Plus Size Friendly Care

Plus Size Friendly Care? What do we mean by it? If you’re a healthcare professional, how do you ensure you’re delivering it?

What is Plus Size Friendly Care?

I was lucky enough to attend the Primary Care and Public Health conference (PCPH) in Birmingham recently. (Thank you Parenting Science Gang and Wellcome for making that happen!) There I had the opportunity to speak to many midwives and other health professionals about the issues we face in the maternity system.

I took with me two big banners displaying the quotes we had gathered from our Parenting Science Gang Research. The white banner displayed what women wanted and expected from their care – i.e. plus size friendly care; the blue banner showed their real life experiences… which were less friendly. (Click here to read about our research)

Our stand at Primary Care and Public Health 2019 - talking to Health Care Professionals about Plus Size Friendly Care

Common themes arose in our study. Bigger women, (much like anyone attending maternity services!) are looking for choice being offered and having options available, feeling supported and heard, feeling respected, and for information to be presented clearly and sensitively.

Sounds sensible! Was this not the case?

Sadly not.

And this was reflected in the conversations I had at PCPH. Most Health Care Professionals I met are clearly are doing great work providing holistic, supportive, sensitive care, and continually reflecting on their practice in order to improve. A few think they’re doing a great job, but after a few moments conversation, the terminology and phraseology they use, and particularly the way they feel about maternal choice, betrayed subconscious biases and less than helpful attitudes.

As soon as a see a woman come in with a long birth plan of things she wants, I know she’s going to be a problem. Worse still if it’s laminated! Half the time, birth plans might as well go straight in the bin, I don’t know why people bother with them…

Comments of a midwife attending PCPH Conference

When having those sorts of conversations (while internally wincing!) I will try to subtly encourage reflection on words used and opinons held. Comments like “But don’t you find that women…?” or “Maybe people do X because they feel…?”, or “Perhaps that’s because they want…?” are ways to introduce a conflicting perspective, without outright challenging the position the HCP holds.

Changing people’s atitudes

Woman looking unimpressed at the lack of Plus Size Friendly Care she's receiving

In all honesty, I know that those who are most likely to have problematic attitudes are also likely to be the most convinced that their way is the right way – because that’s part of the problem! But you catch more flies with honey than with vinegar, as the proverb goes; telling someone with strongly held views they are wrong is just likely to make their views more entrenched. Making them consider the possibility of alternatives is the first step to changing their minds and showing them a better way.

Big Birtha’s Tips For Professionals Wanting To Deliver Plus Size Friendly Care

It’s easy to point out examples of bad practice, but how do we turn that around into a helpful guide for good practice?

I’m a big believer in solution-focused working. No point telling me there’s an issue, if you can’t think of a way of doing it better! So, I’ve written a page for professionals to help give some pointers on how to deliver plus size friendly care. Have a read. Share it, please, if you agree. If you don’t, or I’ve missed anything out, feel free to comment – it’s a work in progress!

The Plus Size Barbie Reality

So, five and a half years ago now, I wrote this article: The Plus-Size Barbie Controversy. Back then, I posed the question:

But which came first, the chicken, or the egg? Did generations of children growing up being marketed the implausibly proportioned Barbie learn to love the lean, or is Barbie merely holding up a mirror to the attitudes already prevalent in society, and giving consumers what they want?

There are other dolls!

Of course, while Mattel is the biggest player in this market, I knew other, more realistically proportioned dolls like Lammily and Lottie existed. They’ve always been very much on the sidelines, however.

Plus-size Barbie Reality - the Lammily doll, Barbie's less fashionable, less popular, still plastic cousin...
Lammily, Barbie’s less fashionable, less popular, cousin…

Lammily is supposed to mirror the proportions of an ‘average’ 19 yer old. She’s chunkier than Barbie, for sure, but still seems to be the average proportions of a slim 19 year old, if you ask me. Lottie is modelled on the proportions of a 9 year old, but with a bigger head to enable more ‘hair play’.

I didn’t really imagine then that Mattel, makers of Barbie, would manufacture a curvier doll. Who would have!?

So what happened next?

Since that time, Lammily seems to have become somewhat a recluse. I couldn’t find a UK retailer for her, just a few ‘first edition’ dolls listed as collectors items on eBay. To be honest, she always seemed duller and less fun than Barbie, with fewer outfits and scenarios. Understandable since she was decades behind in terms of accessories and marketing etc. but there was never any chance of her catching up if she didn’t seem to be any fun! Who wants a dull doll to play with?

Activist Lottie - complete with placard and loudhailer. A more realistically proportioned alternative to Barbie
Activist Lottie – complete with placard and loudhailer! You go girl!

Lottie, however is definitely still going strong, and seems to be having plenty of fun, with a variety of skin and hair colour options, and lots of accessories and outfits available to facilitate imaginative play, from astronomy, to zoology. My personal favourite has to be ‘Activist Lottie‘ complete with placard and loudhailer!

So, whether Mattel heard the criticisms, or saw the rising success of Lottie who, let’s be clear is still a very small player in the market, who knows?

Rise of the Plus Size Barbie – the Fashionistas range!

