This chapter examines the care of women living with ‘obesity’ who access maternity services in the United Kingdom, North America, Australia and New Zealand. The chapter begins with a definition of ‘obesity’, followed by the potential obesity-related risks to the health of pregnant women. We describe how risk assessing using BMI does not consider those who have metabolically healthy bodies. Following this we discuss weight stigma and shame, providing insight into the maternity care experiences of higher-weight women. We then examine the technocratic approaches to risk reduction, considering the medicalised maternity process which objectifies women by reducing them to their bodies, controlling those bodies and coercing them to conform to societal expectations of birth. The chapter concludes with a discussion about how women are required to cope with the technocratic approach to pregnancy and birth and how maternity care providers exhort women to comply with weight gain targets and appointments, adding to the feelings of shame, blame and guilt they experience. Finally, we suggest clinical recommendations to improve the experiences of women and of maternity care professionals.