Episode 45 - Nicola Salmon: You Can Be Fat and Fertile
Nicola (she/her) is a fat positive fertility coach and author of the book Fat and Fertile. In today's conversation, Nicola and Josie touch upon how body size does not dictate health or fertility, how fat folks can advocate for themselves in medical settings and practice self care, as well as unlearning the harm caused by diet culture and fatphobic biased studies that are at the core of the medical system.
Content Warning: Brief mention of witnessing homocide.
[ID: A beige background and orange semi-circle. Text reads: The Intersectional Fertility Podcast Episode 45: Nicola Salmon @fatpositivefertility and Josie Rodriguez-Bouchier @intersectionalfertility.]
Visit Nicola's Website, and follow Nicola on Instagram.
Purchase a copy of Fat and Fertile, and listen to the Fat and Fertile podcast.
Episode Transcript:
Disclaimer: This is an automatically generated transcript edited to be more readable. It may not be 100% accurate.
[00:00:00] Josie: I am Josie Rodriguez-Bouchier, and this is the Intersectional Fertility Podcast, where ideas and identities intersect to deepen our understanding of fertility and ultimately our Whole Selves.
[00:00:32] Nicola is a fat positive fertility coach and author of Fat and Fertile. She helps fat folks navigate getting pregnant in a weight obsessed world, and advocates for change in how fat people are treated whilst accessing help with their fertility. Nicola uses her unique fat positive framework to support people in finding their own version of health without diets advocate for their bodies, relearn how to trust their body, and believe in their ability to get pregnant.
[00:01:08] All right. Welcome to the podcast everyone. I am so excited to introduce a very special guest today. Welcome to the podcast, Nicola.
[00:01:17] Nicola: Thank you for having me, Josie. I'm super, super excited to be here.
[00:01:22] Josie: Oh, I'm so excited to have you. So will you share with us your pronouns and where in the world you're joining us from today?
[00:01:29] Nicola: Yep, my pronouns are she and her, and I am calling in from the UK, specifically a county called Gloucestershire which is between England and Wales. I live in a forest, so it feels very special surrounded by trees. It's a beautiful, beautiful place.
[00:01:44] Josie: Oh my gosh, oh, that sounds magical. I love it.
[00:01:47] Nicola: It does feel like being surrounded by fairies.
[00:01:50] Josie: I bet. I've been to Wales and I've been to England. Wales did feel really magical to me, yeah.
[00:01:57] Nicola: It's a beautiful, beautiful place.
[00:01:58] Josie: It is. So will you share with us your story of what led you to become a fat positive feminist fertility coach? And then also I read that you're trained as an acupuncturist, which I didn't know.
[00:02:11] Nicola: I know, right? I keep that one hidden. So yes, absolutely. I mean, acupuncture's been a huge part of what got me here. It's quite a convoluted journey. So I was, diagnosed myself with polycystic ovarian syndrome when I was 16. That is, gosh, how old am I now? 22? No, yeah, 22 years ago. And so back then there was no real internet.
[00:02:37] Like we didn't have the same resources that we have now. I had no idea what it was. I had never heard anybody else who talked about having it. So it was just this really unknown condition, and the doctor told me that when she diagnosed me, I wouldn't be able to have children. So I took that at face value.
[00:02:54] She gave me the oral contraceptive pill to "cure" my symptoms, in quotes and that was my diagnosis. That was my treatment plan. So I took that away and, it did shape me as a human. It impacted my self-esteem, I thought I was unlovable because I would never be able a parent. I dieted as you know, I was told to do. You take these kind of doctors in their position of power, and I believed what she said.
[00:03:28] So I spent a lot of my teens, a lot of my twenties dieting, trying to make my body smaller. It sometimes worked for the short term, but never for the long term, and I often always regained the weight and more. And then it was when I was in my early twenties that I was working at a hospital. I trained as a clinical scientist and I experienced this traumatic incident when I was living in London and it changed my life.
[00:03:56] So this guy got shot on the street outside where I was living, and I got PTSD, post-traumatic stress disorder from it. So I accessed care with my doctor, I was given some cognitive behavioral therapy, I was given some antidepressants, but nothing was really helping me.
[00:04:14] I struggled to go back to work and in the end I was walking past a health clinic, decided to go in. And you know, asked, what do you recommend? What could help me? And they recommended acupuncture. I had never tried it, I didn't know anybody else who tried it, but it was just one of those things that I was like, okay, I guess there's no harm.
[00:04:37] I'm gonna give it a shot. And it transformed my life. It had such a positive impact on my mental health, on my physical health. I just felt like it was magical. The scientist in me was like, well, why does this work? You know, like, what's going on? How does this happen? So pretty much maybe like a few months after I'd had that experience, I signed up to train as an acupuncturist.