Rise of the Plus Size Barbie! The Fashionistas range - tall, petite 'curvy'...
The ‘Fashionistas’ range including new ‘curvy’ Barbie!

In 2016, Mattel did the unthinkable. They introduced the ‘Fashionistas’ range of Barbies with different proportions. This seismic shift even got them a Time magazine cover!

‘At last!’ I thought. Some diversity emerging in the Barbie doll market – now young girls can play Barbie parties where all the attendees aren’t just identikit featureless Melania Trumps in different outfits, distinguished only by who’s had their toes bitten off, or who’s got regrettable marker-pen make up!

But I’d forgotten my earlier prediction. Do girls actually want to play with a new ‘curvier’ Barbie? Some researchers decided to find out.

Plus Size Barbie – what the researchers discovered

Their article is published in the September issue of Science Direct; yes, I know it’s only July! Science is the future, don’t forget! The title probably tells you everything you need to know at a glance:

You can buy a child a curvy Barbie doll, but you can’t make her like it: Young girls’ beliefs about Barbie dolls with diverse shapes and sizes by Jennifer Harriger et al”

They worked with 84 girls between the ages of 3 and 10, asking them to assign positive and negative traits to the various dolls. Their findings make sad, but not unexpected reading.

Results generally demonstrated greater negative attitudes towards the curvy Barbie doll and more positive attitudes towards dolls with a thinner body size/shape (i.e., original, tall, and petite dolls). Girls identified the curvy Barbie as the doll they least wanted to play with. Additionally, girls with higher levels of body dissatisfaction demonstrated less negative attitudes towards the original doll.

Overall, findings demonstrate a preference for thin bodies and aversion towards larger bodies among young girls. Further, findings suggest that the simple availability of body-diverse dolls may not be a powerful enough intervention to overcome harmful weight attitudes, and highlight the importance of continued efforts to encourage exposure to and acceptance of diverse body shapes and sizes in young children.

Jennifer A.Harriger, Lauren M.Schaefer, J.Kevin Thompson, LiCao

Sigh. maybe I was right in the first place. Perhaps we shouldn’t buy them dolls at all and give them better things to play with!?

Girl playing with Quadrilla marble construction toy
Quadrilla Marble Maze
Hermione Granger Dressing Up Outift
Hermione Granger Dressing Up Outfit
A girl and a boy playing with Gears! Gears! Gears! Movin’ Monkeys Building Set
Gears! Movin’ Monkeys Building Set
Girl constructing with a "Fantasy forts construction set"
Fantasy Forts Constructions Set

Help us with our research!!

Exciting news! For a few months now, I’ve been working with an organisation called Parenting Science Gang – we are a group of mums (there may be a few dads, but it’s mostly mums) doing research into what interests us – and we’ve got a special Big Birthas Parenting Science Gang Group.

We’ve discussed what research we’d like to see, researched what science and data is already out there, and we’ve interviewed other scientists to get their views on what we should research and how to go about it, and now we’re finally ready, have received ethics approval, have volunteers ready to send out, receive, and analyse questionnaires – all we need are a few individuals who fit the criteria we’ve set to answer our email questions!

Could you help us?

We need people who:

  • are over 18
  • have had 2 or more pregnancies where their BMI was over 29
  • whose youngest child is under 3
  • whose births took place in the UK
  • are happy to be interviewed by email about their experiences

If you can say yes to all three, please follow this link for more information and sign up here to be interviewed –

http://parentingsciencegang.org.uk/experiments/big-birthas-research/

your thoughts could really make a difference!

Research on Social Networks for Pregnant and New Mums!

Hi lovely peeps!

I’ve agreed to share this information about a research study that’s relevant to BigBirthas who are pregnant, or gave birth 6-12 months ago.

I’m not involved with developing the research, nor am I a participant – had my babies too long ago now! But I’m always interested to hear of new research involving bigger mums and plus-size pregnancies. Certainly this one is taking an interesting new line in the ‘weight management’ sphere, might be interesting!

There’s more info about the study on the University of Glasgow website:

Maternal obesity is a growing public health issue, with one in five pregnant women classified as obese in the UK. Interventions to date have had modest impact on clinical outcomes. These have mainly focused on individual behaviour change and have methodological limitations.

There is growing evidence on the importance of social networks for obesity-risk behaviours. There are few trials using social networks to reduce maternal obesity and very few qualitative studies exploring social network influences on weight management in pregnancy and postpartum.

As part of this PhD study, we will explore the role of social networks in the development and maintenance of obesity in pregnancy and postpartum. We will also review current evidence related to interventions to help women manage their weight during pregnancy and/or postpartum, and take learning from this to inform the development of an intervention. The study aims to:

  • Complete a systematic review to investigate available interventions using social networks for weight management in pregnant and postpartum women

  • Explore the weight management experiences and the influences of social networks of first-time pregnant and postpartum women

  • Explore the social networks of interview participants to try to understand how these might be used to help them in their weight management attempts

  • Develop initial ideas for a theory-based intervention to support weight related behaviour change for pregnant and postpartum women that are overweight or obese.

     

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