Why I Opted Out Of Weigh-Ins During My Second Pregnancy

“Step on the scale.” I’m 7 months pregnant with my second son, and the medical staff still asks me this. I remind them that I opt out. They always act surprised, and assure me, once again, they’ll note it in my chart.

This isn’t something I knew to ask for during my first pregnancy. It took a baby, a diagnosis, and years of struggling with my weight to advocate for myself.

The weigh-in that changed everything

I didn't need the scale to tell me, it was clear I'd gained weight. My clothes didn't fit the same. I exercised regularly, I ate better than most (sure, I loved my Trader Joe's sea salt chocolate almonds. But we’ve got to live, right!?).

Something didn't add up. By most standards, I was considered mid-sized. By medical standards, I was overweight. But the standards I put on myself (fed to me by society): I was fat. Around that same time, I decided to try for a second baby. I was fat anyway, I may as well grow into it (yes, that was an actual thought I had).

After six months of failing to conceive, my midwife suggested blood work. I thought it’d be a formality, but the results came back indicating an underactive thyroid. At my first endocrinology appointment, he asked me to step on the scale. My cheeks flushed as I watched him record my highest weight ever. It was real now, it was in my charts.

Another blood draw confirmed I had Hashimoto’s disease, which explained my weight gain and struggle to conceive. “If you do get pregnant,” my new endocrinologist told me, “make sure I’m one of the top 5 people you tell. You’ll need your thyroid checked immediately, and we’ll likely adjust your medication. If your thyroid is unstable, you can miscarry or it can cause developmental delays.”

“Will I be able to lose weight now?” No matter that I was more concerned about my current size than this lifelong autoimmune disease.

“It’s impossible to lose weight while your thyroid is underactive. It can take up to six months to regulate it as we figure out your dosage.” Great, I thought.

I was always praised for my thinness

As a child, I had a voracious appetite. I ate what my body told me it needed to grow. I’d down four slices of bread and butter and ask for seconds when we had hot dogs. “Where does she put it?” My grandma would laugh, like it was a badge of honour to eat large quantities while maintaining my thinness. How could I blame her? She was a product of society's programming, too. But I didn’t know I was supposed to put it somewhere yet.

In high school, I shopped at 5-7-9. One day, my boyfriend said out of the blue, “My friends asked me if you've gained weight.” It wasn’t a question, just a statement. You’re getting fat. I worked hard to maintain that size five, was I creeping toward a seven? Shame filled me.

Girls learn their worth through their weight

In her book Sexism & Sensibility: Raising Empowered, Resilient Girls in The Modern World, Jo-Ann Finkelstein, PhD, a clinical psychologist, discusses the pressures young girls receive about their looks.

“The message to girls is they must control all of their appetites—for food, for pleasure, for power—because too much of anything but self-restraint and deprivation is unfeminine. The truth is you get treated better when you’re thin, so it’s no wonder teenage girls everywhere are dieting, throwing up their food, starving themselves, overexercising, and/or preoccupied with every calorie they put in their mouths.”

In college, I’d get wasted, overeat, and slip to the bathroom to purge. It wasn’t consistent enough to be called bulimia, but it wasn’t infrequent enough to be called nothing. I was never diagnosed with a clinical eating disorder, but like many women, food and body size ruled me.

In my first pregnancy, I immediately gained 10 pounds

I thought I must be doing pregnancy wrong. I didn’t think I should gain so much weight so quickly. Around the six-month mark, and 40 more pounds, I was diagnosed with gestational diabetes. My midwife told me I may lose weight as I adjust my diet, which felt like a messed-up silver lining. A friend told me I was all legs with a cute bump. I was glowing.

“Pregnancy can trigger or intensify body image issues because it challenges so many of the ideals women are conditioned to chase,” Finkelstein says. “The body gets softer, rounder, larger, and less controllable. Even though we’re culturally told that pregnancy is a beautiful and natural thing, the messaging is contradictory: women are praised for gaining ‘just the right amount’ of weight, for ‘bouncing back,’ for staying ‘cute and fit’ while growing a human.”

The second time around, I chose differently

In my second pregnancy, I was managing thyroid regulation, gestational diabetes again, physical therapy for a prolapse, and low iron. At 39, I was considered higher risk.

I didn’t need any more metrics to stress about. So at my first prenatal weigh-in, I asked to opt out. Yes, it was just a number, but it was a number that was going to make me feel things—feelings of inadequacy that would contribute to my already complex pregnancy and generalized anxiety disorder.

And guess what? Everyone and everything carried on with their lives, but I was a couple of steps lighter.

Understanding the clinical perspective behind prenatal weigh-ins

I was curious about the medical context for weight monitoring in pregnancy, so I talked to Dena Moes, RN, CNM, clinical midwife and author of It’s Your Body. She explained it serves as an easy, low-resource way to assess nutrition and signify that the placenta, baby, and fluid are all increasing. Another key reason is to catch early signs of preeclampsia, a life-threatening condition that can cause sudden weight gain due to fluid retention and is more likely when nutrition is inadequate.

“As a clinician, I always focus on good nutrition rather than the amount of weight one should gain. I counsel women about protein with every meal and snack, and a rainbow of fruits and vegetables. And of course, calcium sources to prevent bone density loss,” Moes says.

But what about people like me, who are balancing a lot of stressors, including generalized anxiety, I asked.

“It’s important that prenatal care be individualized. What I’ve done for women who don’t want to see their weight is have them step on the scale backwards. But of course, a woman has the right to consent to or decline anything medically.”

The bottom line is that nutrition is more important than numbers on a scale during pregnancy.

Breaking the cycle for my sons

Now I have two sons to raise. Have they seen me scrutinizing the size of my stomach in the mirror? Have they heard me complain about how much weight I’ve gained? Or that I am “so bad” for eating an extra cookie? I don't want them to think their body size is good or bad, or that a woman's worth is in their smallness.

I grew up and still live during a time when so much importance is put on the size and proportions of a woman's body. I asked Finkelstein what advice she’d share with mothers trying to unlearn these messages. In addition to practicing body neutrality, she says, “we can’t expect to raise a child with body confidence if we’re miserable about our weight. If the goal is to make our children feel worthy, regardless of their size, then we must feel it about ourselves, too. It’s so important to do the work you need to do on yourself, whether that’s therapy or some other way. Don’t idealize thinness. As parents, we don’t need to adore our reflections, but basic respect for our bodies is a must.”

Moes agrees with this sentiment: “Pregnancy is a really good time to focus on healing so you don’t pass on disordered attitudes about bodies and food. You want to work out those issues so you can feed your child healthfully, and they can grow up in a home that has healthy attitudes toward bodies and food.”

I haven’t weighed myself in two years. It’s one way I practice body neutrality. I’m still working on appreciating my body. It’s taken a lot of unlearning and reframing. I want my body to be healthy and strong. I want to honour my body for creating and birthing two children. Most importantly, I want my attitude to trickle down to my sons.

So I still opt out at every doctor’s appointment, and on our scale at home. I opt out.

The journey to body neutrality often involves healing our relationship with food and our bodies. If the author's experience resonated with you, you're not alone, and help is available. 

Talk to your doctor, a therapist or reach out to the National Eating Disorder Information Centre (NEDIC) in Canada or the National Eating Disorders Association (NEDA) in the U.S.

Experts

• Jo-Ann Finkelstein, PhD, clinical psychologist, Author of Sexism & Sensibility
• Dena Moes, RN, CNM, clinical midwife and author of It’s Your Body