The perspectives of obese women receiving antenatal care: A qualitative study of women's experiences

Knight-Agarwal, Cathy; Williams, Lauren; Davis, Deborah; Davey, Rachel; Shepherd, Rebecca; Downing, Alice; Lawson, Kathryn

doi:10.1016/j.wombi.2015.10.008

Cited by 44 publications

(45 citation statements)

References 34 publications

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“…Weight management services in pregnancy also have a unique opportunity to further tailor support due to women's interest in the influence of nutrients in foods on the developing fetus, as identified in our study and by others (Porteous et al, 2014;Knight-Agarwal et al, 2016).…”

Section: Resultsmentioning

confidence: 63%

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study

et al. 2017

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Objective: To understand the lived experiences and views of being referred to an antenatal dietetic service from the perspective of pregnant women with obesity.Design: A qualitative, interpretive approach using one-to-one in-depth interviews to explore the lived experience of pregnant women with obesity following referral to an antenatal dietetics service. Thematic content analysis was carried out by two researchers independently to develop data-driven themes.Setting: One NHS Trust maternity and dietetic services, North East England, UK Participants: Fifteen pregnant women with a booking body mass index ≥30kg/m 2 attending an obesity-specific antenatal dietetic service. All women were White, parity between 0-2, and BMI range 30-51kg/m 2 .Findings: Four themes were identified within this concept. 1) Women's overall experience of the service: experiences were predominately positive with only two negative cases identified.2) Process of referral: women placed importance on informative and in-person communication about the service, with health professionals, at the point of referral. 3) 2 Delivery of the service: dietitians were considered to be the experts and women wanted more frequent contact. 4) Content of the service: tailored advice enabled behaviour change, and women desired increased physical activity support and weight monitoring.Key conclusions: Women reported an overall positive experience and thought that dietitians were the expert health professionals to support them. Women in this study felt that tailoring advice specific to their personal circumstances helped them implement changes, and had a strong interest in the nutritional benefits for fetal development. Women considered weight monitoring to be a positive element of the service; however, further research is required given the limited and conflicting evidence-base.Implications for practice: It is important to incorporate women's experiences in the development and delivery of antenatal weight management services to facilitate personcentred care. Communication by health professionals at the point of referral is particularly important to provide accurate expectations of services and to reduce anxieties. Dietitians are considered to be appropriate experts to deliver these services, although they may need additional support to address women's physical activity needs in pregnancy.Keywords obesity, body mass index, dietetic, qualitative, experience, pregnancy IntroductionMaternal obesity (body mass index (BMI) ≥30kg/m 2 ) is increasing in prevalence internationally (Brynhildsen et al., 2006;Ray et al., 2007;Heslehurst et al., 2010;Fisher et al., 2013) and is associated with complex inequalities, including deprivation and ethnic minority groups (Heslehurst et al., 2010(Heslehurst et al., , 2012. There are significantly increased associations with adverse outcomes for women and babies including congenital anomalies, perinatal mortality, macrosomia, gestational diabetes, maternal infections and preterm birth (Heslehurst et al., 2008;Stothard et al., 2009;Tenn...

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Section: Resultsmentioning

confidence: 63%

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study

et al. 2017

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“…Small changes were considered better than none at all, and these changes were important for women beyond pregnancy. Setting small achievable goals may in particular be important to pregnant women with BMI ≥30 kg/m 2 who may be used to being judged based on their weight status [23] and have low self-esteem regarding physical activity or healthy eating [36]. Another barrier to behaviour change was women's cultural and traditional eating behaviour.…”

Section: Discussionmentioning

confidence: 99%

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

Olander

Berg

et al. 2019

Sexual & Reproductive Healthcare

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“…The characteristics of the included studies have been summarised in S6 Table. Only seven studies set out to explore either of the questions of this review [18][19][20][21][22][23][24]. Most studies set out to document women's experiences of healthcare when obese and pregnant.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Perceptions of risk and influences of choice in pregnant women with obesity. An evidence synthesis of qualitative research

et al. 2020

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Background Between 7-35% of the maternity population are obese in high income countries and 1-40% in lower or middle-income countries. Women with obesity are traditionally limited by the choices available to them during pregnancy and birth because of the higher risk of complications. This evidence synthesis set out to summarise how women with obesity's perceptions of pregnancy and birth risk influence the care choices that they make. Methods A search of medical and health databases for qualitative studies written in the English language, published Jan 1993-April 2019 and reporting on pregnant women with obesity's perception of risk and influence of pregnancy and birth choices. Data was extracted by two reviewers onto a questions framework and then analysed using a thematic synthesis technique. Confidence in the qualitative findings was assessed using GRADE-CERQual. Results 23 full texts were included. The common themes on perception of risk were: 'Self-blame arising from others' stereotyped beliefs ', 'Normalisation', 'Lack of preparation', 'Fearful acceptance and inevitability' and 'Baby prioritised over mother'. For influence of choices, the themes were: 'External influences from personal stresses', 'Restrictive guidelines', 'Relationship with healthcare professional' and 'Perception of Risk'. Conclusions Evidence on what influences women with obesity's pregnancy choices is limited. Further research is needed on the best methods to discuss the risks of pregnancy and birth for women with obesity in a sensitive and acceptable manner and to identify the key influences when women with obesity make choices antenatally and for birth planning.

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The perspectives of obese women receiving antenatal care: A qualitative study of women's experiences

Cited by 44 publications

References 34 publications

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study

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

Perceptions of risk and influences of choice in pregnant women with obesity. An evidence synthesis of qualitative research

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