African American and White women׳s perceptions of weight gain, physical activity, and nutrition during pregnancy

Abstract

Objective To describe African American and White women’s perceptions of weight gain, physical activity, and nutrition during pregnancy and to explore differences in perceptions by race. Design Qualitative interview study. Setting Two Ob/Gyn clinics in South Carolina, USA. Participants Thirty pregnant women (15 African American, 15 White) between 20–30 weeks gestation, equally represented across pre-pregnancy BMI categories (10 normal weight, 10 overweight, and 10 obese). Findings White women more frequently described intentions to meet weight gain, physical activity, and dietary guidelines in pregnancy than African American women. African American women were more concerned with inadequate weight gain while White women more commonly expressed concerns about excessive weight gain. More White women discussed the importance of physical activity for weight management. Regardless of race, few women described risks of excessive weight gain or benefits of physical activity as it relates to the baby’s health. The primary cited barrier of healthy eating was the high cost of fresh produce. Key conclusions and implications for practice Several knowledge gaps as well as race differences were identified in women’s perceptions and intentions toward weight gain, physical activity, and nutrition during pregnancy. Future interventions should seek to educate women about common misperceptions. It may be necessary to culturally tailor gestational weight gain interventions to optimize health outcomes.

Correlates of pregnant women's gestational weight gain knowledge

“…The major change to GWG guidelines in the past few decades has been to include separate guidelines for different ppBMIs, in part, given the multiplication of risk of women entering pregnancy overweight or obese with subsequent large GWG (IOM et al, 2009). Research indicates that women remain unaware of the risks of excess GWG and that many health professionals infrequently discuss GWG with women and tend to be more likely to advise overweight and obese women to gain weight in excess of recommendations (Willcox et al, 2012, van der Pligt et al, 2011, Brown and Avery, 2012, Whitaker et al, 2016 The overestimation of GWG in our sample is consistent with results of Groth and Kearney's qualitative study with 49 women which found that women were concerned about the effects of insufficient pregnancy weight gain on the infant but were unaware of the infant risks of excessive gain (Groth and Kearney, 2009). Knowledge of GWG at different ppBMIs may be a reflection of the extensive time it takes for research findings or guidelines to be translated into practice or consumer information sources (Grimshaw andRussell, 1993, Grol, 2001).…”

“…While a variety of GWG guidelines exist, many countries have adopted the Institute of Medicine (IOM) guidelines (Alavi et al, 2013, IOM et al, 2009, including Australia, where these guidelines have recently been included in the Australian Dietary Guidelines (National Health and Medical Research Council, 2013). Despite incorporation of the IOM recommendations into national guidelines, evidence suggests that both health professionals and women lack knowledge and acceptance of these guidelines in pregnancy, and that women are not aware of the health consequences of insufficient or excess GWG (Groth and Kearney, 2009, Wilkinson and Stapleton, 2012, Willcox et al, 2012, Whitaker et al, 2016.…”

Advice given by community members to pregnant women: a mixed methods study

“…These studies suggest that the friends and family of low-income, African American pregnant women are likely to encourage “eating for two,” without acknowledging the dangers of too much weight gain, or acknowledging the different recommendations for weight gain depending on pre-pregnancy BMI [11, 25]. One study found that pregnant women believe that weight gain during pregnancy is uniformly vital for having a healthy baby [26].…”

Weight management during pregnancy: a qualitative thematic analysis on knowledge, perceptions and experiences of overweight and obese women in Singapore

“…In view of the aforementioned adverse effects, Western studies [27–33] from Australia, the USA, the UK have explored the perceptions of women during pregnancy, which targeted women who were White, Latina and African-American. For example, in a study [27] which compared perceptions of White women and African American women, it was found that African American women were more concerned with inadequate weight gain whereas White women more frequently expressed worry on excessive weight gain, and that the primary cited barrier of a healthy diet was the high cost of fresh produce.…”

“…For example, in a study [27] which compared perceptions of White women and African American women, it was found that African American women were more concerned with inadequate weight gain whereas White women more frequently expressed worry on excessive weight gain, and that the primary cited barrier of a healthy diet was the high cost of fresh produce. In another Australian study, the authors reported that conversations on weight and gestational weight gain can be conflicting, confusing and judgmental, and that healthcare providers should approach the issue of maternal obesity in an informative but non-judgmental way [28], while a study in Boston targeting Latina women [29] revealed that in comparison to healthy weight and obese women, overweight women least often reported viewing weight as important, making efforts to control their gestational weight gain, being aware of the role of diet on gestational weight gain, and receiving gestational weight gain advice from health-care providers.…”