Let”s address common misconceptions of having a pregnancy in a larger body with these plus size pregnancy myths and facts.
Please note that this information should not be considered medical advice. While it’s written by a certified childbirth educator specializing in plus size pregnancy, always conduct your own research and address any medical concerns with your care provider.
1. All Plus Size Pregnancies are High-Risk
Myth: All plus size pregnancies are high-risk .
Fact: Being plus size does not automatically indicate a high-risk pregnancy.
Research shows that many plus size individuals have healthy, uncomplicated pregnancies. So, not all plus size pregnancies are high-risk.
While some care providers might label you as high-risk based solely on your size, this categorization often comes from their business policies.
The American College of Obstetricians and Gynecologists (ACOG) does not recommend categorizing individuals as high-risk based solely on Body Mass Index (BMI). However, they do recommend some increased testing and screening near the end of pregnancy.
A high-risk classification can vary depending on the provider or any specific medical concerns.
Some people appreciate being classified as high-risk during their pregnancy because it means they get extra care and more frequent ultrasounds, offering more chances to see their baby. This can provide great peace of mind and reassurance.
However, others find the added appointments and tests to be inconvenient and costly, especially if extra monitoring isn’t medically necessary. For them, the high-risk label can feel like an added stress they don’t need during this special time.
Also, classifying someone as high-risk during pregnancy can limit their options around childbirth, such as access to birth centers, the midwifery model of care, hydrotherapy, and more.
While plus size pregnancies come with increased risks, the actual risk is often minor compared to how the media and some care providers portray it.
It’s important to connect with a care provider whose view of your pregnancy aligns with the level of oversight you desire, while also understanding that if complications arise, labels and care plans may need to change accordingly.
Related Article: Nonstress Tests for High BMI in Pregnancy: Vital or Excessive?
2. You Can’t Have a Healthy Pregnancy if Your BMI is Over 40
Myth: You can’t have a healthy pregnancy if your BMI is over 40.
Fact: Healthy pregnancies come in all sizes!
There’s a common myth that you can’t have a healthy pregnancy if your BMI is over 40, but the fact is that people of all sizes can have healthy outcomes, as well as face challenges, in pregnancy.
BMI is often considered outdated, as it oversimplifies health by reducing it to a number based on weight and height, ignoring many other factors.
And relying solely on BMI can be problematic, especially in pregnancy care, as it may lead to generalized assumptions that overlook the individual’s unique health condition, lifestyle, and nutritional needs.
The key to a thriving pregnancy isn’t about size; it’s about focusing on your overall wellness.
Tips for a Healthy Plus Size Pregnancy
Select Your Care Team: Individualized healthcare is crucial, and connecting with a size-friendly care team, including a size-inclusive doula, can make a big difference.
Nourishment: Focus on nutritious food for you and your baby and eating intuitively rather than dieting. Consider connecting with a Health At Every Size® informed nutritionist.
Stay Active: From starting a walking group to joining water aerobics at a community center – make movement fun! There are many recommended plus size pregnancy exercises, just be sure to get clearance from your care provider before starting a new routine.
Monitor Health Indicators: People of all sizes can develop complications during pregnancy, so work with your care team to ensure your overall wellness throughout prenatal care.
Emotional Well-being: Your loved ones are there to uplift and support you! But don’t hesitate to set boundaries with those who make you feel insecure about your body’s ability to have a healthy outcome.
You’ve got this!
3. If You Have a Miscarriage, It’s Because of Your Weight
Myth: If you have a miscarriage when you’re plus size, it’s because of your weight.
Fact: Most often, the cause of a miscarriage is unknown or related to chromosomal abnormalities.
Miscarriages can be a deeply personal and often misunderstood experience. Most of the time, pinpointing the exact cause of a miscarriage is simply not possible.
Blaming body weight oversimplifies a complex issue and can cause unnecessary guilt and shame.
Everyone’s journey with pregnancy is unique, and it’s essential to approach it with empathy and understanding.
If you or someone you know is struggling with a loss, contact a healthcare provider who can offer support and individualized care.
Related: Navigating Miscarriage and Self-Blame as a Plus-Size Individual
4. You Won’t Be Able to See Your Baby Bump
Myth: You won’t be able to see your baby bump.
Fact: While many will see a noticeable bump, some might not, and that’s completely normal.
The appearance of a baby bump can be influenced by many factors, such as body type, the baby’s position, and more.
Baby bumps can vary in shape and size throughout pregnancy, and it’s all completely normal.
Some common bump shapes include:
D-Shaped: This is the classic baby bump shape that protrudes outward and is rounded like the letter D. Many people expect this shape, but it’s not the only normal shape.
B-Shaped: Some bumps have a dip or indentation around the navel area, making the bump appear more like the letter B when you stand to the side. This B-Belly plus size pregnancy belly shape is quite common but rarely discussed.
