my son was getting a little bit older and bigger. I wanted to try a ring sling carrier and, luckily, I knew another mom on Instagram who had a body like mine, and she had gotten really great at using it. So that opened up a lot of validation and feelings I could relate to, that opened up that community for me. But I really didn’t see a lot of moms my size wearing their babies, and I wanted to change that.”

Feeling close

Mia begs plus size women to know, “that no matter what your size, there is a carrier that will fit you and will be comfortable for you.” But mostly she wants the many benefits of wearing your baby to be touted.

“Babywearing is not only about a carrier, it’s about the amazing bond and power of the bond between you and your child. It’s about the power of your body nurturing and benefiting that baby. Babywearing has a myriad of benefits for children and also, what we don’t talk about enough, are the benefits it has for the birthing parent.

“Babywearing allows for oxytocin production, which is the love hormone, and enhances the bond between you and your baby. It can also help slow bleeding if you have any after your birth. And it can support milk production and work to prevent postpartum anxiety and postpartum depression.”

Mia has also “seen babywearing work miracles for people who experience traumatic births and for people who have children that had to stay in the NICU. Babywearing is incredibly soothing to the postpartum parent and it’s also a way of reconnecting to your body that has just gone through a tremendous amount. Even in the best of birth, your body has gone through a lot and it’s incredibly healing for the postpartum body. I think that’s not talked about enough and known enough how healing it can be for the postpartum parent”

Feeling fed

Another category that is finally coming around is the area of nursing with brands starting to offer extended sizing for plus size moms. It’s especially hard to find an all-in-one nursing and hands-free pumping bra for this group. You can usually find one or the other but they still might not fit right. Asking for one that’s also beautiful rather than utilitarian-looking is a tall order. But all three women noted the Milkful collection by The Dairy Fairy as one of the only plus size nursing bras designed with a bigger-bodied woman in mind.

Jen says, “I really like how Emily, of The Dairy Fairy, went out of her way to design a nursing bra with plus-sized bodies in mind. It wasn’t just a size, it wasn’t like, ‘Let’s go to the biggest size on the market.’ It was, ‘How do we design a bra that is functional, beautiful, and really designed to fit a person of size and their unique needs?’ And I feel that’s what makes it one of the top plus size nursing bras on the market.” Before collections like Milkful, Jen says, “a lot of plus size people were taking their own bras and purchasing nursing bra clips and making” their own nursing bras.

Feeling cared for

Finding size-friendly care providers, whether it be a doctor or a midwife, is another difficult task for a plus-size pregnant woman. This is when women can come up against some hard-core discrimination and fear tactics. To Jen “it’s really, really important to connect with a size-inclusive care provider and to seek out positive evidence-based resources to know that your body is capable of having a healthy pregnancy and a positive birth experience. We can’t guarantee anything but we can do everything within our abilities to set ourselves up for success.”

And finding the right caregiver can make all the difference when it comes to a successful pregnancy and birth. Jen shares, “Everything changed for me when I switched from an OB to a midwife. My midwife was the first care provider to ever touch my body with compassion. My midwife helped me to believe that my body was healthy and capable of having a healthy outcome.

“So that was the first time when I was like, ‘Oh, there’s a care provider that isn’t focusing everything on my weight, and they’re praising me for all I’m doing to be healthy.’ She said, ‘You’re doing all the right things,’ and it was just nice to know that I could be healthy and that I was healthy as a plus-sized person because I had never heard that message before. And that was life-altering.”

If you’re looking for a size-friendly care provider, Jen recommends the Pregnancy for Every Body site and she also offers a free guide to help in that search. Mia says her biggest complaint about navigating plus size birth is, “limited access to supportive and helpful medical care and facilities in which to give birth as well as fertility clinics. She notes that “unnecessary interventions based on discriminatory practices” are common.

Erica wishes doctors knew that “we already know. Like I was told my blood pressure is high. ‘I know.’ Your body mass is this. ‘I know.’” She too wants to dispel the myth that if you’re plus size, you’re going to have to have a c-section.

