Debunking the “High-Risk” Label in Plus-Size Pregnancy

If you’ve ever been told your pregnancy is “high-risk” solely because of your BMI, you’re not alone. Too many women with higher BMIs feel dismissed, judged, or even scared, often without being given the full picture. But the reality is that a higher BMI does not automatically mean a high-risk pregnancy.

Read on to find out what you can do to have a supported and empowered pregnancy journey no matter your size.

What Does “High-Risk” Actually Mean?

In medical terms, a high-risk pregnancy typically refers to one where there are increased chances of complications that require additional monitoring or care. But, in practice, the term is often thrown around with little nuance, especially for people with a higher BMI. Too frequently, it’s used as a blanket label, found more in outdated guidelines and weight stigma than in an accurate assessment of individual health.

Why BMI Isn’t a Good Risk Indicator

The Body Mass Index (BMI) was never designed to assess pregnancy outcomes. It’s a crude measure that doesn’t account for muscle mass, metabolic health, or individual differences. Yet, in many healthcare settings, BMI is still used as a shortcut for assessing risk. This over-reliance can lead to:

• Assumptions about your health before any tests are done

• Increased monitoring or intervention with little clinical justification

• Being denied fertility treatment or birthing options without evidence-based reasoning

The Impact of Fat Bias in Maternity and Fertility Care

Stigma around weight isn’t just emotionally harmful; it directly affects the quality of care people receive. Studies show that plus-size individuals often:

• Receive fewer explanations from healthcare professionals

• Are spoken to in dismissive or judgmental ways

• Experience higher rates of medical trauma and distrust in healthcare systems

This kind of bias can lead to avoidable stress, delayed care, or even missed diagnoses, and that’s not because of size, but because of how size is perceived.

What does the data say?

Yes, there are slightly increased risks associated with higher BMIs during pregnancy, like gestational diabetes or preeclampsia. But, these risks are not guarantees, and they vary widely between individuals. When monitored and supported appropriately, many plus-size people have perfectly healthy pregnancies and births, and research shows that outcomes improve significantly when people receive respectful, non-judgmental, and individualised care, regardless of BMI.

What Does Supportive Care Look Like?

Here’s what respectful maternity or fertility care should include:

• Conversations based on your individual health, not assumptions

• Full access to information, choices, and birth options

• Language that’s free of shame or blame

• A collaborative approach where you're treated as an expert on your own body

You deserve care that focuses on your whole health and not just your weight.

Navigating Fertility Treatment with a Higher BMI

For those undergoing IVF or other fertility treatments, the hurdles can be even more frustrating. Many clinics impose BMI cutoffs without flexibility or discussion, even though people of all sizes can conceive successfully. Advocacy and second opinions matter here - so does finding practitioners who are up-to-date with the latest research and who centre respectful care.

A Final Word: You Are Not a Risk Category

Being labelled “high-risk” because of your size can be demoralising. But remember this: your body is not broken, and you’re not automatically in danger. With supportive care, informed decision-making, and a provider who sees you, not just your weight, a safe and empowering pregnancy is absolutely possible.

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