This week I've been reading the Two For The Price Of One government report. It's about poor body image during pregnancy and the postnatal period.
It can be very hard as midwives to support and advocate for women in our idealistic culture.
We live in a weird world which demands women get back their 'pre-pregnancy shape' at the same time as advertising junk food. We have an obsession with thinness alongside an obesity epidemic.
In this post I want to offer 4 tips for promoting good body image as a midwife. Off we go!
1. It sounds basic, but a compliment from a midwife or student can be something a woman remembers forever.
Saying 'your skin is looking so healthy, is that pregnancy?' or 'It's too early to listen in just yet but your baby's heart will be beating already, isn't your body amazing?' may change the whole first point of contact.
Not only can a midwife validate the astonishing process that's going on inside a woman, they can also fight the messages that society sends.
Even if you only see a woman once, she'll still get a flood of oxytocin from an authentic compliment from a professional.
The significance of this can't be underestimated. Good associations with the maternity services mean women may be able to relax more during labour and birth. As well as providing safe care, midwives are trying to establish a good midwife-mother relationship which can have an impact on outcomes.
And, as a bonus, when you do a nice thing for a client you'll get a shot of oxytocin too, and feel happier and more energetic. Giving encouragement and complimenting Mums is one of the perks of the job 🙂
2. Midwives can help by being clear about why certain measurements are taken.
In this month's The Practising Midwife, there's an article about eating disorders that reports women can think fundal height measurements are for checking up on weight gain. It might seem silly but for many women, a tape measure being placed on their abdomen comes with years of associations of shame and 'failure' to be thin.
A tweak as simple as 'let's see how baby's growing' as opposed to 'let's measure you' solves this issue.
BMI is also calculated for many reasons, not just to identify women who are obese and this is important to discuss clearly too.
Finally, this piece of research suggests poor body image can mean women breastfeed for less time. Again, a quiet (or loud!) word from a respected midwife can make all the difference.
'Isn’t it amazing, look who you made!'
'You look like you’re doing exactly what you need to – feeding your baby, in your PJs. I’m always a bit worried when I go round and women are in jeans!'
And there’s that lovely postnatal moment to celebrate too, when a baby’s put on weight and you can see a Mum thinking ‘that was entirely me and my milk’.
What’s not to love about that! Tell them!
3. Combat the image of obese women as 'lazy'.
Obese people, women especially, are treated in the media as 'lazy' or as having no self-control.
I believe this is unfair. The way I look at it is that back in the 1960s only a tiny percentage of the population were obese and those people weren't fundamentally different to how we are now.
These days we have much more processed food (with ingredients such as 'butylated hydrozyttoluene' in everything from cheese to soft drinks - ?!!).
Many people are addicted to sugar.
I think it’s even more important to authentically compliment obese pregnant women.
I remember one of my midwifery mentors saying 'Haven’t you got a lovely baby on board', to a woman clearly embarrassed at showing us her abdomen. Her face lit up.
It can feel like giving a compliment is the wrong thing to do as it undermines the serious complications that can come with obesity.
But women aren’t stupid, they know they’re obese, better than we do in fact. Education and facts are of course important but as the RCM reports, many women try and lose weight and change habits right as they get pregnant. At a first appointment, you may well be talking to a client who is feeling optimistic because she’s recently lost half a stone and started biking.
To encourage her to continue this achievement, calm facts and compliments seem the best course.
4. My final tip to share is Professor Michael Pollan's food rule, which I think balances good health and body image:
'Eat Food. Not Too Much. Mainly Plants.'
Can't go wrong there! I love it because it's simple 🙂
Now I’d love to hear from you. I’m fascinated to hear what your education around midwifery and body image has been like.
Can you leave me a comment telling me:
What's the most effective way of promoting good body image that you've come across?
If you're a Mum yourself, what else could the maternity services do to support good body image in your opinion?