[00:05:05] There wasn't a lot of thought into it. Like I didn't do my research. I literally just found a college in London that was training acupuncturists and signed up for this four year course. So that's what I did. And the college where I trained, trained you as a naturopath as well, so they kinda worked together as a pair.
[00:05:25] And yeah, that kind started me on my journey to supporting folks who navigating fertility because when I was a trained acupuncturist, I went out in the world as a newbie and the clients that came to me were people who were struggling with fertility. It was a big interest of mine because I had my own issues with my polycystic ovarian syndrome and hormones, and I expected that to be a problem for me.
[00:05:49] So that's what I specialized in. That's what I started to help folks with. And it was through that work that I realized that there was a huge component that I was missing from my own acupuncture training around supporting people emotionally. Which is why I end up training as a fertility coach.
[00:06:05] And that kinda sucked me into the world of online business and growing like a platform and you know, all the stuff that I do now. So that was kind of where the fertility part came in, but it was through my own journey with my own body that I discovered feminism very late actually. And also kinda the fat positive movement and fat activism.
[00:06:29] So all this time that I was training and doing my acupuncture, I'd met my partner. We decided to get married, so we got married and then we decided that we wanted to start trying to get pregnant. And I was still in this very much, this diet rollercoaster. I was still convinced that I had to be smaller in order to get pregnant.
[00:06:50] But I wasn't, you know, I had my PCOS, I still had a hundred plus day cycles. Like my cycles were very, very irregular. So we weren't taking contraception. We weren't, you know, taking any precautions to not get pregnant. And it just happened. And I was totally shocked and I spent so much of that pregnancy, terrified that something was gonna go wrong, because that's what I was told.
[00:07:15] We're told that people in bigger bodies, you know, experience higher rates of pregnancy complications. So I was terrified through that whole pregnancy, but nothing happened. It was completely unremarkable. The birth was fine, like everything was just boring and ordinary. Nothing happened, which was fantastic.
[00:07:33] But you know, my brain wasn't thinking that way. My brain was like catastrophizing everything, because that's what I expected. And when my son was born and he was about, you know, between six and 12 months, it was really that point for me that was like, I am exhausted. I have this tiny human. I cannot even begin to think about changing my body and dieting and, you know, all this and this.
[00:07:59] The pressure is so high on new parents as well. Going through that to like shrink your body back to like pre-baby. It's just wild. And it was, you know, I just caught myself like thinking about how I talk about my body and how I talk about food and I was like, no, I don't wanna pass this onto him.
[00:08:17] I don't want him to talk about his body this way. And I don't want him to have this relationship with food. So. That was when I made this like pact with myself, that was when I was like, no more. I am done. This has not worked. It's not worked for me. And I refused to continue to do the same thing over and over again.
[00:08:36] So I said, no more dieting. I'm not gonna weigh myself again. And I stuck with it. I haven't done either of those things since. I haven't needed to. And obviously there are small, you know, there's a chance in the future that I might need to weight myself. And, you know, as I become more familiar and more comfortable and more confident in my body, then the number on the scale has less and less power.
[00:09:03] So I'm hopeful that one day that I'll be able to step on a scale and it won't mean anything at all to me. So maybe I will eventually one day, maybe go back to that practice out of curiosity and see what happens. But that was the beginning of my fat acceptance journey, and I was lucky enough to find so many other incredible fat people on the internet talking about this and talking about how you can be fat and happy.
[00:09:28] Because I was convinced as soon as I've made this pact of like, oh, well that just means I'm gonna be miserable for the rest of my life because we're sold this idea that, you know, to be happy, you need to be thin, white, you know, blonde hair, big bum, you know, all of these kind of beauty norms.
[00:09:45] And so for a long time, it took me a long time to build that up and to learn more about what fact activism is, how that intersects with my feminism. Learning more and more and more about marginalizations and how that impacts fertility. So they kind of collided at some point in my business about five years ago, and I realized that nobody was talking about how we can help fat people get pregnant.
[00:10:12] Everybody was just saying, lose weight, lose weight. Go on this diet, go on keto, go on this, do that. And I was like, I've just gotta start talking about this because I can't not talk about this anymore. It was such an important part of my own personal journey and my own work that I just, you know, in a parallel universe, I would be this person who was struggling to get pregnant and it didn't happen for me that way.
[00:10:36] But I was expecting it to, and I knew that if I was that person that it would be very difficult to access care and support that I needed, so, I just decided that this was gonna be the thing that I was gonna do because my gosh, people really need an alternative to, you know, supporting themselves with fertility, without dieting and weight loss, and all the stigma that's associated with being a fat person in our world.
