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?
Ellie x
I am a student midwife and have just done a piece of artwork for a university module which I have focused around body image in pregnancy! I have created a 3D torso on a canvas and covered it in words from women who have had babies and/or are pregnant….I asked women to think of something positive to say..which many struggled with…I assumed due to the impact of media on the general public, that some may find it a little difficult but I was shocked at how many really struggled at first to be positive!!! I see awesome women and their incredible bodies growing a human and I am frequently amazed at how fascinating and brilliant childbearing/birth is…but these women don’t seem to see it….I will definitely try to empower women about their amazing bodies and boost their body confidence more in future!
That sounds amazing Charlotte – do you have a picture? What an awesome project x
I’ll never forget the words of a HCA at our wonderful small midwife led maternity unit after the birth of my third child. She pointed to my tummy less than 5 hours after giving birth and said ‘you’ve got a lot of work to do!’
Thankfully I was old enough and wise enough to know how a woman’s body will look for many months after birth and that I looked completely normal. Looking back I wish I’d said something to shock her as much as her comments had shocked me. The same words to someone less confident about her body image may have had a devastating impact.
The right words are so important.
That’s terrible. I wonder how that piece of care went so wrong? Thanks for sharing, do you have any insight into whether it was a mistake due to tiredness, awkwardness or just part of our very poor culture in terms of women’s bodies?
It most definitely is the smallest thinks that make the biggest difference. I remember after my first baby was born the two midwifes were commented on how I still looked amazing after giving birth, something I very much doubt but have carried through to my own care of women. I honestly think that comment set me up as a future mum, empowering me in my new role.
With my second I remember a midwife commenting on my PJ’s. Strange to think this would be something that stuck in my mind but it made me feel good after two days of sitting on an antenatal ward being induced.
I believe women remember the fine details of pregnancy and labour like no other life event so the smallest of remarks have great impact. It’s very cliche but women really do need to look after each other and instill positivity in one another, this world is cruel in so many ways, especially when it comes to the media and social media.
The fine details as you put it are crucial. Thanks for such an insightful comment. I’ve seen Davina McCall talk about her independent midwife like this, she said she made her feel beautiful in labour. It made me cry!