Interactions with providers during pregnancy had psychological and emotional effects on women with obesity and influenced the content and perceived quality of their care. Further research is required to explore this phenomenon and its implications for care of women during pregnancy and birth outcomes. In the meantime, providers may wish to consider greater sensitivity to the needs of women with obesity during the perinatal period.

Obesity stigma has been linked to poor health outcomes on an individual and population basis. However, little research has been conducted on the role of chronic or recent obesity stigma in the health disparities experienced by pregnant women with high body mass index. The purpose of this article is to discuss poor birth outcomes in this population from an integrated perinatal health framework perspective, incorporating obesity stigma as a social determinant. In studies of non-pregnant populations, obesity stigma has been associated with stress, unhealthy coping strategies, psychological disorders, and exacerbations of physical illness. This article examines the mechanisms by which obesity stigma influences health outcomes and suggests how they might apply to selected complications of pregnancy, including macrosomia, preterm birth and cesarean delivery. Given the rates of obesity and associated pregnancy complications in the United States, it is critical to examine the determinants of those problems from a life course and multiple determinants perspective. This paper offers a conceptual framework to guide exploratory research in this area, incorporating the construct of obesity stigma.

Introduction During the coronavirus disease 2019 (COVID‐19) pandemic, midwives have reported increased demand for community birth services. The purpose of this qualitative study was to understand childbearing persons’ decision‐making during the pandemic and to illuminate their experiences giving birth in community settings. Methods The study was framed by the interpretive phenomenological approach. Eligible participants were recruited from midwives providing out‐of‐hospital birth services. Of the 26 women who agreed to an interview, 17 were able to be reached and interviewed. Interviews followed a semistructured guide. Early paradigm cases were coded by all researchers, and then the first author coded the remaining transcripts. The final thematic structure was developed by the research team through an iterative process and validated through member checking. Results Four themes were identified: prior desire for a community birth, perceived susceptibility, barriers to choice, and isolation. Discussion Many participants had a preexisting desire for community birth and used the pandemic to justify their choice. However, birth options were often limited by finances and geography. Attitude toward COVID‐19 varied by knowledge and experience. Many participants experienced stress and isolation.

No abstract

To promote midwifery among this population, advocates should continue public education efforts through a variety of media and communication strategies, with an emphasis on the safety of midwifery care.