02-06-2025
First-time mum left feeling 'devastated' after facing questions over her weight at hospital appointments
First-time mum Emily Chamberlain went into her 20-week pregnancy check-up jittery and excited.
"Falling pregnant took us a little while so when we did it already felt like such a miracle," she said.
She left "devastated and in tears", after being told that her body was putting her baby at-risk.
Ms Chamberlain said the midwife at the regional Queensland hospital had determined her pregnancy as high-risk due to her body mass index (BMI).
"My overall health physically just didn't really come into it; despite the fact me and bub were doing really well."
The 31-year-old said she saw a new clinician at every appointment, and her weight was discussed each time.
"After the third appointment where I was lectured about my weight, instead of supported to be a healthy mother, I came home sobbing," she said.
Maternity researchers say every year expectant mothers across the country experience weight discrimination during pregnancy, something they say is unfounded in medical research and dangerous to both the mother and baby.
Obstetric physician Leonie Callaway leads a new program at the Royal Brisbane and Women's Hospital, which aims to dismantle the "profoundly troubling" bias against larger bodied women in medicine.
Professor Callaway said she knew the system was broken after hearing from a patient who was told "she was too fat" to go ahead with a routine maternity procedure.
"We are not saying that some women won't need particular attention, but if you fat shame them they're going to disengage entirely and not get the care they need for what could be a higher-risk pregnancy," she said.
BMI is a method used to sort patients by weight into four categories from underweight to obese.
It's calculated by dividing someone's weight by their height in square metres.
Professor Callaway said the use of BMI has long been contested because while it is a "useful scientific measure" on an individual basis it "doesn't account for any of the things that go towards an individual's actual health".
"Shame and stigma don't support healthy lifestyle changes, they just get in the way of health care engagement; the result is women and babies exposed to unnecessary harm," she said.
While it's well documented weight plays an important role in a healthy pregnancy, public health experts say there's a raft of environmental factors which need to be tackled well before a woman steps into an obstetrician's office.
Health psychology researcher at Monash University, Dr Briony Hill, believes "focusing on body weight and size when a woman is already pregnant takes away from a woman centred approach".
"What we should be doing is focusing on her health and wellbeing and working out how we can help her have the best pregnancy outcome," she said.
Ms Chamberlain lives in a farming town on Queensland's Darling Downs, where the nearest hospital is five kilometres up the road from her family home.
She was told she needed to travel almost two hours to a larger facility due to her BMI, even though she and her baby were healthy throughout her whole pregnancy.
Maternity wellbeing research shows the importance of limiting unnecessary stress on mothers during pregnancy cannot be overstated.
"We know depression and anxiety during pregnancy pose a major risk for mums and babies in the long and short term," Dr Hill said.
"Mothers can struggle to bond with their babies and it's not just emotional but physical too, there's the risk of high blood pressure and a reduction in breastfeeding rates."
A key finding from Professor Callaway's program was the significance of providing appropriate infrastructure for all bodies.
"Something as simple as having the right sized beds and chairs makes a space welcoming," she said.
"We'd hear of women coming in to have their observations taken and suddenly there's this great hunt to find a blood pressure cuff that fits, and that's humiliating, when in reality 50 per cent of women will need a larger cuff during their maternity."
Professor Callaway's research hopes to educate clinicians on just how damaging their words can be to an expecting mother.
"There's a lot of nuance in providing maternity care but the bottom line is we need to take a look at the woman in front of us and not just the black and white data of a BMI," Professor Callaway said.
After months of feeling shamed and unheard in the public health system, Ms Chamberlain enlisted a private midwife to provide consistent care.
She said having a clinician who considered her whole health as opposed to just her BMI in isolation "changed her pregnancy".
Despite the uphill battle she faced, Ms Chamberlain gave birth naturally to a healthy little boy.
Now almost two-years-old, her son Levi is a daily reminder of Ms Chamberlain's strength during an incredibly trying time.