[00:11:03] Josie: Yes. Oh my gosh, yes. I was so excited to find you and your work, because I see this play out so frequently with my patients, and it is just, it makes me feel so infuriated the way that they are treated and the messages that they're receiving from healthcare practitioners. And like you said, like that's a power dynamic that is uneven.
[00:11:27] And so then people take that more seriously cuz it's from a quote unquote doctor. So, yeah. I'm so grateful that you're doing this work, so thank you. And like you said too, it's like, nothing inspires us to change more than like not wanting to pass it on to the next generation, right?
[00:11:46] Nicola: Oh yes. That is a big motivator and it's something I love to think about. You know, the fact that for me and for every person that I work with, we are breaking those chains and we are not passing on diet culture to the next generation. And those ripples feel really powerful.
[00:12:03] Josie: Yes, they are. I just got goosebumps. I love that.
[00:12:07] So, and you kind of mentioned your pact that you made to yourself. I loved reading the part in your book, that I have right here. It's called Fat and Fertile and we're gonna talk more about it. So, so good. I love the part where you wrote that you smashed your scale to smithereens. Will you talk about that experience and what that was like?
[00:12:28] Nicola: Oh yeah, it was so powerful yet, I mean, it was incredible to have that power of like this item, which has had so much power over me for so many years of my life to determine whether I had a good day or not, if I was a good person or not. You know, I'd put so much of the value of who I was as a human being into a number on that scale.
[00:12:52] And it felt so liberating to literally smash it onto the concrete. Unfortunately it was made of glass so it meant, it meant that there was hundreds of pieces of glass in my back garden and I kept finding them from months and months afterwards. So I didn't really think it through, especially cuz I had a toddler.
[00:13:15] But it was well worth it. It felt such, it just felt like this huge weight had been lifted because I can't even count the number of hours, the, as much energy, time, money that I must have spent through those formative years of my life thinking about food and thinking about my body and how I can change it, and how much I hate it.
[00:13:40] Like, it makes me so sad for younger Nicola that she didn't have the opportunity to do other things with that time and energy and money. It just, yeah, it really makes me sad that that was wasted. But on the flip side, it brought me to here and I'm so grateful to be doing this work and to be, you know, have the honor of supporting folks as they're going through such a vulnerable stage of their lives.
[00:14:09] Josie: Yeah, totally. Totally. I think that you really hit the nail in the head when you described in your book that when someone really starts to stray from dominant cultural view, especially of quote unquote health and quote unquote happiness, it makes people really question their own values and choices. Like you said, it really freaks people out.
[00:14:30] Have you experienced this reaction from people or healthcare practitioners in your life? I'm wondering, and if there's any stories around that that you'd like to share?
[00:14:39] Nicola: Absolutely. So I think for me it was at the very beginning of this kind of, when I was starting to do this work that I had the most experiences around other people's reaction to my work.
[00:14:53] And a lot of it was not friends, but maybe peers that I had. Both with my colleagues in terms of acupuncture, that was mainly what I was still doing at the time. And other healthcare professionals who I was in the field with who we were on friendly terms and as soon as I started talking about this idea that maybe we don't need to recommend that people need to lose weight, then.
[00:15:19] It was a bit of a pile on really. I'm gonna be honest. You know, the messages that I received about how unethical it was that I was talking about this and how all of the research supported this and that was harming people. It was pretty wild. Because I was still quite new it, you know, I kind of went back in my shell a little bit and it's been a, you know, an in and out journey for a while there at the beginning because I didn't feel confident talking about it.
[00:15:46] I didn't have the same research that I've done that I've got now. You know, there's hours and hours that I've spent like, picking through the research with a fine tooth comb and really trying to figure out the pieces of the puzzle because, well, A. Research isn't the thing that we put it all onto this pedestal to be, because it's done by people who live in this world who also have the same biases as so many of us do.
[00:16:11] And it's done by a lot of weight loss companies. Like there are, you really need to dig into who's paying for the research to be able to kind of decipher who's benefiting from the results of that research and what it says. So there's nobody doing fat positive research because there's nobody gonna profit from it.
[00:16:34] It's taken me, you know, a long time and it's still taking me time to kind of unpack where these messages come from, why doctors believe these things and how. We can use that research as a tool for ourselves rather than as a weapon against us. It's been a wild ride and the comments that I got from practitioners and health providers really made me question myself and really made me question whether I was harming.
[00:17:01] And the more I've done this work, the more I've come to realize that being in this space, doing this work, I absolutely am gonna harm folks because I can't know everything. I do not know the lived experience of queer folks, trans folks, non-binary folks, Black folks navigating this space. All I can do is my best and show up and keep showing up.
[00:17:22] And keep making sure that I am listening when folks call me in, when folks, you know, advise me of things that are not helpful and are harmful. But yeah, it was challenging and it continues to be challenging, but I take that as a sign that I'm doing the right work and the important work because sometimes we need to be challenged to keep doing the work that needs to be done.
