Maternal gestational weight gain during pregnancy: prioritising the conversation

Abstract

Pregnancy is a critical stage of life requiring urgent attention when taking a lifespan approach to obesity prevention. Excessive gestational weight gain (GWG) is highly predictive of overweight and obesity later in life for women and their offspring. This discussion describes the challenges faced by health professionals (general practitioners, midwives, allied health) in primary care in Australia when addressing GWG, presents evidence that supports re-prioritising GWG and highlights strategies that can be used to address GWG. The revised National Health and Medical Research Council antenatal care guidelines (to be formally released in early 2018) indicate it will be the responsibility of health professionals in antenatal care to initiate conversations about GWG with women. Women are open to discussing this sensitive topic and health professionals in primary care have an opportunity to be proactive in addressing barriers that have hindered conversations about GWG in the past so that women are supported to manage their weight during pregnancy.

Maternal nutrition and weight management in pregnancy: A nudge in the right direction

“…; Walker et al . ). For the majority of health professionals, their training had little time to cover nutrition in already crowded curricula (Adams et al .…”

“…; Walker et al . ); however, they will inevitably close off when the advice does not meet their needs or expectations (Atkinson et al . ).…”

“…The need for further health professional training regarding the delivery of information about nutrition and weight management in pregnancy has been highlighted by many (Campbell et al 2011;Macleod et al 2013;Heslehurst et al 2014;Walker et al 2017). For the majority of health professionals, their training had little time to cover nutrition in already crowded curricula (Adams et al 2015) and, consequently, many are unprepared to answer nutrition/diet questions with authority.…”

“…Health professionals tend not to bring up nutrition and weight with their pregnant patients because they recognise these as sensitive topics (Furness et al 2011;Schmied et al 2011) and are concerned about women feeling criticised (Olander et al 2011). While health professionals are highly skilled in patient-centred care, training and professional development to help them engage in difficult discussions around weight and nutrition during pregnancy are necessary (Zhu et al 2011;Walker et al 2017).…”

“…Contemporary women are open to advice (Swift et al 2016;Walker et al 2017); however, they will inevitably close off when the advice does not meet their needs or expectations (Atkinson et al 2013). Women consider relational aspects of care such as the interpersonal relationships with staff, continuity of care, and availability of health professionals to be highly important, perhaps even more so than hospital facilities and structured systems of care (Jenkins et al 2014).…”