Perinatal Health for Every Body
Health At Every Size (HAES) Principles for an Empowered Perinatal Experience
By Emma Clark, PMH-C, Psychotherapy Intern
A Note on Language:In this blog, the term “fat” is used as a non-derogatory, descriptive term. Fat liberationists have reclaimed this word and use it to describe their bodies and the movement. At times, the term “person in a larger body” may also be used.
The perinatal period, and the physical changes that often come with it, can stir up complicated feelings about bodies. You might feel wonder at what your body can do, frustration when it doesn’t function the way you wish it would, gratitude for its resilience, and disappointment in how it has changed over time. At the same time, you may be inundated with messaging about “bouncing back” after baby, the latest diet or weight loss trend, or (often unrealistic) social media images. This is a lot to take in, and it can be overwhelming!
On top of this, not every body is treated equally during the perinatal period. Bias, misinformation, and structural inequities can interfere with individuals and families receiving the quality, compassionate care they deserve. One group significantly impacted by these inequities is perinatal people in larger bodies—1 in 5 report experiencing discrimination while receiving fertility, pregnancy, birth, and postpartum care.
This is where Health at Every Size (HAES) can be an incredibly helpful framework.
Health At Every Size (HAES) is a public health framework aimed at addressing weight bias in healthcare, and is a vital tool for changing how healthcare systems treat and understand bodies of all sizes, and how individuals relate to their own bodies. HAES is based on the fundamental idea that “health care must be accessible to people no matter their size, and no matter why they are any given size.” While HAES is especially relevant for patients in fat bodies and the providers who care for them, its principles are universally applicable.
The HAES Framework: Key Principles
HAES is founded on four key principles:
#1 “Healthcare is a human right for people of all sizes, including those at the highest end of the size spectrum.”Regardless of body size, every person deserves safe, compassionate, high-quality care.
#2 “Wellbeing, care, and healing are both collective and deeply personal.”Each person has the right to choose the care that works for them and to decide how they prioritize health among other important aspects of life. Environmental factors such as access to safety, clean air and water, and adequate food also play a critical role in health.
#3 “Care is fully provided only when free from anti-fat bias and offered with people of all sizes in mind.”Current standards in healthcare do not truly care for all bodies. People of all sizes deserve whole-person care that respects body diversity.
#4 “Health is a sociopolitical construct that reflects the values of society.”Definitions of “health” are rooted in histories of racism, ableism, and healthism, and they continue to evolve over time.
HAES in the Perinatal Period
HAES can serve as a grounding framework while navigating healthcare during the perinatal period, and while learning to accept and care for your body as it is. It serves as a reminder that health looks different for everyone and is possible at every size.
To incorporate HAES into your perinatal journey, consider the following:
Use the HAES Provider Directory or the Size-Friendly Directory (for doulas and other maternity care providers) to find providers who will support your health and goals.
Consider printing cards (such as HAES’s self-advocacy cards) to share your care preferences with providers.
Ask questions. Learning about concepts like “relative” vs. “absolute” risk can be useful when discussing how weight may impact perinatal outcomes, and can help prevent misinformation and fearmongering.
Seek out content that celebrates the perinatal experience for people in larger bodies, such as:
Fat and Pregnant (website and podcast)
Plus Mommy Podcast
Evidence Based Birth Podcast (episodes 234 and 348)
Plus Size Birth (website)
Fat Positive Fertility (website and podcast)
For broader resources on Health At Every Size, fat justice, and size inclusivity, you might explore:
HAES Health Sheet Library
Maintenance Phase podcast
The Fat Lip podcast
She’s All Fat podcast
The Fat Doctor podcast
Peach Please podcast
What We Don’t Talk About When We Talk About Fat by Aubrey Gordon
More Than a Body by Lindsey and Lexi Kite
Your Body Is Not an Apology Workbook by Sonya Renee Taylor
Weight and Health Care Substack by Ragen Chastain
Social media creators and advocates:
@stephanieyeboah
@yrfatfriend
@fatmarquisele
@huntythelion
@ayeyofatgirlpodcast
@thefatdoctor
@virgietovar
Every perinatal person deserves quality, compassionate, and equitable physical and mental healthcare, regardless of body size. At PMHC Chicago, we strive to honor the diversity of perinatal bodies and experiences, and to offer supportive care for all.
