Prior family planning experiences of obese women seeking abortion care

Previous studies have shown that overweight and obese women avoid seeking healthcare due to weight stigma or shame, often based on negative treatment by healthcare providers. This study examined how weight impacts reproductive healthcare and family planning by studying the experiences of obese women seeking abortion care. Methods: 651 women were surveyed at 5 abortion care facilities across the country using self-administered iPad surveys. A sub-sample of 124 obese women (BMI over 30 kg/m2) completed a survey about prior experiences with family planning (FP). Subjects also completed the Weight Bias Internalization Scale. Findings: Contrary to expectations, few women reported healthcare avoidance or poor treatment by facility staff at prior clinical encounters. However, over half of the women did report difficulty with one or more items of medical equipment and almost 10% reported their clinic seemed unprepared to handle heavy women. Obese and non-obese women were compared based on their attitudes about the appropriateness of weight loss discussions during FP visits. Results of the self stigma scale provide insight into the lived experiences of obese women of reproductive age. Conclusions: Although few of the women in this sub-sample reported healthcare avoidance due to weight, the fact that over half the women experienced some difficultly with an aspect of FP care points to a gap in the quality of care. Also, providers need to understand how obese women feel about weight loss advice as part of the FP clinical encounter and the role that self-stigma plays in obese women's lives.