Offering weight management support to pregnant women with high body mass index: A qualitative study with midwives

Olander, Ellinor K.; Berg, Frida; Berg, Marie; Dencker, Anna

doi:10.1016/j.srhc.2019.04.001

Cited by 13 publications

(18 citation statements)

References 34 publications

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“…In line with previous research, participants were generally supportive of health professionals raising issues such as maternal weight and pregnancy weight gain [25,26,74,82,83] and to child growth/weight [29], even if they would be hard to hear, if done in a non-judgemental, supportive way. Continuity of care, and the associated development of trusting, respectful relationships and rapport with health professionals, were highly valued by parents in this study, similar to prior research concerning antenatal care [74], weight and/or gestational weight gain [84][85][86], and infant feeding [47,64]. Thus, parents desire more support and for health professionals-with whom they have good rapport with-to be more pro-active in raising such issues.…”

Section: Discussionsupporting

confidence: 77%

“They Just Need to Come Down a Little Bit to Your Level”: A Qualitative Study of Parents’ Views and Experiences of Early Life Interventions to Promote Healthy Growth and Associated Behaviours

Hennessy

Byrne

Laws

et al. 2020

IJERPH

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The first 1000 days is a critical window of opportunity to promote healthy growth and associated behaviours. Health professionals can play an important role, in part due to the large number of routine contacts they have with parents. There is an absence of research on the views of parents towards obesity prevention and the range of associated behaviours during this time period. This study aimed to elicit parents’ views on early life interventions to promote healthy growth/prevent childhood obesity, particularly those delivered by health professionals. Semi-structured interviews were conducted with 29 parents (24 mothers, 5 fathers) who were resident in Ireland and had at least one child aged under 30 months. Data were analysed using reflexive thematic analysis. Two central themes were generated: (1) navigating the uncertainty, stress, worries, and challenges of parenting whilst under scrutiny and (2) accessing support in the broader system. Parents would welcome support during this critical time period; particularly around feeding. Such support, however, needs to be practical, realistic, evidence-based, timely, accessible, multi-level, non-judgemental, and from trusted sources, including both health professionals and peers. Interventions to promote healthy growth and related behaviours need to be developed and implemented in a way that supports parents and their views and circumstances.

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Section: Discussionsupporting

confidence: 77%

“They Just Need to Come Down a Little Bit to Your Level”: A Qualitative Study of Parents’ Views and Experiences of Early Life Interventions to Promote Healthy Growth and Associated Behaviours

Hennessy

Byrne

Laws

et al. 2020

IJERPH

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“…Unfortunately, education sessions with other major referring staff were unable to be delivered which may explain the more successful attendance rates with midwife referrals. However, evidence also suggests that midwives build a relationship with women prior to discussing weight, and are central to supporting women with weight management during pregnancy . Smoking during pregnancy, and in general, has been linked with lower health literacy which may explain their lower attendance to dietitian appointments .…”

Section: Discussionmentioning

confidence: 99%

Attendance rates and characteristics of women with obesity referred to the dietitian for individual weight management advice during pregnancy

Porteous

Jersey

Palmer

2020

Aust NZ J Obst Gynaeco

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Background: Engagement in services to support healthy weight management during pregnancy is poor. A better understanding of those who attend is important in supporting women to participate in preventative health services. Aims: This retrospective observational study aimed to report attendance rates of pregnant women with obesity (body mass index (BMI) ≥ 30 kg/m 2) referred to a dietitian between 2012 and 2018 for weight management and describe who was referred and attended. Materials and Methods: Demographic, attendance and medical data for women with obesity who were either referred to a dietitian or were not referred were sourced from hospital data. Chi-squared and t-tests were used to compare groups. Binary logistic regression analysis was used to identify characteristics associated with attendance within the referred group. Results: Of 5426 eligible women, 523 were referred to the dietitian, and 4903 women were not referred (Total sample: 29 ± 6 years, 39.0 ± 2.1 weeks gestation at birth). Referred women self-reported a 6.7 kg/m 2 higher pre-pregnancy BMI, 7% more were subsequently diagnosed with gestational diabetes mellitus (GDM), and 9% more were induced (P < 0.001) indicating a higher risk of adverse outcomes. Referred women attended a median (range) of 2 (0-8) appointments. The majority (78%) attended ≥1 appointment, and 41% attended ≥3 appointments. Women referred by a midwife (65%) or diagnosed with GDM were 1.9 and 3.0 times more likely to attend, respectively (P < 0.01). Being a smoker was negatively associated with attendance (odds ratio 0.388, P < 0.001). Conclusions: Pregnant women with obesity referred for dietetic weight management appear at higher risk of adverse outcomes, with most attending ≥1 appointment. Engaging midwives in promoting referrals may increase attendance.

