You’re listening to Burnt Toast!

I’m Virginia Sole-Smith, and today my guest is Nicola Salmon.

Nicola is a leading voice for fat folks seeking fertility support, and author of the book Fat and Fertile. As a fertility coach and fat activist, Nicola works to challenge the fertility industry’s entrenched weight bias and empower marginalized folks to take control of their reproductive health. (You may know her from Instagram.)

The intersection of anti-fatness and infertility is a story I've been covering for over six years now, and depressingly, the situation seems to only be getting worse. I hear from so many of you all the time who are navigating fertility treatment and encountering doctor after doctor who all tell you to lose weight before they'll consider helping you.

As I wrote for The New York Times in 2019, this is pretty clear cut medical discrimination—and yet we haven't made much headway in getting clinics to change these policies. If you want more on this whole conversation, check out episode 29 of this podcast, where I talked through all of my reporting and the research on weight and fertility, as it stood at that point. And then go listen to episode two of Cult of Perfect, where we explored the fat mother narrative—and the kind of healthcare that fat moms, and fat pregnant people, get.

PS. If you enjoy today’s conversation, please tap the heart on this post — likes are one of the biggest drivers of traffic from Substack’s Notes, so that’s a super easy, free way to support the show! And, make sure you’re following us (it’s free!) in your podcast player! We’re on Apple Podcasts, Spotify, Stitcher, and Pocket Casts! And while you’re there, please leave us a rating or review. (We like 5 stars!)

You’re listening to this episode because you value my input as a journalist who reports on these issues and therefore has a lot of informed opinions. Neither my guest today nor I are healthcare providers, and this conversation is not meant to substitute for medical or therapeutic advice. AND: If you are in the thick of your own fertility journey, and today’s episode doesn't feel good for you to hear, please take good care.

Episode 160 Transcript

Nicola

I am what I call a fat positive fertility coach, which means specifically that I support fat folks who want to get pregnant in bigger bodies. So that involves lots of different things: Working one-to-one with people, doing courses and basically just getting lots of information out there which fat folks might need, and then navigating the healthcare system when they are looking to get pregnant and maybe not finding that support with their doctors or their clinics. Just doing everything I can to make sure that fat folks have everything they need to get pregnant and don’t feel guilted or shamed or judged in the process.

Virginia

Which is all too common. We know that anti-fatness shows up in every realm of healthcare and fertility seems to be a particular hot spot. I’m curious: Why do you think fertility care is where we see so much medical anti-fat bias?

Nicola

People want this so bad—growing their families, having babies. And I think there is often this lack of control that we have around the process. We cannot control when we ovulate. We cannot tell our bodies, “okay, now’s the time! Go, go, go!” 

I think because of that lack of control, people are desperately seeking other ways of controll