[00:17:48] Josie: Right. To have an even stronger conviction, I would imagine it's like kind of inspiring to be like, okay, I'm gonna go find more, you know, more to back this up and, and dig deeper and yeah.
[00:18:00] Nicola: It's really fuel to the fire because as soon as somebody comes at me with an argument and if I don't have an answer, I'll be like thanks for raising that for me let me go away and do some research. And then I'll be beavering away behind the screen going okay, well this is what this research says, and this is what this research says. How can we piece that together?
[00:18:17] And what does that look like with weight bias? And what does that look like for the lived experience of fat people and how would that change things? And yeah. It's a blessing and a curse, I think. I'm quite a sensitive soul, so when, you know, when I receive criticism, it sometimes takes me a little while to calm down my nervous system and realize that it's not a personal attack on me and that I can manage this, I can deal with this and I can move forward with it.
[00:18:44] Josie: Totally.
[00:18:45] Nicola: A lot of personal growth.
[00:18:47] Josie: Yeah. Oh, I can totally relate to that. Yeah, for sure.
[00:18:51] So I would love to talk more about your book and the framework that you've developed. So, I love when you say in your book, thin does not equal fertile. I underlined that a million times. I was like, yes, I agree.
[00:19:05] I've certainly seen this to be true in my clinical practice and I've said it before on this podcast, that I actually, the most challenging fertility cases that I work with are patients that are too thin. Cause that can really pose a lot of problems fertility wise. And I'm wondering, and you've kind of mentioned the research, but will you talk a little bit about how you've been able to come to that conclusion? Thin does not equal fertile, and if there's any research around that that you'd like to share.
[00:19:32] Nicola: Yeah, absolutely. So my first realization was my own body because I got pregnant with both of my boys really easily. My first, as I've already talked about, we weren't quote unquote trying. It happened for us when we weren't on contraception and the second one, my son was a year old. I talk about him as an immaculate conception because my son was in hospital when he was in his first birthday, and I do not remember, in that period of time when he was not very well ever having sex.
[00:20:04] So, they were both super easy. So for me, in a fat body, That was the only, the only evidence that I needed that thin does not equal fertile because I was a fat person getting pregnant, having no complications, and having wonderfully healthy, if not very loud children out the other end. And that was the seed that was planted in me for like, well, if it was so easy for me with PCOS with these a hundred plus day cycles.
[00:20:34] Why are we talking about this like it's a problem for all fat people? Fat people aren't a monolith. How can we say that fat people have more difficulties getting pregnant and it's the fat in their body that's the cause? When the fat on my body didn't cause that, it didn't make any sense to me.
[00:20:52] So, In terms of the research that I found, like I mentioned before, it's almost like a jigsaw puzzle. There are a lot of pieces that kind of need to go together to really kind of pin and understand what's going on. But a lot of the research that kind of looks at the relationship between BMI, body mass index, and fertility, starts with this baseline assumption that fat is bad.
[00:21:22] If you read the papers, you can immediately get a sense of where the author is at because they'll go into the whole quote unquote obesity epidemic that's taking over the world and how we know that fat is a billion times worse than anything else you could possibly be suffering from.
[00:21:40] And you know, you can tell by the. By the introductory paragraphs, how they see fat people and how they see the world. Instantly with those biases as a scientist, your science is gonna lean a certain way. And what we're seeing is we're seeing correlation. So we're seeing as one goes up, the other goes up.
[00:22:01] And these scientists are assuming that that is causation, as in one is causing the other. And we know that, you know, this is fertility, you know, this is research methods 101. Like we know that correlation does not equal causation. And what they are looking at is that they are saying, okay, well we see this is increasing.
[00:22:19] We see we're gonna make the assumption that this is causing this when actually the evidence doesn't show that overwhelmingly, you know, it's not all the evidence that shows that. And what none of the research ever takes into account, is the lived experience of fat people. And that can show up in a number of ways and impact their fertility.
[00:22:41] So the first one is so many people have got a history of dieting. And a history of restriction. And a history of not giving their body the fuel and the nourishment that it needs, in order to feel safe, in order to get pregnant. And this just doesn't, this doesn't just apply to fat people. This applies to so many people who are within diet culture, that they are not getting the nourishment, they are not getting the calories, they're not getting the food intake that they need in order to let their body thrive.
[00:23:11] And fat folks have, you know, a history of this yoyo dieting of going on diets, multiple times of their weight going up and down, and this phenomena of weight cycling as it's called in the research. Has been shown to impact metabolism. It's been shown to increase our inflammation levels, to increase our stress hormones, like we can measure a very physiological result of, of experiencing this yo-yo dieting and this weight cycling.
