Sized Out: Fatness, Fertility Care, and Reproductive Justice in Aotearoa New Zealand

Abstract

Access to publicly funded fertility care in Aotearoa New Zealand is determined by clinical priority access criteria (CPAC). The CPAC for infertility is designed to ration public access to treatment based on those most likely to benefit. Included in the criteria is the requirement that the body mass index (BMI) of the person seeking fertility care be within the range of 18–32 kg/m2 automatically excluding fat people without regard to their broader health and infertility context nor to variations in mean BMI amongst different ethnic groups. This chapter presents a critical discussion about the implications of the CPAC drawing on affective-discursive analysis of qualitative interviews with six ethnically diverse women who were unable to access fertility care because of their size. Key themes are explored including challenging the conflation of fatness with poor maternal health; fat shame and stigma and its effects; and the broader gendered, raced, and classed implications of the CPAC in terms of who can access assisted reproductive technologies and form families. We conclude by drawing on the principles of reproductive justice to insist on assisted reproductive technology policy (and funding) that decolonises assisted reproductive technologies and is fair, just, and inclusive.