Apron Belly: Also known as a pannus, an apron belly occurs when the lower part of the abdomen hangs down, sometimes overlapping the pubic area. This can happen with any bump shape and is also normal.
Little to No Visible Change: Some people might find their bump less visible or experience minimal outward change, and that’s normal, too!
It’s perfectly okay if your belly looks different than you expected during pregnancy.
The absence or presence of a visible bump doesn’t define your experience, but most people eventually notice a difference as their pregnancy progresses.
5. You Won’t Feel the Baby Move if You’re Plus Size
Myth: You won’t feel the baby move.
Fact: Most feel their baby’s movements!
While the initial sensations of your baby moving, like gentle flutters and tender kicks, may arrive a bit later than you expect, most people eventually feel movement.
You’ll often read that baby flutters usually start to be felt around 18-22 weeks of pregnancy. Those in larger bodies might need to wait a little bit longer.
These initial sensations may also be affected by factors such as the baby’s position, the amount of amniotic fluid, and the location of the placenta. If the placenta is positioned at the front of the uterus (anterior placenta), it might cushion the movements, making them harder to feel.
Whether those movements take time to be felt or are subtle, the wonder happening inside you is truly amazing.
Be sure to address any concerns with your care provider to ensure your peace of mind.
6. Pregnancy Tests Don’t Work When You’re Plus Size
Myth: Pregnancy tests don’t work when you’re plus size.
Fact: Pregnancy tests can work for plus size individuals, but lower hCG levels early on might delay a positive result.
Pregnancy tests detect the hormone hCG in urine. Plus size individuals may have slightly lower hCG levels early in pregnancy, which can delay a positive test result.
This doesn’t mean the tests don’t work; it may just take a few extra days.
So, if you don’t get a positive result right away, wait a few days and test again. hCG levels double every 2-3 days, increasing the likelihood of an accurate result.
Those extra days can sure feel like forever, but patience and retesting bring clarity.
7. If You’re Plus Size, You’ll Need Fertility Support to Get Pregnant
Myth: If you’re plus size, you’ll need fertility support to get pregnant.
Fact: People of all sizes can conceive naturally without needing fertility treatments.
Fertility is influenced by a range of factors, including overall health, lifestyle, and genetics, rather than size alone.
While certain health conditions associated with a higher BMI, such as Polycystic Ovary Syndrome (PCOS), can affect fertility, many plus size individuals conceive without any medical intervention.
It’s perfectly okay if you do need support if you’re plus size while trying to conceive.
Unfortunately, it’s common for people to face BMI restrictions. But the good news is that size-friendly fertility specialists are out there and can provide care without bias.
Consulting with a supportive provider can offer personalized insights and debunk common myths, ensuring a more accurate understanding of fertility and conception.
8. Noninvasive Prenatal Testing (NIPT) Doesn’t Work When You Have a High BMI
Myth: Noninvasive prenatal testing (NIPT) doesn’t work when you have a high BMI.
Fact: NIPT is effective for people of all sizes, including those with high BMI. Waiting longer before testing or using specialized tests improves accuracy.
A NIPT, or NIPS (noninvasive prenatal screen), is typically offered early in pregnancy to evaluate the risk of specific genetic conditions in the baby. This test provides early insights and reassurance without requiring invasive procedures, enabling expectant parents to make informed decisions about their prenatal care.
It’s common for people with a high BMI to receive a “no result” or inconclusive NIPT results due to lower amounts of fetal DNA in the blood sample being tested.
Higher body weight can dilute the fetal DNA, making it harder to detect early in pregnancy.
However, waiting a bit longer before testing allows for an increased concentration of fetal DNA, improving the chances of obtaining a clear result.
Also, specialized NIPT tests designed for higher-weight individuals can further enhance the accuracy and reliability of the screening.
Always consult with your healthcare provider to determine the best approach for your situation.
9. Plus Size Women Should Lose Weight During Pregnancy
Myth: Plus size women should lose weight during pregnancy.
Fact: Weight loss is not recommended for anyone during pregnancy.
The Institute of Medicine (IOM) advises against weight loss during pregnancy, and ACOG echoes this recommendation in its committee opinion on pregnancy for higher-weight individuals.
Instead, IOM provides weight gain recommendations based on BMI, and your care provider might adjust these guidelines based on your individual needs and circumstances.
If you don’t already know your BMI, it’s easy to find with a BMI calculator, but please remember it’s not an accurate measurement of health.
Pregnancy Weight Gain Recommendations by BMI*:
18.5: Gain 28-40 pounds
18.5-24.9: Gain 25-35 pounds
25-29.9: Gain 15-25 pounds
30 and above: Gain 11-20 pounds
*for a single pregnancy.