[00:23:39] And then the second kind of big part of that is how people in bigger bodys experience healthcare. So both internally in their own brains, if they've had bad experiences with doctors in the past, that's gonna definitely increase the likelihood of them not wanting to go and see their doctor and to delay them to access treatment.
[00:23:59] Delay accessing alternative therapies like acupuncture. Like often people will be too frightened in case they like worried about breaking the bed or worried about being fat shamed. It really reduces the amount of care and support that they feel they can access. And then, you know, that then shows up in real life.
[00:24:18] If they do eventually go and see their doctor, their doctor will often say, come back in six months when you've lost X pounds or X stone or X kilos. So therefore, Further delaying any potential tests that they might need, any potential treatment that they might be able to access. And we know time is a factor.
[00:24:36] Obviously it's not this cliff that we fall off when we get to age, but we know time influences fertility. So the longer people are left without that care, support and help, the more likely it is that if something is going on, something is wrong, then it's gonna be more difficult for them as they're older.
[00:24:53] So, there's many different pieces as to why this correlation might be there. If it is there. That I'm not taking into account with the research and it's got nothing to do with the fat on my body. It's to do with how fat people are treated within our society.
[00:25:11] Josie: Totally. Oh my gosh. Yeah. Thank you for explaining that so clearly.
[00:25:16] That makes total sense to me. Yeah, absolutely. And I also just want to pause and acknowledge how anti-fat bias in the fertility world, world is amplified when someone is also queer, or trans or non-binary and is amplified again when someone is Black, Indigenous or a Person of the Global Majority.
[00:25:36] And then of course, there's all sorts of other factors that negatively influence how someone receives care, like ageism and ableism. And if folks are in a polyamorous relationship or an expansively structured family system. If they're an immigrant, if they're incarcerated, you know, on and on and on.
[00:25:54] It's like all these different, the list is long.
[00:25:58] Nicola: The list is long in terms of who can't, and who is told they shouldn't be able to access this kind of care and support.
[00:26:06] Josie: Right, right. Exactly. So will you talk about the fertility framework and how do you say it? Is it fat-ive? How do you,
[00:26:14] Nicola: Fat positive.
[00:26:15] Josie: Fat positive, okay. I was like, I wonder if you pronounce the VE at the end?
[00:26:20] Nicola: No. Oh, absolutely. No, it's fat positive. And. In the kind of certain senses, like my work is fat positive. That's why I pitched it. So yeah, I absolutely can describe it. So the F in FAT positive stands for Formulate, and what that means for the people that I work with is that we are looking at a way that we can redefine the way that they focus on goals and the way they focus on health.
[00:26:45] So many folks, The only health goal that they've ever had is to lose weight, or to make their body smaller. What we do is we explore where they are now, where they want to be in terms of their health. Maybe that's having more energy, feeling stronger in their body. We're looking at things that are gonna have a real world impact on their quality of life, how they feel in themselves, and take tiny, tiny, tiny baby steps as to kind of where they want to be.
[00:27:11] But also looking at what their internal instruction manual is saying, like, why they do the things they do, what old diet rules have they, you know, still got ingrained in their head and how to work through those. So we're really completely switching how they think about their health and how they want to take action on their health, and looking how we can do that differently.
[00:27:34] So it often includes loads more rest. Thinking about feeding them enough. Like I don't care what you put in your mouth, as long as you've given your body enough fuel and enough food. Finding ways to move in a really supportive way because so many folks use exercise as punishment and have a really negative relationship with movement.
[00:27:53] So finding ways that they can get the benefits of movement, which there are many, many, many of, but in a way that feels safe, in a way that feels secure in a way that doesn't bring them any more harm. So that kind of, that piece of the puzzle. So they feel like they're taking action, they're taking control.
[00:28:08] They still have that sense of doing something. But without all the restriction, without all the shame, without all the judgment. And it's just on their own terms, at their own speed.
[00:28:18] The A is for advocate, so this is a huge part of the work that I do, is giving people tools, research. We talk through research, we look at clinics. We find all the ways that we can to influence the care that they receive and advocate for their bodies and to access any tests, any treatment, any support that they might need through getting pregnant.
[00:28:41] Then the T is the trust. So often for folks, you know, most folks who've been brought into this world, we've been told that we can't trust our bodies, that we can't trust our hunger cues, that we can't trust what our body is trying to tell us, that our bodies are broken.
[00:28:57] There are so many stories around how we feel like our bodies are failing us in so many different ways if they don't look a certain way or act a certain way. So it's about rebuilding that relationship of trust with our bodies and believing that they are totally capable of getting pregnant and having and sustaining a healthy pregnancy and just having your own back.
[00:29:18] So, no matter what happens on that experience through that journey, that you know that you are doing your best, your body is doing your best, and you are both on the same team.
