Explicit and implicit anti-fat biases are widespread among healthcare providers, leading to significant negative consequences for pregnant people, including poorer health outcomes. Fear of childbirth (FOC) can affect the length of labor, increase the risk of cesarean delivery, and negatively influence a new parent’s perception of infant bonding. This study investigated the impact of perceived anti-fat bias on FOC among pregnant people. Data were gathered from 329 pregnant people recruited from three large academic prenatal centers in the United States and via social media. Participants completed a survey that included validated instruments measuring perceptions of anti-fat bias and FOC. Participants perceiving anti-fat bias reported higher FOC. Black participants perceiving anti-fat bias reported higher FOC. These findings suggest that perceived anti-fat bias from providers is associated with FOC for pregnant people, particularly those who identify as Black. Interventions to educate providers on these important concepts could help improve pregnant people’s experience within the healthcare system.