Feeling included

Mia suggests that larger-bodied mothers to be should “stay off all the mainstream pregnancy apps. Stay away from them. And stay away from anything that is hyper-focused on what and how much weight you gain or lose during each trimester. That’s between you and your doctor and you and your care provider. Stop listening to other people’s stories and just focus on feeding your body in ways that feel good.”

Erica simply says to plus-size pregnant women, “Don’t worry about your belly. Don’t worry about your belly, because it’s going to pop eventually. You don’t want to look big your whole pregnancy. You wanted to be pregnant, enjoy it for yourself.”

One way to help plus-size women enjoy their pregnancies more is to use the right language. Jen asks us, “…to be very mindful of the language that is used when talking to people of size. ‘Obese’ is a word that, well, yes, used in medical technology is fine but it really is a barrier for the patient.” She also wants “to encourage care providers to work on their own size bias. That is critical. They need to work on their own biases in order to provide evidence-based medical care.”

Terms like ‘people of size’ and ‘people in larger bodies’ are acceptable with most plus-size women. But Jen also adds, “There are people like me who self-identify as ‘fat,’ and that is a word that we’re comfortable using, but not everyone is. And there’s a big movement in the advocacy community to use the word ‘fat,’ to take it back because it’s been weaponized against people of size for so long.”

Feeling supported

As if being ignored, unrepresented, and mistreated isn’t enough, plus-size women are more prone to postpartum depression (PPD) and postpartum anxiety(PPA), according to this study by the National Institutes of Health. PPD is “depression suffered by a mother following childbirth, typically arising from the combination of hormonal changes, psychological adjustment to motherhood, and fatigue” while PPA is “irrational fear or exaggerated worry that something is wrong and usually involves worrying all day, every day, and about many different things. It’s similar to regular anxiety but is more closely linked with having a baby and becoming a parent,” according to WhatToExpect.com.

Both postpartum depression and postpartum anxiety are treatable but are not always detected by the mom or their caregivers and make life as a new parent even harder. PPD and PPA can interfere with not only a woman’s mental and physical health but also her ability to care for her baby. It is critical to reach out for help if a mother is feeling any of these symptoms whether it be through your caregiver or resources like Postpartum Support International’s free bilingual hotline, support groups, and directories of medical professionals.

In the postpartum period of motherhood, Jen notes, “It’s really critical to ask for help. And it’s actually a sign of strength. Ask for the help you need to set yourself up with a team. And maybe that team is just your partner or your local community. It’s wonderful if you can hire a postpartum doula but I know that’s not accessible to everyone. Setting yourself up for success by asking for help is really, really important. And it means you’re taking really good care of yourself.”

Feeling full

One way of caring for a newborn is, of course, feeding your baby. Breastfeeding vs. formula feeding is already a controversial topic that gets even further complicated when the mom is plus size. Jen wants to say, “There’s a lot of bias against people of size, especially when it comes to breastfeeding. There are a lot of assumptions that we’re incapable of breastfeeding or, on the contrary, that we overproduce milk. I think there’s just so much misinformation.

“But there are also some really harmful things that are said to people of size like if we have large breasts we’ll smother our babies. So when you already don’t have clothing that’s accessible and a bias that’s out there, it’s not surprising that we see a lower incidence of long-term breastfeeding for people of size, or even initiating breastfeeding, for people of size.”

Jen reminds us that, when it comes to breastfeeding, inclusion in representation is really important. “That helps people feel like they can have positive outcomes.” And, if you have PCOS (polycystic ovarian syndrome) it can be more difficult to breastfeed. That is one of many instances when it is smart to seek support from a lactation consultant, or an IBCLC, who is certified by the International Board of Lactation Consultant Examiners or reach out to your local branch of La Leche League.

She continues, “I always want to refer people back to the experts because there’s so much misinformation online. And not to negate community support or anyone like that, but I think there’s just a lot of confusion and misinformation. It’s so important to always try to get support whenever possible.” Mia adds that she didn’t feel like her lactation consultant understood her body or her mobility so she chose to figure it out on her own. So trying to find someone who is educated in the unique needs of a larger body is very important.

