More about choices -- this time, from a fat perspective

I talk a lot in this blog about choices, and how informed choice is what frames my ideas of birth. I also talk about the fact that, for all the rhetoric of choice in this country, if you aren't born with an awful lot of privilege, you may not have all the choices you supposedly have. This isn't just true with economic privilege or abortion rights.

This and this show how fat women are often told that their choices don't matter and are forced to use medical treatment that is against hard medical evidence (being given statins during pregnancy, or getting a vertical incision c-section) and which is often dehumanizing or demeaning. Being told to make funeral arrangements? Pressure to be sterilized? This is disgusting treatment that no one should be forced to go through.

I am strongly drawn to unassisted home birth for reasons that I have talked about in previous entries, but I regret the fact that another component of my decision is grounded in fear. I am deeply afraid of a doctor treating me the way Gina Marie's doctor treated her. I'm afraid of being pressured into doing things against my will at an extremely vulnerable time. At my weight, I would very likely be "risked out" of a great many midwifery practices, and even going to a midwife doesn't guarantee that you'll get good treatment, as the Gina Marie story so clearly illustrates. Over and over, I've seen doctors treat fat people like they were less than human, and asking them to follow courses of treatment that are not medically sound (one example? Having a doctor recommend an 800 calorie starvation diet, a surefire recipe for muscle loss, metabolism slowdown, and eventual weight regain).

Because I believe I would want an unassisted birth regardless of all this, I hate the fact that my choice is also one made because I fear the other options. This is especially bad because, of course, if there is a labor emergency requiring medical attention I would want and need to go to the hospital. I am counting on my labor support people to get my wishes through to any particularly thick skulls in the hospital. Our local hospital, which is so small it doesn't have a full-time OB or most medical specialists, has weight loss surgery seminars and support groups every week, so I'm doubting it's exactly size-positive.

I wish I felt I could trust doctors to do what is right for me. I wish I could trust them not to take advantage of labor's hormones and emotions to push an anti-fat agenda. But I can't. Staying out of the hospital from start to finish is the only way to guarantee that my care won't be severely compromised just because I'm fat.