[00:29:27] And then the positive bit is all about kind of positive mindset. So it's not like toxic positivity, everything has to be hopeful and joyful all the time. It's more about digging into the beliefs that you have around being a fat person who wants to get pregnant and really examining where those beliefs come from.
[00:29:46] What they mean, how they show up in your day-to-day life and the things that you do, and then deciding whether you want to still believe that or whether you want believe something else.
[00:29:54] And looking at how that could impact and change not only your physical health, but your mental health and how you navigate that experience. So all of those different pieces kind add up together to really give fat folks a really supportive and caring experience that they deserve from every single practitioner that they encounter that they don't often get.
[00:30:16] Josie: Right. Ugh, that's amazing. I feel so relaxed in my body. When you are explaining all the different aspects of that framework, it feels like, ah. Just like almost like a thank goodness that this is like being thought of and implemented and this exists in the world, you know? I think it just feels healing to even hear about it.
[00:30:37] So I would love to talk about how people in bigger bodies can advocate for and protect themselves on their fertility journey. What are some ways that people in bigger bodies can advocate for themselves and protect, their mental health, really on their fertility journey?
[00:30:53] Nicola: I think the first thing is always about kind of expectations. So, If you expect yourself to go into that appointment and talk about the research and to have compelling arguments and to be completely succinct and have a speech like in the movies, it's never gonna happen like that. We are human beings, we are learning a skill. The majority of us have never been taught how to advocate for ourselves.
[00:31:21] So we are practicing, we are learning as we go, and our nervous systems are incredibly important and they want to keep us safe. But what that often means is that when we go in stressful situations like the doctor's office, where maybe we've experienced trauma before. It's gonna want to activate, and that could mean any number of things that could mean you just freeze. You don't say anything, you just kind of sit there and nod.
[00:31:43] It could mean that you immediately burst into tears, which is what my nervous system often does, and you struggle to talk through the tears and you feel bad for crying and you know, that can take you down the kind of spiral of not feeling like you're putting your point across.
[00:31:58] You could get angry, you could just not book the appointment, cancel, not turn up. There are so many ways in which your nervous system is trying to keep you safe. So I think being really gentle with yourself and recognizing that's totally normal if that happens in an appointment, and that's totally okay is really important.
[00:32:16] Because it manages the expectation of what that's gonna look like, and it gives yourself the opportunity to be kind and compassionate to yourself so that if it does happen, you know it's totally normal. It's not your fault, and hopefully you still got something out of that appointment.
[00:32:31] And if not, there's always another time, hopefully to be able to have that conversation or to get that care. But when I'm working with folks, I kind of have a framework of prepare and care. So we do a lot of preparation beforehand in terms of making a list of questions that they want to know the answers to so that they have all the information they need to make a fully informed decision.
[00:32:53] So they can object to any potential treatments or, you know, understand a little bit more about what they need. I'll go through research with folks if they feel comfortable to do that and want to take that in with them so that they can counter any arguments that doctors might have.
[00:33:08] So often there'll be research around dieting and weight loss and how that's not helpful. We could be talking about safety of IVF, for example. That's often a common thing that comes up. So I'll give them papers where they can go in and say, well, actually the research shows this. Can we have a conversation about why this isn't appropriate?
[00:33:26] Just so that they feel that they've got that in their back pocket to be able to talk about if it feels safe to do so in the session. And just, you know, practical things like taking a bottle of water so that if you are feeling particularly stressed, you can take a sip, you can take a breath and just having all that different preparation done.
[00:33:44] And then the care aspect of that is making sure that they take some time beforehand to really plan how they're gonna care for themselves afterwards. So whether that's picking up some snacks that they love, whether that's picking a romcom or a sitcom or something that's gonna help them feel just better in their bodies after that experience and having friends or family around them, if that feels good.
[00:34:09] It's about looking at ways that they can really support their nervous system after they've been through that experience because, It's really important to recognize that this isn't work they should have to do. This is just care that they should be given already and it's not fair that they have to work harder to access that.
[00:34:24] Any way that they can make them feel like they've given themselves a big old hug is, you know, I think really important after they've been through that process to help them feel better afterwards and calm down and just yeah, really look after themselves and support themselves as well.
[00:34:41] Josie: Right. Oh, I love that. Yeah, totally and you're right, it's not fair. And to acknowledge that, but that also just feels so good to be able to envision how am I gonna take care of myself after the situation? How am I gonna be prepared? Do you ever recommend like bringing, having them bring a person with them?
[00:35:07] Nicola: Yeah, absolutely. Depending on what is gonna help them feel the most safe in that appointment. So if they've got a partner that feels comfortable to take in with them, amazing.
