Response to Attack on Fat Mothers Options

[~Heather~]

Thanks to Carla for writing this incredible Op-Ed, which unfortunately NYT chose not to publish.

On June 06, 2010, The New York Times published Anemona Hartocollis’ article, “Growing Obesity Increases Perils of Childbearing.” The article received Sunday, front-page coverage in the continuing trend toward anti-fat panic and “obesity epidemic” hysteria in our country. In the typical tradition of this genre, the article featured sensationalistic, pitying, and shaming portrayals to supposedly illustrate the personal, social, and material high “costs” of fatness. Indeed, a byline proclaims: “Obese Mothers a Burden on Hospital Resources.” In what has become the most predictable and problematic aspect of this oeuvre, at least from a scientific perspective, the article also uncritically uses fatness as a proxy for illness and draws clear causal arrows pointing directly from fatness (always transformed into the supposed medical crisis of “obesity”) to a “constellation” of illness and disease, medical complications and accommodations, effects on society and others, and death.

It is never considered that, perhaps, some of the “burden”some accommodations being made for fat people in medical settings (such as sturdier examination tables, development of alternate examination methods, procurement of sophisticated medical technologies, and enhanced sensitivity training for medical professionals) might not only be a matter of social justice in medical care for fat people, but shifts that might ultimately benefit all patients. Instead, Hartocollis’ article centers on the vignette of “Ms. Garcia,” an “obese,” diabetic woman who gave birth, via Caesarean section, to an underweight and premature baby. It does not go unremarked that this was a costly delivery--more than fifteen times the cost of a “normal” delivery. From this vignette, we might come to believe that fat women and their glut of underweight, prematurely-delivered babies are jeopardizing the entire healthcare system. Are we to believe that Garcia’s situation is emblematic, even typical, of most fat women having children today?

Oddly, Hartocollis makes no mention of Ms. Garcia’s relatively advanced maternal age (38 years), her socioeconomic status (whether or not she had access to adequate prenatal care), or the fact that she is “Ms. Garcia” rather than “Ms. Smith.” Apparently, none of that might matter. This rabid focus on fatness obscures complicated intersections between many risk factors associated with health and illness--age, race and ethnicity, socioeconomic status, and access to non-stigmatizing and comprehensive medical care, to name but a few. Further, it never seems to warrant mention that the Garcia case study actually presents a scenario that is statistically less likely among fat mothers than thinner mothers-delivery of an underweight, premature fetus. Indeed, most articles seeking to link fatness with poor fetal outcomes warn about the tendency for fatter mothers to deliver fatter babies.

Some of the medical professionals contributing their perspectives on the issue of fat mothers describe being “anatomically… turned off” by them. They recount instances of becoming “angry” with them, “complain[ing]” about them, being “worried” that tables will collapse under their weight, counseling them to have medically-risky bariatric surgeries before becoming pregnant, and intoning “demand[s] and siren song[s]” that BMI be calculated for all patients since “eyeballing” them is insufficient surveillance for fatness, pitying and feeling “sympathetic” toward them, and being “stuck between Scylla and Charybdis” when it comes to their presumably-annoying and personally-inconveniencing medical care. None of this is scrutinized as ethically problematic, insensitive, unprofessional, misinformed, or even plainly cruel.

Indeed, it does seem that we are met with a Scylla and Charybdis situation when it comes to fatness at this point in our own cultural mythos; but it is fat people who are truly “stuck” in this dilemma. No matter what the outcome, it seems that fatness, per se, will be resolutely assigned as the independent source of each and every social and medical problem. And our society’s (and medical professionals’) problematic, over-simplistic, and stigmatizing portrayal of fatness as the greatest public health plague of our time is subjected to little reasoned public critique. In this social context, it is actual fat people, like Ms. Garcia, who will continue to personally bear the blame and shame imposed upon their socially-unruly bodies, “promising” to go on “a strict, strict, strict diet” to placate the resounding, authoritative, and punitive clucks of social disapproval and disgust. I would suggest that it may not be only "water retention" that leaves fat people, like Ms. Garcia, “too numb… to feel anything.”

--Carla A. Pfeffer, Ph.D.
Assistant Professor of Sociology
Department of Social Sciences
Purdue University (North Central campus)