How do BMI-restrictive policies impact women seeking NHS-funded IVF in the United Kingdom? A qualitative analysis of online forum discussions

英国的BMI限制政策如何影响寻求NHS资助的试管婴儿治疗的女性?一项基于在线论坛讨论的定性分析

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Abstract

BACKGROUND: Across the United Kingdom's National Health Service (NHS), women with a Body Mass Index (BMI) of > 30 face restrictions accessing In Vitro Fertilisation (IVF) treatment. This study asks: what are the (un)expected and (un)intended harms and consequences experienced by women restricted from accessing NHS-funded IVF due to BMI threshold criteria? METHODS: Posts from a popular infertility online forum were collected and reflexively thematically analysed. RESULTS: On the forum, users discussed how they struggled to lose weight, how they faced time pressures to meet BMI thresholds, and they shared knowledge on how to comply or appear compliant with BMI cut-offs. Our study found widespread moral discourses around body weight were reproduced in the forum, particularly commonplace narratives that body weight is under personal control, that people with a high BMI should 'work' to change their bodies, and that this work helps demonstrate deservingness for IVF treatment. Moralising discourses around weight were linked to the responsibilities of a hoped-for future of motherhood, as users performed deservingness through emphasising their commitment to meeting the BMI threshold. CONCLUSION: We conclude that NHS-IVF policies in the United Kingdom do not consider the burdensome emotional and moral work placed on people seeking treatment due to inflexible upper-limit BMI criteria.

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