[00:35:18] Maybe they've got a friend who's a really good advocate or that's skilled in that's department. Even if they don't have anybody else, because often, you know, some people are experiencing and going through this on their own. You can ask for an advocate with many hospitals and many practices will offer that service.
[00:35:35] So there are options for everybody to be able to take someone in, and sometimes just having another person in that room who is rooting for you and who's gonna be there even just to hold your hand or to have the questions in front of them as well, so that you know when you are in that situation.
[00:35:54] It's really easy to miss things and really easy to misunderstand things or not have things explained properly. So, having another set of ears, another set of eyes can sometimes be really reassuring that you don't have to do it all yourself.
[00:36:06] Josie: Yeah, totally. And I remember what I was gonna say earlier about your framework that you've developed too, is that it seems like most of the work. That you are coaching people through is unlearning. Is just like this unlearning of everything we've been steeped in since day one.
[00:36:24] Nicola: Yeah, and I really wish it didn't have to be that. I often say that I want to do myself out of the job. Like I don't want people to have to unlearn all this stuff. I don't want people to have these beliefs in them that say that fat people can't get pregnant and that I don't deserve, or I'm not worthy of being a parent.
[00:36:43] That so many people do believe or have experienced. So, yeah. It's my mission in my life to make sure that I do myself out of my work and I'm no longer needed.
[00:36:56] Josie: Yes, yes. Exactly. I love that.
[00:36:59] So what is your advice to someone who's listening right now who has been told that they won't be able to conceive, or that they'll have trouble conceiving because of their weight?
[00:37:09] Nicola: I just wanna recognize that that is hard to hear when people tell you that. Whether it's healthcare professionals, whether it's the media, whether it's friends, family, whoever's telling it to you, it's hard, and I'm really sorry that. Somebody else felt it appropriate to say that to you, but it's not true and you don't have to believe it.
[00:37:34] I am my own example. Like it was totally possible for me, and there is, when I look at somebody, I cannot tell from their body whether they are fertile or not, there is no way to tell from somebody's body size how easy it's for them to get pregnant or not. We can't tell nothing from your body size, nothing about your health, nothing about your personality.
[00:37:57] It tells me nothing apart from what size your body is. And there's no reason to believe that it's gonna be difficult for you. And if it is harder, then there's no reason to believe that you won't be able to get the care you deserve. Because there are so many practitioners out there who will be helpful.
[00:38:16] And if you do struggle to find that care, there are people in your corner. I am here if you need me. There are incredible people out there doing this work to help folks navigate this experience and you're not alone. There are so many people navigating this often it feels very quiet because people don't feel confident to talk about it.
[00:38:39] They're so worried of being fat, shamed, or being told just to try and lose weight again or to, you know, often people won't tell friends, don't tell family what they're experiencing. So there are so many more people out there going through this, and you are not alone. If you need support, if you need advice, you know, I'm so happy to help however I can.
[00:39:00] Josie: Beautiful, I love that. And are you able to support folks outside of the UK since it's virtual?
[00:39:06] Nicola: Yeah, yes. I support people all over the world. US, Southern Canada, Australia, New Zealand, and a couple in Europe as well, so, that is the wonders of our world now. You know, we can really be everywhere, which is incredible.
[00:39:24] Josie: Yes. I love that. So is there anything that we didn't get a chance to talk about today that you want listeners to know about being fat and fertile?
[00:39:33] Nicola: Just that you are worthy of accessing that care. I think so often we're told that we're somehow less than folks in smaller bodies, that we don't deserve the same level of care. We don't deserve the same level of support, and that it's our fault that the responsibility for our quote unquote health or non-health, however, people perceive that is our fault and we need to do something about it.
[00:40:01] So I just want people to know that it is not your fault that your body looks the way it looks. Genetics plays a huge role in that. The way that we are conditioned in this world and the coping mechanisms we need to use in order to keep ourselves safe, play a huge role in that. And yeah, weight is non-modifiable. You can't change your weight and you are totally worthy of all the care and support that you need.
[00:40:29] Josie: I love that. Yeah, absolutely. So I love to ask this question to all my guests. In Chinese medicine, our fertility is referred to as our essence. So the more we're able to get in touch with who we really are, or our essence, the more access we have to our fertile potential and creative power. Do you have any personal practices or rituals in place that allow you to connect with your essence or your Whole Self?
[00:40:54] Nicola: Hmm, I love this question. So there's a couple of hobbies that I've started taking up in the past couple of years that really, really kind of helped me connect with who I am and just bring me so much joy. The first one is cold water swimming.
[00:41:14] Josie: Oh, wow. Oh, cold water swimming. Oh my gosh.
[00:41:16] Nicola: In the winter. It's just, there's something about it that is so magical. So where we live, there are a couple of lakes that we can go to in the winter and it just, it brings my body alive in a way that nothing else does. It's just, yeah the sensations and the, I've read, there's quite a lot of research about why it's really effective for helping folks with like depression and mental health issues, and they talk about it as this, like micro stress.