While those numbers might feel alarming, focusing on overall wellness will help your body do what it needs during pregnancy. And connecting with a Health at Every Size® (HAES)- informed nutritionist can help you prioritize wellness over dieting.
It’s also important to find a form of joyful movement, drink plenty of fluids, take your vitamins, get lots of good sleep, and follow other great pregnancy wellness recommendations.
Note that weight loss during pregnancy might occur because of morning sickness or naturally due to habit changes, so it’s not always something to worry about.
Always address any concerns with your care provider, and prioritize your mental health just as much as your physical health throughout pregnancy.
10. Plus Size Individuals Will Always Have High Blood Pressure During Pregnancy
Myth: Plus size individuals will always have high blood pressure during pregnancy.
Fact: While there is a higher risk, many plus size individuals maintain normal blood pressure with proper care.
Studies show a higher likelihood of developing hypertension by about 2-3 times, but when we look at the actual risk the rate is just under 20%. That means if you have no health concerns and just a high BMI, you have about an 80% chance of not developing preeclampsia.
To help reduce high blood pressure during pregnancy:
Eat Mindfully: Focus on fruits, vegetables, whole grains, and lean proteins.
Stay Active: Engage in regular, moderate exercise like walking or aerobics.
Take Baby Aspirin if Prescribed: Follow your care provider’s recommendations, as there’s good evidenced behind this recommendation.
Stay Hydrated: Drink plenty of fluids.
Manage Stress: Practice relaxation techniques like meditation or deep breathing.
Always consult with your healthcare provider for personalized advice.
11. Plus Size Individuals Always Have Big Babies
Myth: Plus size individuals always have big babies.
Fact: Baby size is influenced by many factors, not just the parent’s BMI.
If there’s a real concern, it’s important to do testing as there is an increased risk. However, there’s a common misconception that plus size individuals always have big babies, known as fetal macrosomia.
This misconception often leads to multiple tests for gestational diabetes beyond early screening and routine testing at 24 – 28 weeks. It also reflects weight bias in maternity care and contribute to a higher cesarean birth rate.
Many people are told they need to induce labor for a big baby, only to find their babies are born within the normal weight range.
To navigate these biases while balancing out any true concerns, it’s essential to utilize resources like Evidence Based Birth’s article on induction or cesarean for a big baby.
Additionally, learn how to advocate for yourself against weight bias in maternity care, and seek out size-inclusive providers to help you feel confident about your care provider’s recommendations.
12. It’s Impossible to Find Stylish Plus Size Maternity Clothes
Myth: It’s impossible to find stylish plus size maternity clothes.
Fact: While options may be limited, stylish plus size maternity clothes do exist.
Tips for Finding Plus Size Maternity Clothes
Shop Online: Explore online retailers that specialize in plus size maternity wear. Websites like PinkBlush offer a range of stylish options up to size 3XL. Etsy provides customizable sizing on items like beautiful plus size maternity dresses, ensuring there are stylish options for every body during pregnancy.
Ask Around: Ask your plus size mom friends for recommendations or check online plus size maternity clothing swap groups for great finds.
Mix and Match: Combine regular plus size clothing with maternity essentials like belly bands and stretchy pants to create comfortable and stylish outfits.
Comfort First: Prioritize comfort by choosing clothes made from stretchy, adjustable fabrics that can grow with you throughout your pregnancy.
Read Reviews: Look for reviews from other plus size individuals to find the best brands and fits. Customer feedback can help you find hidden gems that suit your style and needs.
For more tips and options, see our plus size maternity clothing guide for all the latest finds.
13. If You’re Plus Size, You’ll Need to Be Induced
Myth: If you’re plus size, you’ll need to be induced.
Fact: Induction decisions are based on individual health and pregnancy progression, not BMI alone.
While the induction rate is high for people of all sizes due to various factors, ACOG does not recommend induction based on BMI alone.
It’s important to have conversations with your care provider early on and often to understand their stance on induction and the reasons behind it.
If you prefer not to be induced unless medically indicated, you might need to seek out another care provider. That’s why it’s critical to discuss these topics early in your pregnancy to ensure your care aligns with your preferences and health needs.
14. You Can’t Use a Midwife if You’re Plus Size
Myth: You can’t use a midwife if you’re plus size.
Fact: Midwives can support people with a high BMI.
The midwifery model of care offers numerous benefits, including individualized support, lower intervention rates, and a reduced risk of a cesarean birth.
Midwives promote a holistic approach to prenatal and postnatal care and can support both medicated and unmedicated births.
Overall, midwives tend to be more size-friendly and can be a great option for a plus size family’s care team.
However, some barriers exist. Rural hospitals, birth centers, and some major medical facilities may have BMI restrictions for midwifery care.
Despite these limitations, many families successfully access midwifery services.
Tips for Finding a Size-Friendly Midwife
Research Online: Look for midwives and birthing centers that specifically mention being size-inclusive or that don’t have BMI restrictions.