Feeling represented

When it comes to maternity clothes Mia says, “I wish I knew that I didn’t need to bother with plus size maternity clothes. That I could just size up on regular clothes and look fantastic. I wish I had figured that out sooner. And the one thing I want a lot of plus size people to know is that they don’t even need to size up very much in most cases. Besides a good winter coat. But, otherwise, you can just size up in pretty much anything and it will serve you really well and you can look really cute.

“I know that people really, really want to buy maternity clothes because so much of our experience in pregnancy is kind of taken from us. We don’t get to feel seen in very much. We don’t feel celebrated very much. Some people don’t even acknowledge that we are pregnant. We just don’t feel seen very often, so a lot of plus-size people really, really want that maternity clothing experience, and I get that, but I also think at the end of the day you want to look cute in your photos. You want a cute outfit and you can achieve that look, that maternity look by sizing up in really cute clothes and you’ll look amazing and you’ll feel great.”

Jen points out that while a lot of brands are offering extended sizing now for plus size women, “they are still keeping it online and that doesn’t really make it accessible to everyone and doesn’t make people of size feel included. It’s frustrating when brands are touting that they go to every size and then they stop at 3X.

“I also think it’s frustrating when they aren’t including plus-size models and images of plus-size people wearing their clothes. So I think that there are baby steps being made, but there are leaps and bounds that need to happen before we’re fully inclusive. And people of size want to spend money! We want these clothes, so they need to become more accessible.”

Feeling understood

According to Mia, “We take care of each other, the plus-size community, because there are no spaces for us. If you look at some of the big pregnancy and motherhood media companies, apps, any media that you see, you’re not going to see diverse body types in those. When you search for plus-size maternity photos, you’re not going to see diverse bodies in those. So there’s just this complete eraser in both a representational sense and an identity sense.

“And, then, also, practically speaking, not having the supplies, not being allowed to birth the way that we want to…There are very practical ways in which it is very inaccessible and hard to be pregnant in a plus-sized body. And then there are all these other things as well, just the idea that you don’t see anyone who looks like you pregnant, nursing, wearing their baby, all those things.”

Erica adds, “I think we all should do better. I couldn’t name one clothing brand off the off top of my head that is embracing the plus-size community unless they were specifically for plus size. My friend noticed on Old Navy’s website that whenever they have those amazing sales, it does not include the pregnancy line and it doesn’t include plus size. And that doesn’t make sense when they say their clothing is for the whole family. They need to make more of an effort.”

Feeling loved

Mia says the exclusion of plus-size pregnant women from the media, “creates a fear of one’s own body created by both a medical community that is discriminatory and a society that does not recognize our experience as pregnant people.

“Then there’s also a supply and fashion component to this, which is that plus-sized maternity clothing is inaccessible and it’s compounded by the fact that plus-size clothing is already somewhat inaccessible. Maternity clothing is very inaccessible, not only in terms of what’s available but also economically inaccessible too. And then this comes down to plus size nursing bras, this comes down to pumping equipment not made for larger busted, larger body people, so that also excludes us in this experience, or creates difficulties and hurdles to climb within our pregnancy or postpartum experience.”

Finally, Jen offers, “I think it starts with our own internal dialogue and working on our own history with being fat. We need to change our own phobia. Our kids really listen to everything that we say, so if we say something negative about our bodies, we’re planting those seeds for our children to pick up on those messages.

“That’s a really important place to start, your own personal self-love journey. And then study really healthy boundaries with loved ones and care providers and everyone in your circle. If someone is shaming you because of your size, that’s really unhealthy and it’s counter-productive to helping you to feel healthy and happy in your own life.” In the end, Erica says, “You have to be the best for yourself. No one’s going to decide my happiness but me.” And we can see, no matter what their size, that’s all that really matters.

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Previously Published on medium

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