Eugenics at the Obstetrician’s Office: Fatphobia and Reproductive Rights

Article by Alexandra Zybinova

Graphic by Lisa Verberne

The body is akin to a battleground, as women* all over the world have to fight the state for control over their own reproduction. Some of the most controversial topics in US politics today include women’s access to abortion and birth control, as the Republican claims to strive to “protect most fundamental right, [one’s] right to live” (U.S. Congressman Jim Jordan, qtd in PBS). However, even the most avid anti-choice/pro-life supporters do not value all fetuses and their life potential equally, as reproductive discrimination bars many who want to conceive from accessing necessary treatments. Mainstream media is silent on the medical institution’s marginalization of disabled** women’s reproductive rights – and by the same logic their potential fetus’s rights to life. Disabled women are denied access to family planning  services, specifically prenatal care and infertility treatments. This article will focus on the eugenic attitudes in the medical establishment by analyzing marginalization and fatphobia fat women face when trying to access prenatal care and fertility treatments.  

Eugenics in the medical field can be traced back to the nineteenth century, when  statistics were used not only to identify the norm, but diminish deviations to improve human population and achieve the ideal human form. Eugenics creates a “dominant  hegemonic vision of what a human body should be” (Davis, 8). Therefore, as eugenics strives to perfect the future generation, it is intrinsically intertwined with controlling human procreation, selecting which traits should be preserved, and whose genetic material gets to be passed on. From a eugenicist point of view, fat women would not make the cut for motherhood because their body does not conform to the socially constructed standards of “normal” created by a eugenic bell curve, which not only attempts to standardize the population but also rank its qualities by preference. Thus, fat women’s biology is pervasive to the cultural narrative of continuous improvement of the human race, condemning them as failing femininity in corporeal terms, since reproductive ability is a major (if not the main) quality of stereotypical femininity. This supposed lack of ability to contribute to society by birthing and raising children pathologizes fat women, producing socially constructed obstacles to reproduction, through both fatphobic social attitudes and institutionalized discrimination (Herndon, 132).  

Fatphobia preventing women from having children comes in different forms, including disguising itself as medicine or factual science, as scientific facts can be twisted by fatphobic interpretation (Herndon, 125). For example, there are persistent beliefs that fat women are not biologically fit to carry a child to term, that their child will be unhealthy, or that pregnancy poses a threat for them; however, in many cases the medical practitioner makes these assumptions without ever evaluating the health of their patient (Delisle). These sweeping generalizations are used to discourage fat women from having children due to their pathologized social status, which positions them as less likely to be good mothers. Regardless of their actual wellbeing, these women are seen as failing at maintaining their health and therefore their potential ability to take  care of a baby is scrutinized. In addition, it is a popular belief that a fat mother will have a fat child – in other words, an undesirable one, as the child is pathologized before it is even conceived. Even though fat women do tend to have bigger babies, it does not justify discrimination against an unborn baby, regardless of what size it is likely to be (Delisle). 

Beliefs that fat women have more difficulties conceiving than straight-sized women are widespread, however there is little scientific evidence to prove causation between weight and fertility (Snyder). There is however a correlation between the two that can potentially be explained by the discrimination fat women face, for example inability to access proper healthcare to address other medical conditions that  may lead to infertility. Often fat women suffer from medical negligence because their doctors attribute all of their health issues to their weight, only to discover the actual condition that troubles the patient years later, if ever. Many women are repeatedly told to lose weight to treat their infertility, only to find out through their independent research that the condition causing their infertility left them predisposed to weight gain, rather than the reverse. For example, women who suffer from polycystic ovary syndrome (PCOS) have  hormonal imbalance that causes weight gain and retention, while also lowering chances of conception. Despite the condition being highly treatable with hormonal therapy, often even women with the established diagnosis do not get access to medication due to the stigma around fatness. Stigma prevents the medical professional from seeing past the person’s size to properly evaluate other reasons that can be causing infertility, taking the symptom for a root cause (Delisle). Moreover, many fat women are told to first lose weight and only then try to conceive.  This alienates fat women for whom weight loss may not be a possibility, completely erasing the possibility of motherhood from their future (Herndon, 125). 

This violence against fat women poses risks for their physical health, as “bariatric surgeries, which often reduce stomach capacity to around two tablespoons and bypass sections of bowel, are encouraged despite questionable outcomes” (Herndon, 129). The procedure could potentially pose more danger than the pregnancy itself, yet bariatric surgery is still a widespread practice because it aims to make fat bodies conform to social standards. Moreover, fat women   experience more complications when giving birth, some of which can be fatal, yet it is unclear whether this is caused by their physical health, or poor care they receive because of the staff’s fatphobia.Despite being  marginalized as society exercises power over fat bodies, there is little that fat women can do to battle the system. In Canada, some fertility clinics openly state on their  website that they will not accept patients over a certain BMI, which is stigma induced discrimination and is prohibited by law, yet it is still prevalent in modern society (Pederson). Adopting a group identity as disabled could potentially address the problem of open discrimination, as it would make the discrimination they experience fit the legal mold. This would require a social understanding that fatness is not a voluntary condition one is personally responsible for, shifting the blame from the individual to the society that constructs fatness in a way that it is disabling to the individual, in this case by limiting access to healthcare (Herndon,  123). Fat women live at an intersection of disability and gender, thus to achieve equal rights for them, a reproductive justice movement that is fully inclusive of and aligned with disability justice is required. Bringing into light the stigma fat women face would allow for politicizing of fat identity in order to address fatphobia and its impacts on the lives of fat women. It also highlights how variable the standards of the pro-life argument because of the weight of the mother, going against the doctrine of sanctity of life, which states that all life is uniformly good and valuable. While it will not be enough to completely eradicate the stigma around fatness or abortion, it is a starting point for identifying eugenic attitudes in the medical establishment and curbing at least some of the practices damaging lives of fat women.


* In this text, women refers to any individuals who identify as a woman, including trans women and gender queer people who situationally may find this label apply to them

** This text assumes a social model of disability, where certain bodies are privileged over others based on the socially constructed definitions of ‘able-bodied’ and ‘disabled’


Davis, Lennard J. “Constructing Normalcy: The Bell Curve, the Novel, and the Invention of the Disabled Body in the Nineteenth Century.” The Disability Studies Reader. 2nd ed., Routledge, 2006. 

Delisle, Raina. “We Need to Stop Discriminating against plus-Size Pregnant Women”. Today’s Parent. 11  Jan. 2018, stop-discriminating-against-plus-size-pregnant-women/.  

Herndon, April. “Disparate but Disabled: Fat Embodiment and Disability Studies.” Nwsa  Journal, vol. 14, no. 3, 2002, pp. 120–137.

Jalonick, Mary Clare. Quoting Jim Jordan in “House Republicans use new majority to approve anti-abortion measures.” PBS News Hour. 11 Jan. 2023. politics/house-republicans-use-new-majority-to-approve-anti-abortion-measures.

Pedersen, Sue. “Should Fertility Clinics Deny Treatment To Women With Obesity?” Dr  Sue, 6 Sept. 2018,  

Ross, Loretta J. “Reproductive Justice As Intersectional Feminist Activism.” Souls, vol.  19, no. 3, 2017, pp. 286–314., doi:10.1080/10999949. 2017.1389634. 

Snyder, Brianna. “Fat-Shaming The Pregnant: How The Medical Community Fails  Overweight Moms.” Huffington Post, 9 May 2018,

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