Talking about weight in pregnancy: An exploration of practitioners' and women's perceptions

Abstract

Prevalence of maternal obesity is increasing, with health risks for mother and infant. Effective health promotion depends on sufficient knowledge and appropriate communication skills. We aimed to explore women's, midwives' and health visitors' perceptions of current practice in helping women manage their weight and supporting healthy behaviour change during pregnancy, and their perceived training needs. A modified grounded theory methodology was adopted, based upon critical realist assumptions. Following consultation events with fifty six practitioners to inform data collection tools, twenty (different) practitioners and nine women participated in focus groups. Comparative analysis generated four themes: A core theme, "Discouraging discourses", described health professionals' negative beliefs and reactive approach to communicating about weight. "Staff resources" identified limitations in and requirements for practitioner knowledge, skills and tools for effective communication. "Contextual influences" were social factors, which hindered practitioners' efforts to achieve healthy behaviour change. "Communicating as a Team" identified the importance of and challenges to a team approach. Findings have implications for weight management in pregnancy, practitioner resources, teamwork, and national health promotion campaigns.

Investigating weight-related lifestyle choices in pregnant women who are overweight

“…Participants were tentative about raising the issue of weight with women who are overweight, through fears of compromising their relationship and jeopardising future attendance, which is also a finding reported elsewhere in the maternal obesity literature (e.g. Furness et al, 2015). McCourt (2006) found that midwives have tended to adopt hierarchical and conventional styles of communication at the booking appointment (McCourt, 2006).…”

“…However, there was an acceptance that in the postpartum period they would revert back to the healthier lifestyle they lead prepregnancy. Therefore, intervening postpartum might prove a more opportune time for WO to change their weight-related behaviours, which has been reported previously Furness et al, 2015;Atkinson, Olander & French, 2016). Many HCP's have proposed the pre-pregnancy period as the time to intervene, rendering pregnancy 'too late' to change (Heslehurst et al, 2007).…”

“…Therefore, some felt the postpartum period might be an opportune time to support women who are overweight to make lifestyle changes, so they did not begin subsequent pregnancies obese. Many women have reported their motivation to address their weight does not begin until the postpartum period Furness et al, 2015). Also, some evidence suggests that women are receptive to engaging in support post birth to address their dietary and physical activity behaviours, as well as have their weight regularly monitored by a HCP (Atkinson, Olander & French, 2016).…”

Relationship of social cognitive theory concepts to dietary habits of pregnant women

“…[ 4 5 6 ] The consumption of fast food and soft drinks, excessive sugar intake, and lack of consumption of fruits, vegetables, and food with high fiber content are consequences of the nutrition transition that have affected all social classes including women. [ 7 8 ] A study showed that the diet of 73% of Iranians require modification. [ 9 ] Moreover, 63.90% of Iranian women are overweight or obese, 35% of which gain more weight than recommended during pregnancy.…”

“…Various interventions have been implemented for weight management and nutritional modification during pregnancy, but their results have not presented long-term effects. [ 7 ] Researchers' lack of consideration of psychological issues related to nutritional behavior has been reported as one of the main reasons for the lack of success of interventions and education in this regard. [ 11 ] In many studies, specialists in this field have emphasized on appropriate goal determination for the most important individual, social, and environmental factors in order to improve health behavior such as nutritional habits.…”