Small Babies

What is up with pregnant women here not eating so they won't have to give birth to a "big" baby?? I am telling you this really gets to me.
Yesterday was Thursday and I was on day shift. Wednesday, Thursday, and Friday are the days when we do "prenatals." On these days we see anywhere from 15 to 40 patients. Yesterday, I personally did 10 prenatal check ups. I was one of four staff on duty. It was a busy day.
One of my patients was a "primi," meaning it's her first baby. She's also quite young, only 20. I noticed she had a cotton ball taped to her belly button. When I asked her about it she told me she doesn't want it to pop out. I thought to myself, Ok, it probably won't work, but it's not harmful so I won't worry with it.
During her check up I noticed that her fundal height (the size of her belly) was quite small compared to where it should be at 35 weeks. It has been small and lagging for the past several prenatal check ups, staying around 31 cm. We have a minimum of 32 cm in order for patients to give birth in our clinic.
When I asked her what she's eating. She said "nothing." I figured she didn't understand my English so I got help from a midwife to translate for me. Again, in Cebuano (I understand this word) she said, "nothing." "For how long," the midwife asked? The young woman said, "3 days."
Upon further questioning we found out that she typically eats once a day but for some unknown reason that she wasn't willing to divulge, she hadn't eaten in 3 days. When asked why, she said she's not hungry but I could tell she wasn't being honest with me. The Filipina midwives I was on duty with later explained to me that it is quite common for women to do this during their pregnancies so they won't have a "big" baby.
Apparently this is quite common in the Philippines - or at least among many of our patients. Some days I feel like I am giving the same talk over and over and over again. Eat 3 complete meals every day plus 1-2 snacks - each containing and energy food, a protein food, and fruits and vegetables... take your iron with vitamin C... eat iron-rich foods such as... you don't want to be exhausted in labor... make sure you're drinking enough fluids...you're at risk of hemorrhaging since you are still anemic... if your hemoglobin stays low, we'll have to insert IV in labor unless you can improve it...
Yesterday was tiring because I had several patients who seemingly weren't eating enough. This is common but for a lot of our women it's because they have no money to eat well, or to eat enough. But for this young woman, lack of money wasn't her problem. My impression is that she just didn't want to have a big baby.
With any patient-practitioner interaction I have learned that you're not supposed to judge or react to patients when they tell you things that aren't in line with your expectations or what you think should be so but when this woman told us she hadn't eaten for 3 days I have to admit I reacted emotionally. I was mad at her. I tried not to show it but I did try to scare her into eating by listing all the possible consequences of her choices.
I gave her very clear diet guidelines and told her to record everything she is eating and bring the record with her next week. If her belly doesn't grow, she may not be able to deliver at our clinic. I hope she chooses to eat. Clearly she doesn't understand the short-term and long-term affects this level of malnutrition could have on herself and especially her baby.
It's one thing to see women who try to do everything they can for their child but limited by support and resources. It's another thing to see a woman with resources make such an ignorant choice to starve her baby.