“What My Doctor Didn't Tell Me”: Examining Health Care Provider Advice to Overweight and Obese Pregnant Women on Gestational Weight Gain and Physical Activity

Abstract

Background Appropriate gestational weight gain (GWG) is vital, as excessive GWG is strongly associated with postpartum weight retention and long-term obesity. How health care providers counsel overweight and obese pregnant women on appropriate GWG and physical activity remains largely unexplored. Methods We conducted semi-structured interviews with overweight and obese women following the birth of their first child to ascertain their experiences with GWG. A grounded theory approach was used to identify themes on provider advice received about GWG and physical activity during pregnancy. Results Twenty-four women were included in the analysis. Three themes emerged in discussions regarding provider advice on GWG—(1) Women were advised to gain too much weight or given no recommendation for GWG at all; (2) Providers were perceived as being unconcerned about excessive GWG; and (3) Women desire and value GWG advice from their providers. On the topic of provider advice on exercise in pregnancy, three themes were identified: (1) Women received limited or no advice on appropriate physical activity during pregnancy; (2) Women were advised to be cautious and limit exercise during pregnancy and (3) Women perceived that provider knowledge on appropriate exercise intensity and frequency in pregnancy was limited. Conclusions This study suggests that provider advice on GWG and exercise is insufficient and often inappropriate, and thus unlikely to positively influence how overweight and obese women shape goals and expectations in regard to GWG and exercise behaviors. Interventions to help pregnant women attain healthy GWG and adequate physical activity are needed.

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

“…Similar findings were made in a U.S. study of advice received by pregnant women regarding GWG. [48] It could be assumed that health professionals are overestimating or misremembering what they have discussed or might, as identified here, have "skirted around" the issue because of its sensitivity. Another explanation is that women had forgotten or misremembered the information given.…”

“If she wants to eat…and eat and eat…fine! It's gonna feed the baby”: Pregnant women and partners' perceptions and experiences of pregnancy with a BMI >40 kg/m 2

“…The views and experiences of pregnant women with a raised BMI regarding health and weight have been explored in previous studies (Furber and McGowan 2010;Mills et al, 2011;Smith and Lavender 2011;Stengel et al, 2012;Heslehurst et al, 2013a); however, the views of couples have not previously been explored. Using qualitative methods, the complex histories and accounts that women provide for their weight have been accessed, including how individuals within a couple may experience and resist weight stigma together, or on behalf of a partner.…”

What the Health? Information Sources and Maternal Lifestyle Behaviors (Preprint)

“…On the other hand, studies have shown that low quality is a problem on the Internet [10] and others have found that pregnant women may perceive advice from family physicians and midwives confusing, vague, contradictory and frequently changing [8,[11][12][13]. Also, research show that most health care providers, regardless of medical training, lack knowledge and awareness of the ACOG [6] PA guidelines [12,14], and the majority of pregnant women being counselled about weight gain report that the advice is generally discordant with the Institute of Medicine (IOM) [15] GWG guidelines [7,12,16,17].…”

“…Also, research show that most health care providers, regardless of medical training, lack knowledge and awareness of the ACOG [6] PA guidelines [12,14], and the majority of pregnant women being counselled about weight gain report that the advice is generally discordant with the Institute of Medicine (IOM) [15] GWG guidelines [7,12,16,17].…”

“…However, the population sizes were generally small (n = 17-60) [8,12,13,18,20,23], and information sources were rarely the main outcome [8,12,16,[19][20][21][22][23]. Three studies had moderate methodological quality and sufficient population sizes (n = 350-368) [7,9,24].…”