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A Promising Look At The Evidence Behind Plus Size Pregnancy Risks

If you spend a few minutes Googling “plus size pregnancy risks,” it’s nearly impossible to believe that people of size can have a healthy pregnancy. But what does the evidence say?

The facts might surprise you!

Rebecca Dekker, PhD, RN, the founder of Evidence Based Birth®, joins us for a needed conversation about the evidence behind plus size pregnancy risks.

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The Evidence Behind Plus Size Pregnancy Risks

Rebecca started Evidence Based Birth® in 2012, after the birth of her second baby. She was an assistant professor in a nursing college at a big university.

While Rebecca’s first birth was the routine hospital care many people receive, the experience left her feeling somewhat traumatized. She sought out different care for her second pregnancy, including seeing a midwife.

There was a stark difference between the treatment she received from the obstetric and midwifery model of care. She wondered why there weren’t more evidence-based resources providing parents with information about their options throughout maternity care.

Rebecca refers to research as her “Love Language.” She did a ton of fact-finding during both of her pregnancies. The knowledge she gained during that time ignited what is now one of the most well-respected resources for evidence-based maternity care – Evidence Based Birth®!

Related: What Is Birth Trauma And How To Heal

When it comes to Rebecca’s views on plus size pregnancy, she wants to make her philosophy known – wellness is for everyone, regardless of size!

Rebecca echoes frustrations regarding the plus size pregnancy information people find online.

Articles on plus size pregnancy risks are often misleading. They almost exclusively focuses on the relative risk. It’s challenging to find the actual numbers – a person’s absolute risk.

Relative risk is a rate compared to another rate. It’s common to read that a person with a high BMI has double or triple the risk of someone with a lower BMI.

What does that really mean? 50% increase in risk sounds scary, right?

Rebecca breaks it down by saying that a 50% increase of the relative risk means you take the baseline risk, and you increase it by 50%.

If your baseline risk is 1 per 1,000 and you increase it by 50%, that means your risk increases to 1.5 per 1,000.

1.5 sure doesn’t sound as frightening as 50% or double the risk!

Related: 7 Things You Should Know About Being Plus Size And Pregnant

If your care provider tells you that you’re at a much higher risk for Gestational diabetes mellitus (GDM), Rebecca recommends asking your provider for your absolute risk. Just don’t be surprised if your provider doesn’t know the answer.

Let’s look at the numbers!

Rebecca points to her Evidence On: Diagnosing Gestational Diabetes research article. People with a BMI of about 25 to 30 have about a 5% chance of having GDM. If you have a BMI 30 to 35, you have about a 5.5% chance. And if you have a BMI above 35, you have an 11.5% chance.

Yes, if you have a BMI over 35, you have more than twice the increased risk of someone with a BMI under 30. However, when you look at the actual number, it’s 11.5%.

That means you have approximately 88.5% of NOT developing GDM.

By not fully expaining the actual risk, people of size often feel defeated. They are led to believe they will automatically have a high risk pregnancy.

When you look at the absolute risk vs. relative risk, the evidence clearly shows that the majority of plus size pregnant people have healthy outcomes!

We need to empower people of size with positive, evidence-based information to encourage healthy decision making throughout pregnancy and beyond.

Related: When You’ve Been Fat-Shamed By Your Doctor

Along with talking about plus size pregnancy risks, we need to talk about the bias against people of size that exists in the medical community.

When Rebecca was teaching Pathophysiology to nursing students in a big lecture hall, she’d always have her mom give a guest speech by video. For many years her mother ran a support group for plus size women. She talks about the struggles people of size face.

Following this insightful talk, Rebecca would ask the nursing students a question. She asked them to raise their hand if they have heard nurses or doctors disparage patients because of their size or mock them in any way. Every time this question was asked, 100% of the students would raise their hands in the large auditorium.

Rebecca strongly believes having these conversations early on with medical students is critical to reducing the unethical harm patients of size experience.

The time for change is now! 

Listen to this informative episode of the Plus Mommy Podcast. Rebecca digs into the research of plus size pregnancy risks, addresses care provider bias against people of size, and talks about her new book!

Recording & Show Notes: Plus Mommy Podcast Episode 70

Resources Mentioned On The Show:

Rebecca Dekker

Rebecca L. Dekker, PhD, RN, is the founder of Evidence Based Birth® and author of Babies Are Not Pizzas: They’re born, not delivered! Dr. Dekker received her Master of Science in Nursing and her Doctor of Philosophy in Nursing from the University of Kentucky.  She earned a Bachelor of Science in Nursing from Calvin College in Grand Rapids, Michigan. Dr. Dekker has built a strong reputation in maternal and infant health circles for her pioneering work as the founder of Evidence Based Birth.® The mission of EBB is to raise the quality of childbirth care globally, by putting accurate, evidence based research into the hands of families and communities, so they can make informed, empowered choices.

Thank You To Our Sponsor:

This episode is also brought to you by Plus Size Birth! Use coupon code PlusMommy to receive 20% off the My Plus Size Pregnancy Guide. This guide covers everything you could want to know about having a plus size pregnancy.

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