Ask for Recommendations: Connect with local online groups for referrals and post a question asking for size-friendly midwife recommendations.
Interview Potential Midwives: Discuss their experience with plus size patients and ask about their approach to care.
For more tips, check out our free guide on connecting with a size-friendly care provider.
15. A Person’s Vagina Can Get Too Fat to Birth Their Baby
Myth: A person’s vagina can get too fat to birth their baby.
Fact: The size or weight of a person does not affect the ability of the vagina to stretch and accommodate childbirth.
This myth is rooted in fatphobia and weight bias in healthcare.
The vaginal canal is designed to stretch significantly to allow for the passage of a baby.
Concerns about childbirth should focus on individual health and medical conditions, not on the size of the vagina.
Research shows that people with higher BMIs do not spend more time in the second stage of labor, the pushing stage, than those with lower BMIs. While some providers cite an increased risk of shoulder dystocia, this risk remains extremely low.
The idea that a “fat vagina” can obstruct childbirth is not supported by evidence.
If a provider claims your vagina is too fat to give birth, it’s a big red flag, and you should seek a new provider whenever possible.
Related: Is My Vagina Too Fat To Give Birth? Yes, This Is A Real Question!
16. You Can’t Have an Unmedicated Birth if You’re Plus Size
Myth: You can’t have an unmedicated birth if you’re plus size.
Fact: Your size doesn’t determine your ability to have an unmedicated birth. Every body is different, and many individuals with larger bodies have successful natural births.
Choosing an unmedicated birth is a personal decision and can be achieved with preparation and support.
Factors such as individual health, prenatal care, and having a supportive birth team are more critical to the process than size.
Focus on building a birth plan that aligns with your goals and finding a size-friendly care provider who supports your choices.
Birth unfolds in many unexpected ways for people of all sizes. If medical interventions are needed or even desired, it’s okay if plans change.
Related Birth Story: Plus Size Natural Childbirth With A Midwife
17. You’ll Need to Have a C-section if Your BMI is Over 40
Myth: You’ll need to have a c-section if your BMI is over 40.
Fact: While there are higher c-section rates for individuals with a BMI over 40, many still have vaginal births.
According to the CDC, the cesarean delivery rate increases with BMI, reaching about 52% for those with a BMI of 40 or higher.
Weight bias and the higher intervention rates often pushed on individuals in larger bodies also contribute significantly to the increased c-section rates.
However, this does not mean a cesarean birth is inevitable, as many factors influence birth outcomes, including overall health and prenatal care.
To reduce the risk of a cesarean birth, it’s essential to build a strong birth team, including a doula. Access to the midwifery model of care can also be beneficial.
It’s also important to recognize that needing or choosing to have a cesarean birth is perfectly valid. Since there is an elevated risk, it’s crucial to become informed about the procedure and your options.
Plus size individuals can also have VBACs (vaginal birth after cesarean), providing more choices for future births.
When learning about plus size pregnancy myths and facts, remember that you’re stronger than the myths and more powerful than the misconceptions.
Your journey is unique and powerful, just like you.
What are some other myths you’ve heard? Share in the comments below!
References
- ACOG Committee opinion no. 549: Obesity in pregnancy
- ACOG Committee opinion no. 548: Weight Gain During Pregnancy
- Incollingo Rodriguez, A.C., Smieszek, S.M., Nippert, K.E. et al. Pregnant and postpartum women’s experiences of weight stigma in healthcare. BMC Pregnancy Childbirth 20, 499 (2020). doi.org/10.1186/s12884-020-03202-5
- Paula C Brady, Leslie V Farland, Elizabeth S Ginsburg, (2018) Serum Human Chorionic Gonadotropin Among Women With and Without Obesity After Single Embryo Transfers, The Journal of Clinical Endocrinology & Metabolism, Volume 103, Issue 11, November 2018, Pages 4209–4215, doi.org/10.1210/jc.2018-01057
- Dencker, A., Premberg, Å., Olander, E. K., McCourt, C., Haby, K., Dencker, S., Berg, M. (2016). Adopting a healthy lifestyle when pregnant and ob*se – an interview study three years after childbirth. BMC Pregnancy and Childbirth, 16, 201. doi:10.1186/s12884-016-0969
- Davenport MH, Ruchat SM, Poitras VJ, et al. (2018) Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis. Br J Sports Med. 2018;52(21):1367‐1375.
- Muktabhant B, Lawrie TA, Lumbiganon P, Laopaiboon M. Diet or exercise, or both, for preventing excessive weight gain in pregnancy. Cochrane Database of Systematic Reviews 2015, Issue 6. Art. No.: CD007145.
- Coroyannakis, C., & Khalil, A. (2019). Management of Hypertension in the Ob*se Pregnant Patient. Current hypertension reports, 21(3), 24.
