Rhonda Fellows, Doula

Approach to care

• What does it look like for you to provide care to patients in larger bodies? How is, or isn’t, your approach different from how you care for patients in smaller bodies? If you work with children, how is or isn’t your approach different when working with children?

  My approach is similar, realizing we all need to prepare our bodies for birth: daily movement, eating from multiple food groups daily, finding body work like chiro and PT etc. What is different from some other providers is the understanding that pregnancy is NOT the time to lose weight and over exercise. My focus is not weight loss but teaching about some of the muscles and ligaments they can focus on stretching and releasing tension. Movement is always about what each body can do without causing pain. Talking about eating colorful meals whenever possible- NOT talking about weight or calories.

• What is your perspective on how weight is or is not related to health?

  Sometimes there's a correlation however, many of are overweight and healthy. Those topics don't always need to be talked about together. You can be pregnant, overweight and not have any complications just like you can be small and high risk.

• Finish this sentence: “Fat people are…” 

  Human!

• How do you, your clinic, and the healthcare system you work in use BMI (i.e BMI cutoffs for accessing certain services, BMI on charts and printouts, etc)? Is this flexible?

  NA as a doula

• If a patient declines to be weighed, how do you and/or your staff proceed?

  As a doula, if my client has anxiety around being weighed, I ask them what they would prefer to do. Some don't get weighed and others may want to report a weight they do at home or in clinic when no one is looking.

• If a patient declines to discuss weight loss, nutrition, and/or exercise, how do you proceed?

  As a doula, I do talk through meals and movement as clients are willing but it is never in weight loss or diet. My response to anything a doula client declines is to ask what is their plan. So many people have already thought this through but few seem to ask their thoughts. Just going through a script can be dangerous for the mental health of the client.

• What does the physical accessibility of your office space look like? What kinds of accommodations are present for people in larger bodies? Are there things you wish were in place that are currently not? 

  I do not have any office. My visits are where the client would like to meet (often the home) or virtual.

• What do you do to allow fat people to feel comfortable and welcome in your office? 

  NA

• If you’d like to use this space to talk about any identities (gender, race, size, sexuality, etc.) you hold and how this relates to your care, please do so. 

  I am a fat, black, cis/het doula. When I go to clinic appointments, I do not get weighed because I weigh myself at home a few times a year. I know I've gained weight and don't need them to discuss that with me. I monitor my health and get bloodwork regularly to make sure my health is intact.