[00:41:45] So being in the cold water puts your body in this like micro stress and it means that you can't think about all those other things that your brain often consumes itself with. Like your body is really focused on this moment and being present. And it's a really, it feels like a very magical, very spiritual experience.
[00:42:03] It's just beautiful. And the other thing that I've been doing is practicing on my piano. So I don't play the piano well. I love playing music, but I'm not, brilliant at it, but there's something really magical about not being good at it. I can just show up. It's for me only, it doesn't matter if it's awful, but it just, I think it's something about really being present with it and it filling my brain in a way that means I can't be in the past or in the future, thinking about other things.
[00:42:34] It really grounds me and brings me kind of into that present moment. But yeah, I mean as well for me, something that I've been doing recently is I've been exploring a potential diagnosis of ADHD. And when I read this question that you often ask, it was for me, it really brought up this idea of the process that I'm going through, the moment of learning how to unmask.
[00:42:59] So for a lot of folks who have neurodivergencies, they learn how to present in the world and how to show up in the world and be quote unquote normal. So a lot process of me learning more about neurodivergence and ADHD has been looking at how I unpeel those layers and unpeel that masking.
[00:43:18] And that really kind of reminds me of this idea of kind of finding yourself and bringing yourself back to kind of your essence and who your Whole Self is. So yeah. A lot of exploration going on.
[00:43:34] Josie: Oh, I love that. Yeah. I love that unmasking, I mean literally of just of like showing up as you. You know, your essence, your Whole Self.
[00:43:43] I love that. Yeah. That's so, so beautiful. Oh my gosh, I can't stop thinking about the cold water swimming.
[00:43:53] Nicola: Do you have any like outdoor swimming nearby where you live? Is it something that happens?
[00:43:58] Josie: I mean, not really. I mean, there might be, I'll have to look into it actually. I mean, I'm sure there are in the mountains. I'm sure there's some cold lakes in the mountains where I am in Colorado. Oh my gosh. Yeah. And I'm sure just the aspect of being outside is an additional.
[00:44:16] Nicola: Oh yes, absolutely. You know, we, I moved to where I live now by 18 months ago, purely because I knew that I needed to be surrounded by nature. And being outside is such an important aspect of my life. Like I love being in the trees. I love being surrounded by nature and yeah, that is another beautiful thing that I now get to experience every day. I get to take my dog for his walk.
[00:44:42] Or just go into the woods. You know, we'll come across some deer, Or we've got some wild boar. It's like, you know, seen a badger. Like, it's just magical. It feels honestly like one of those like cartoons of like the English countryside where you've got all the little animals rolling around. It's purely magical.
[00:45:00] Josie: I love it. Sounds like a children's book.
[00:45:05] Oh, well thank you so much Nicola. How can people find you and support you and sign up for all your things?
[00:45:12] Nicola: So, I'm most active on Instagram. My handle is @fatpositivefertility all one word. I post on there about all the things that I do. I have just started my own podcast, which is in its very early stages, is called Fat and Fertile.
[00:45:26] Oh, awesome. So I'm kinda talking about different myths at the moment of like, fatness and fertility. I got my book, which is on Amazon, also called Fat and Fertile, and my website is nicolasalmon.co.uk and that's got all the different free things that I offer.
[00:45:42] So I have some free research people can download, some tips. There's workshops and things that I've done specifically around evidence around IVF and fatness. Just really, as many different ways I could think of to make these resources as easy for folks to access as possible, because everybody should have the opportunity to be able to access the resources that they need to navigate all the challenges that come with being fat and wanting to get pregnant.
[00:46:09] Josie: Amazing, incredible. I'll be checking out those resources for myself as well. Thank, and I just, I highly recommend following you on Instagram for folks. I just love your content. I'm always like, repost. Repost. Every time.
[00:46:23] Yes, so good. Well, thank you so much Nicola. I loved this conversation. This is so important for for folks to hear.
[00:46:33] Nicola: Oh, I'm so grateful for you too Josie.
[00:46:36] Josie: Thanks for listening to the Intersectional Fertility podcast. To get customized fertility recommendations based on your Whole Self Fertility Method element, join my mailing list at intersectionalfertility.com and get immediate access to my two minute quiz.
[00:46:53] If you like the show and want to hear more, tap subscribe on your favorite podcast platform and please leave us a review, it really truly helps.
[00:47:02] The Intersectional Fertility Podcast is hosted by me, Josie Rodriguez-Bouchier, and produced by Rozarie Productions with original music by Jen Korte.
All content offered through The Intersectional Fertility Podcast is created for informational purposes only, it is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.