Knowledge, experiences and attitudes of midwives in maternity care in encounters with pregnant women with obesity - are adverse childhood experiences understood and explored as a contributing factor?

Bjørsmo, Eline Haug; Sandsæter, Heidi Linn; Horn, Julie

doi:10.1016/j.midw.2022.103461

Cited by 2 publications

(1 citation statement)

References 36 publications

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“…However, several studies indicate that the topic of weight is often ignored or addressed in a way that women find stigmatizing [22]. This is often justified by time pressure, limited knowledge of healthcare personnel and barriers to talking about weight in pregnancy among both staff and pregnant women with obesity [23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Weight development from childhood to motherhood—embodied experiences in women with pre-pregnancy obesity: a qualitative study

Sandsæter,

Eik-Nes,

Getz

et al. 2024

Reprod Health

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Background Pre-pregnancy obesity increases the risk of perinatal complications. Post-pregnancy is a time of preparation for the next pregnancy and lifestyle advice in antenatal care and postpartum follow-up is therefore recommended. However, behavioral changes are difficult to achieve, and a better understanding of pregnant women’s perspectives and experiences of pre-pregnancy weight development is crucial. Methods We used a qualitative design and conducted semi-structured interviews with 14 women in Norway with pre-pregnancy obesity 3–12 months postpartum. Data were analyzed using thematic analysis. Results Four themes addressing women’s experiences and understanding of their weight development were generated: (1) Unmet essential needs, (2) Genetic predisposition for obesity, challenging life course transitions and turning points, (3) Under a critical eye: an ever-present negative bodily awareness, and (4) Wrestling with food. Parents’ inability to meet children’s essential needs caused weight gain through an unbalanced diet, increased stress, and emotional eating patterns. Body criticism and a feeling of not belonging led to negative body awareness that influenced behavioral patterns and relationships. Participants reporting having had a good childhood more often described their weight development as a result of genetic predisposition, challenging life course transitions and turning points, such as illness and injuries. Nevertheless, these participants also described how eating patterns were influenced by stress and negative emotions. Conclusions Healthcare providers should pay attention to the insider perspectives of pre-pregnancy weight development. An open and shared understanding of the root causes of these women’s weight development can form a basis for more successful lifestyle guidance.

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Section: Introductionmentioning

confidence: 99%

Weight development from childhood to motherhood—embodied experiences in women with pre-pregnancy obesity: a qualitative study

Sandsæter,

Eik-Nes,

Getz

et al. 2024

Reprod Health

Self Cite

View full text Add to dashboard Cite

show abstract

Navigating weight, risk and lifestyle conversations in maternity care: a qualitative study among pregnant women with obesity

Sandsaeter,

Eik-Nes,

Getz

et al. 2024

BMC Pregnancy Childbirth

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Background Pregnant women with obesity face heightened focus on weight during pregnancy due to greater risk of medical complications. Closer follow-up in maternety care may contribute to reduce risk and promote health in these women. The aim of this study was to gain a deeper insight in how pregnant women with obesity experience encounters with healthcare providers in maternity care. How is the received maternity care affected by their weight, and how do they describe the way healthcare providers express attitudes towards obesity in pregnancy? Methods We conducted in-depth interviews with 14 women in Trøndelag county in Norway with pre-pregnancy BMI of ≥ 30 kg/m2, between 3 and 12 months postpartum. The study sample was strategic regarding age, relationship status, education level, obesity class, and parity. Themes were developed using reflexive thematic analysis. The analysis was informed by contextual information from a prior study, describing the same participants’ weight history from childhood to motherhood along with their perceptions of childhood quality. Results This study comprised of an overarching theme supported by three main themes. The overarching theme, Being pregnant with a high BMI: a vulnerable condition, reflected the challenge of entering maternity care with obesity, especially for women unprepared to be seen as “outside the norm”. Women who had grown up with body criticism and childhood bullying were more prepared to have their weight addressed in maternity care. The first theme, Loaded conversations: a balancing act, emphasizes how pregnant women with a history of body criticism or obesity-related otherness proactively protect their integrity against weight bias, stigma and shame. The women also described how some healthcare providers balance or avoid weight and risk conversations for the same reasons. Dehumanization: an unintended drawback of standardized care makes apparent the pitfalls of prioritizing standardization over person-centered care. Finally, the third theme, The ambivalence of discussing weight and lifestyle, represent women’s underlying ambivalence towards current weight practices in maternity care. Conclusions Our findings indicate that standardized weight and risk monitoring, along with lifestyle guidance in maternity care, can place the pregnant women with obesity in a vulnerable position, contrasting with the emotionally supportive care that women with obesity report needing. Learning from these women’s experiences and their urge for an unloaded communication to protect their integrity highlights the importance of focusing on patient-centered practices instead of standardized care to create a safe space for health promotion.

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Knowledge, experiences and attitudes of midwives in maternity care in encounters with pregnant women with obesity - are adverse childhood experiences understood and explored as a contributing factor?

Cited by 2 publications

References 36 publications

Weight development from childhood to motherhood—embodied experiences in women with pre-pregnancy obesity: a qualitative study

Weight development from childhood to motherhood—embodied experiences in women with pre-pregnancy obesity: a qualitative study

Navigating weight, risk and lifestyle conversations in maternity care: a qualitative study among pregnant women with obesity

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