Nicola Salmon, a UK-based fat-positive fertility specialist, joins us to talk about her personal experiences becoming a mom, activism, and being an ally. We talk about why women deserve fat-positive, weight-inclusive fertility (and overall healthcare, of course). We take a hard look at the evidence, some of which we're still missing because the research world is still heavily weight-centric. And we review ways in which ALL of us can do better to support practitioners that are weight-inclusive. 

Follow Nicola's work: @FatPositiveFertility | FatPositiveFertility.com

The things we referenced:

• Nicola's free resource: The Fat Girl's Guide to Getting Pregnant
• "Exaggerating the Risks Again" via The Well-Rounded Mama
• "When You're Told You're Too Fat to Get Pregnant" by Virginia Sole-Smith for New York Times*
• A diagram "comparing 'maximal efficiency' outcomes in IVF" by Jess @HAES_StudentDoctor
• Advocating for weight-inclusive healthcare/assessing whether you'll receive fat-positive healthcare, by Nicola Salmon

Additional resources: 

1. A Review of Pregnancy in Women Over 35
2. Stigma in Practice: Barriers to Health for Fat Women
3. Weight-loss surgery and risk of pregnancy and birth complications

*Snippets from the article (though the full text is an important read): 

“In 1952, a pair of Boston physicians published a study in The New England Journal of Medicine titled “The Relation of Obesity to Menstrual Disturbances.” The authors surveyed 100 women between the ages of 16 and 40 who had been given diagnoses of menstrual disorders and compared their weights with a control group with no reproductive health issues. 43% of the patients with menstrual disorders weighed 20% or more than their “ideal weight,” compared with just 13% of the control subjects. Their findings, the authors concluded, gave ‘factual proof to the clinical impression of the association of obesity and menstrual disturbances.’”
A study done like this today would likely not go so far as to claim ‘factual proof’, but rather correlation with weight and menstrual disorders. However, it’s crucial to look at all of the factors, instead of zoning in on one (weight).  

“...data collected on 7,327 pregnancies from 1959 to 1965 --it took heavier women a median of one to two months longer to conceive, compared with women with B.M.I.s in the “normal weight” range. A 2015 study of 1,602 Italian women undergoing I.V.F. found that the bigger women were just as likely to get pregnant, but were more likely to miscarry. All in all, the research shows a correlating decline in successful pregnancy rates as B.M.I. rises.” (The latter is also true of age.)

“In comparison, a 2008 evidence review of the relationship between maternal age and stillbirth risk found that thinner women over 35 were also almost twice as likely to have a stillborn delivery compared with their younger counterparts.”

OTHER STUFF: 

Reach out with questions for the show, comments, or feedback anytime: RDRealTalk at Gmail.com 

Follow Heather Caplan's work: HeatherCaplan.com , @RDRealTalk