Mama's Got a Plan:

Maternity Care, Health Insurance, and Reproductive Justice

How bad can it be?

How bad can it be?


Some women1 are pregnant. Some women are fat.2 Some women are fat and pregnant. Almost all of these women need jobs, the same as anyone else. Employment discrimination in hiring is sadly not unknown to many would-be employees, but the fat-and/or-pregnant job-seeker encounters specific additional challenges.


The Pregnancy Discrimination Act of 1978 forbids employment discrimination on the basis of pregnancy, considering it a form of sex discrimination. The strongest protections apply to the hiring process, but are difficult to access unless an employer documents their decision to discriminate. Employers are not allowed to ask applicants if they have children, plan to have children, or are currently pregnant. Of course, at a certain point a pregnancy becomes visible – unless it is mistaken for fatness.


Discrimination faced by fat people is widespread. Fat people are seen not only as failures at controlling their body size, but also as generally untrustworthy, incompetent, and unhealthy. Most U.S. jurisdictions offer no legal protection against weight-based discrimination in employment or any other context. Even if legal protection were available, remedies might remain elusive should traditional code words for overlooking fat applicants be used: “unprofessional appearance” or “incompatible with company image.” Now for the double whammy …

Fat AND pregnant?

Yes, Virginia, fat people get pregnant and have babies! It is in these circumstances that employers fall prey to the particularly injurious prejudices about fat people, who are so often characterized as being “one cheeseburger away from a fatal heart attack.” Imagine if a fat person is also pregnant! It’s practically a death sentence! This rate of fatality would be highly inconvenient to employers – not to mention the fat person herself – if it were true.

There are higher risks of some complications of pregnancy associated with higher body weights, but that is true of other (visible) conditions as well: very low body weight, twin or multiple pregnancy, and pregnancy for African-American women, whose maternal mortality is tragically 3-4 times that of white women. The scientific evidence is finally beginning to concede that higher mortality for the African-American population is not the result of race, but of racism. The role of bias and stigma may also be behind the associations of certain types of risk with bad outcomes for fat pregnant women. Regardless of the science, the popular perception is as stated in Frame 4: hiring a pregnant fat woman will bankrupt your business through high health care costs3 when her pregnancy inevitably goes south.

Why do these beliefs persist?

The cultural understanding of women’s participation in the workplace remains far from settled, at least when women take valued positions previously held exclusively by men. Even women who are not pregnant or incapable of becoming pregnant can suffer from employer suspicion that members of the sex that “naturally” acts as family caretakers are likely to be called to do just that, to the detriment of their jobs. Applicants who are pregnant are felt to be freeloading: if other new employees are not permitted to take leave until they have put in the required amount of time, why can babymakers? They should have kept their legs closed!

As for fat pregnant women, well, should they really be permitted to reproduce? Not only will they almost certainly harm their babies and themselves in the process, draining company and public health dollars at an alarming rate, but they might produce more little fat people. A job would just encourage them! 

While these last paragraphs are increasingly sardonic in style, they serve to illustrate the result of combining over a century of anti-fat bias, medical eagerness to believe that fat is the cause of all ills, pressure on businesses to reduce health care spending, an economic framework that blames the need of the human race to reproduce on the people doing the reproducing, and a general lack of understanding that we are all in this together. And this moral mess hasn’t even begun to address the additional and intersectional issues encountered by people of color, LGBTQ people, people with disabilities, or immigrants.

“I want to do the right thing – what is it?”

You don’t really need us to tell you, do you? Stop discriminating! 

Admittedly, it’s not that simple. However, like charity, abuse begins at home – and that’s a good place to stop abusing your fat friends and family members. Even if you’re doing it because you’re “concerned for their health.” Especially then.

Then take up the standard in your workplace. Make sure that both pregnant and fat people are accepted as full members of the workforce. If you are responsible for hiring, then you are especially positioned to make change. Finally, when the common beliefs about fat and/or pregnant people begin to budge, work with policymakers to forbid this kind of discrimination. 

1We usually use the phrase “pregnant people” or “birthing people.” However, because the topic of this cartoon is extremely gendered, we will refer to “women,” with the understanding that pregnant people who do not identify as women face additional problems beyond the scope of this post.
2The accepted medical term these days seems to be people who “have obesity.” We use “fat” as the term preferred by the fat acceptance movement.
3Obviously, the structure of the U.S. health care payor system is a key culprit in employers’ general fears about health care costs. This post is not trying to solve that problem. One thing at a time, okay?



Image credits

All images are shared under a Creative Commons license, unless otherwise noted. Where required by license, changes to the image are noted.


Inciting mommy wars

An article of dubious quality quotes President Obama’s remarks on improving daycare:

And sometimes, someone, usually mom, leaves the workplace to stay home with the kids, which then leaves her earning a lower wage for the rest of her life as a result.  And that’s not a choice we want Americans to make.

Then it misinterprets these remarks with this title: Obama on Moms Who Stay Home to Raise Kids: ‘That’s Not a Choice We Want Americans to Make.’

It troubles me that readers take the article at face value and allow discussion of it to devolve into an argument about whether it is “better” for mothers to stay at home with small children or to remain in the paid workforce. These arguments serve only to divide us and to keep us from uniting in support of policies that safeguard all families.

On the whole I believe that making sure families have access to quality daycare is a positive move. I do, however, find some things troubling in the President’s speech.

Choosing to stay home – whose choice?

We love that word “choice,” don’t we? Our lives are just one big candy store and we get to pick whatever we want.


(L) Oliver Tarbell Eddy  (R) Dorothea Lange

The truth is that some people do get to pick, which is not to say that all their choices are necessarily desirable. And some people do not. For example, most people receiving government assistance are required to work outside the home. So if we do believe that it is “best” for children to have their mothers at home, clearly we have decided that some children do not deserve the best.

Equal pay for equal work – but what is work?

rosie the riveterPresident Obama supports equal pay for equal work, and I’m glad of it. But that is hardly a new proposition.

When parents leave the workforce in order to spend more time caring for their children, they are hardly leaving work behind – just paid work. We as a nation are reaping the benefit of these parents’ – mostly women’s – unpaid work. Just this week, the UN Special Rapporteur on extreme poverty called on countries “to recognize unpaid care work as a major human rights issue.”

If we really valued the work that is required to raise our children, we would fairly compensate anyone who took on this task: mothers, fathers, and traditional paid caregivers. These last are often parents themselves, struggling to afford care for their own children.

Many young parents do not consider that when forgoing wages in order to take care of children, they are also forfeiting future Social Security payments. Having children is the number one reason women in the U.S. fall into poverty – it’s easy to see why that is the case, but not why it should be.


Earning a lower wage for the rest of our lives – why?

Do we really believe that motherhood robs us of the ability to be competent workers? At the same time that we laud motherhood as being a difficult yet supremely worthwhile task?

People’s experience of parenthood differs, but it is hard to accept that everyone who makes cabinets or medicines or burgers or nuclear reactors somehow irrevocably loses the ability to do so after spending time with children. We can look to other countries that manage to not penalize women for taking time off work to raise children.

There is no reason we cannot adjust our national policy to support all parents – those who would like to be home with their children, those who would not, and those who want a little of both – regardless of whether they can finance these choices themselves or require government assistance to do so. In the end, parents know what is best for their families and should be able to make these decisions, free from mandates imposed on the basis of economics or skin color or profession. This is the third arm of Reproductive Justice: the freedom to raise our children in safe conditions and with dignity.

Are you listening, President Obama? I’ve just written your next speech for you. obama speaking