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“…Regarding weight management opportunities, public health nurses described a lack of resources as the reason counseling and support were missing after birth and weight-management was not part of standard care [30,7]. Resources should be added postnatally for overweight women to facilitate personalized counseling [31].…”

Section: Discussionmentioning

confidence: 99%

“…We found that one of the important aspects of weight management was support from partners and family. Women's partners play a signi cant role in providing advice and are seen as invaluable support [7]. In addition, women described how their family, relatives, friends, and health care professionals in uenced, for example, healthy food choices [32].…”

Section: Discussionmentioning

confidence: 99%

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Identifying Target Behaviors for Weight-management Interventions in Overweight Women during Pregnancy and the Postpartum Period: A Qualitative Study Informed by the Behaviour Change Wheel

Saarikko¹,

Niela‐Vilén²,

Rahmani³

et al. 2020

Preprint

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Background: Maternal overweight is increasing, and it is associated with several risks for both the mother and child. Healthy lifestyle behaviors adopted during pregnancy are likely impact women’s health positively after pregnancy. The study’s aim was to identify and describe weight management behaviors in terms of the Capability, Opportunity and Motivation Behaviour (COM-B) -model to target weight management interventions from the perspectives of overweight women and maternity care professionals. Methods: This qualitative, descriptive study was conducted in 2019–2020. Individual interviews of overweight pregnant and postpartum women (n = 11) and focus group interviews of public health nurses (n = 5) were undertaken in two public maternity clinics in Southwest Finland. The data were analyzed using deductive content analysis consistent with the COM-B model.Results: In the capability category, overweight women and public health nurses thought that there was a need to find consistent ways to broach overweight, which had become a part of women's identities. The use of health technology was considered as a part of antenatal care to broach the subject of weight and weight management. Smart wearables could also support evaluating overweight women’s lifestyles. The opportunity category highlighted a lack of resources for support in perinatal care, especially after birth. Support from family was the most important facilitating factor besides motivation. There was a conflict between pregnancy as an excuse to engage in unhealthy habits and pregnancy as a motivational period during which to change one’s lifestyle. Furthermore, the women wanted a tough stance on weight management and discreet counseling.Conclusions: Our findings offer a theoretical basis for tailoring, testing and implementing interventions that address barriers to effective weight management. Such interventions should offer clear advice and non-judgmental support during pregnancy and after delivery by targeting women’s capabilities, opportunities, and motivation. Health technology could be a valuable component of intervention, as well as an implementation strategy, as it provides ways to broach this topic and support overweight women during maternity care.

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Offering weight management support to pregnant women with high body mass index: A qualitative study with midwives

Abstract: Offering weight management support to pregnant women with high body mass index: a qualitative study with midwives

Cited by 13 publications

References 34 publications

“They Just Need to Come Down a Little Bit to Your Level”: A Qualitative Study of Parents’ Views and Experiences of Early Life Interventions to Promote Healthy Growth and Associated Behaviours

“They Just Need to Come Down a Little Bit to Your Level”: A Qualitative Study of Parents’ Views and Experiences of Early Life Interventions to Promote Healthy Growth and Associated Behaviours

Attendance rates and characteristics of women with obesity referred to the dietitian for individual weight management advice during pregnancy

Identifying Target Behaviors for Weight-management Interventions in Overweight Women during Pregnancy and the Postpartum Period: A Qualitative Study Informed by the Behaviour Change Wheel

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