How do women feel about being weighed during pregnancy? A qualitative exploration of the opinions and experiences of postnatal women

Allen-Walker, Virginia; Mullaney, L.; Turner, Michael J.; Woodside, Jayne V.; Holmes, Valerie; McCartney, D.; McKinley, Michelle

doi:10.1016/j.midw.2016.12.006

Cited by 13 publications

(10 citation statements)

References 22 publications

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“…Nevertheless, many women expressed dissatisfaction about the amount or lack of information they received from pregnancy care providers about weight management, wanted more weight management information and support during pregnancy and postnatally, and felt that this should be incorporated into routine care. These findings are consistent with others that have highlighted the lack of consistent and reliable information women receive from pregnancy and postnatal care providers about weight management [ 25 , 26 , 30 ].…”

Section: Discussionsupporting

confidence: 91%

“…Nonetheless, weighing practices revealed in this study were inconsistent and many women reported that they had expected to be weighed throughout their pregnancy. This is consistent with other studies where women have expressed a preference for more frequent weighing and believe that it should be part of standard pregnancy care as it would provide reassurance and motivation for weight management in pregnancy and postnatally [ 26 , 35 ]. Furthermore, pregnancy care providers in a recent Australian study suggested that weighing all women would avoid stigmatising those who are overweight or obese [ 31 ].…”

Section: Discussionsupporting

confidence: 89%

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Weight management during pregnancy: a qualitative study of women’s and care providers’ experiences and perspectives

Holton

East

Fisher

2017

BMC Pregnancy Childbirth

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BackgroundObesity during pregnancy is a serious health problem for women and their children. Despite the high prevalence of high body mass index (BMI) among women of reproductive age in high-income countries, there is insufficient evidence to inform practice and policy about weight management for women with high BMI who are pregnant. The aim of this project was to describe women’s and midwives’ experiences and perspectives of care for weight management during pregnancy in Melbourne, Australia.MethodsA qualitative study. Semi-structured interviews were conducted with pregnant women and midwives. Transcripts were analysed thematically.ResultsA total of 17 women and 2 midwives were interviewed. Five themes were identified: 1. Reluctance to and difficulties discussing weight and its implications; 2. Barriers to providing appropriate pregnancy care for women with high BMI; 3. Inconsistent weighing practices; 4. Beliefs about the causes of obesity; and 5. Opportunities to assist women to manage their weight. Although most women were satisfied with the pregnancy care they had received, both women and midwives expressed concerns about effective weight management during pregnancy. These included constraints on discussing weight, difficulties accessing appropriate resources and additional support from other health care providers, and inconsistent weighing practices.ConclusionsThe findings suggest that women with high BMI would benefit from additional information and support about weight management prior to conception, during pregnancy, and postnatally.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

Weight management during pregnancy: a qualitative study of women’s and care providers’ experiences and perspectives

Holton

East

Fisher

2017

BMC Pregnancy Childbirth

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“…NICE noted the lack of evidence of benefit, but also expressed concerns that weighing may cause psychological harm. There was no evidence to indicate any health harms in this trial and other studies suggest that, far from increasing anxiety, it is welcomed by women 12 20…”

Section: Discussionmentioning

confidence: 60%

“…Pregnant women have reported that they expect to be weighed during pregnancy and feel that it should be part of routine antenatal care 12 20. However, three previous trials have investigated the effectiveness of behavioural interventions based on regular weighing to prevent excessive gestational weight gain and none of them were effective 7–10.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a behavioural intervention involving regular weighing and feedback by community midwives within routine antenatal care to prevent excessive gestational weight gain: POPS2 randomised controlled trial

et al. 2019

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ObjectivesTo assess the effectiveness of a brief behavioural intervention based on routine antenatal weighing to prevent excessive gestational weight gain (defined by US Institute of Medicine).DesignRandomised controlled trial.SettingAntenatal clinic in England.ParticipantsWomen between 10+0and 14+6weeks gestation, not requiring specialist obstetric care.InterventionsParticipants were randomised to usual antenatal care or usual care (UC) plus the intervention. The intervention involved community midwives weighing women at antenatal appointments, setting maximum weight gain limits between appointments and providing brief feedback. Women were encouraged to monitor and record their own weight weekly to assess their progress against the maximum limits set by their midwife. The comparator was usual maternity care.Primary and secondary outcome measuresExcessive gestational weight gain, depression, anxiety and physical activity.ResultsSix hundred and fifty-six women from four maternity centres were recruited: 329 women were randomised to the intervention group and 327 to UC. We found no evidence that the intervention decreased excessive gestational weight gain. At 38 weeks gestation, the proportions gaining excessive gestational weight were 27.6% (81/305) versus 28.9% (90/311) (adjusted OR 0.84, 95% CI: 0.53 to 1.33) in the intervention and UC group, respectively. There were no significant difference between the groups in anxiety or depression scores (anxiety: adjusted mean −0.58, 95% CI:−1.25 to –0.8; depression: adjusted mean −0.60, 95% CI:−1.24 to –0.05). There were no significant differences in physical activity scores between the groups.ConclusionsA behavioural intervention delivered by community midwives involving routine weighing throughout pregnancy, setting maximum weight gain targets and encouraging women to weigh themselves each week to check progress did not prevent excessive gestational weight gain. There was no evidence of psychological harm.Trial registration numberISRCTN67427351

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“…The development of interventions to help women avoid excessive gestational weight gain is a UK public health priority (National Institute for Health and Clinical Excellence, 2010). Women also expect their weight to be monitored during pregnancy (Daley et al, 2015) and believe it to be beneficial (Allen-Walker et al, 2017). Global recommended practice on the regularity of weighing pregnant women varies (Scott et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Pregnancy and weight monitoring: A feasibility study of weight charts and midwife support

Sanders

Channon

Cannings‐John

et al. 2020

Maternal & Child Nutrition

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Around half of pregnant women in the United Kingdom are overweight or obese. The antenatal period provides an opportunity for encouraging women to adopt positive lifestyle changes, and in recent years, this has included development of strategies to support women in avoiding excessive gestational weight gain. The objective of this interventional cohort study was to incorporate individualised gestational weight monitoring charts supported by motivational interviewing (MI)‐based conversations into midwifery‐led antenatal care and assess potential of the intervention for further development and evaluation. The study setting was a community midwifery team within a large maternity unit. The study explored the facilitators and barriers to engagement with the intervention as experienced by women and midwives; 52 women were recruited, of whom 48 were included in the analysis. A single training session was found adequate to prepare midwives to use antenatal weight charts but was insufficient to result in the incorporation of motivational interview techniques into clinical practice. We did not find sufficient evidence to recommend effectiveness testing of this intervention, and there is currently insufficient evidence to support reintroducing regular weighing of pregnant women into UK antenatal care. Given the public health importance of reducing rates of obesity, future interventions aimed at controlling gestational weight gain should continue to be developed but need to include innovative strategies particularly for women who are already obese or gain weight above that recommended.

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How do women feel about being weighed during pregnancy? A qualitative exploration of the opinions and experiences of postnatal women

Cited by 13 publications

References 22 publications

Weight management during pregnancy: a qualitative study of women’s and care providers’ experiences and perspectives

Weight management during pregnancy: a qualitative study of women’s and care providers’ experiences and perspectives

Effectiveness of a behavioural intervention involving regular weighing and feedback by community midwives within routine antenatal care to prevent excessive gestational weight gain: POPS2 randomised controlled trial

Pregnancy and weight monitoring: A feasibility study of weight charts and midwife support

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