4 - (SYM 118) I Hated Being Treated Like I Was Broken: Body Image and Perinatal Healthcare Experiences Among Postpartum Women Across the Weight Spectrum

Weight stigma (i.e., negative perceptions and stereotypes based on weight) is prevalent and harmful within healthcare systems, such that individuals in larger bodies are often misdiagnosed, provided with unwanted weight loss advice, and even refused care based on their weight. Research shows that weight stigma perpetrated by health providers can exacerbate pre-existing mental and physical health concerns; however, weight-related experiences during obstetric healthcare (OBH) are understudied. The perinatal period represents a critical period for changes in mental health, such as distress related to body-related changes. Thus, the current study (N = 154 postpartum women; mean age = 31; 84% White) explores how OBH impacts pregnant individuals’ body image, and how these experiences may differ as a function of weight status (n = 55 with body mass index [BMI] > 30; n = 49 with BMI of 25-30; n = 50 with BMI < 25). For this study, two independent coders used Structured Tabular Thematic Analysis to code participants’ brief qualitative responses to questions about body-related changes and healthcare experiences during pregnancy and postpartum, and examined differences in theme endorsement across the weight spectrum. We identified four themes related to factors impacting perinatal body image: comparison making (21.4%), social acceptability (22.9%), birthing experience (6.6%), and stage of pregnancy (24.3%), and four themes for response to body changes: empowerment (19.7%), self-criticism (45.1%), desire to change one’s body (25.7%), and acceptance (18.0%). Regarding healthcare needs and suggestions, themes identified included: increased personalization (9.2%), better accessibility (7.7%), reduced focus on weight (20.3%), honest expectations (11.4%), providing resources and referrals (9.7%), more nutritional guidance (17.4%), and improved assessment of mental health (11.1%). Differences in theme endorsement across the weight spectrum were identified and will be discussed in this presentation. For example, the need for more nutritional guidance was endorsed significantly more frequently by participants with higher weight (25%) than lower weight (8%), X² = 6.07, p < .05. Overall, these findings suggest that body image and healthcare concerns are common among pregnant individuals, especially those with higher weight; however, there is no one-size-fits-all solution. Quotes from participants will be shared to better illustrate common experiences, and implications for improving OBH for individuals of all sizes will be discussed.