Women's Perceived Reasons for Their Excessive Postpartum Weight Retention: A Qualitative Interview Study

Abstract

IntroductionObesity in Sweden has doubled to 14% over the last 20 years. New strategies for treatment and prevention are needed. Excessive gestational weight gain has been found to contribute substantially to obesity, and there is a consistent association between postpartum weight retention and obesity later in life. We aimed to explore what factors women perceive as reasons for having substantial postpartum weight retention, to identify areas for new and improved interventions.MethodsQualitative interview study (semi-structured) using an emergent design. Fifteen women, with a postpartum weight retention ≥ 10 kg, were interviewed by a trained cognitive therapist. Eight women had pre-pregnancy BMI below 30 kg/m2. Interviews were transcribed verbatim and data analysed using inductive manifest content analysis. Salient text passages were extracted, shortened, coded and clustered into categories.ResultsParticipants reported no knowledge of current gestational weight gain recommendations or of risks for adverse pregnancy outcomes with excessive weight gain or postpartum weight retention. Excessive eating emerged as a common strategy to provide relief of psychological, emotional and physical discomfort, such as depression and morning sickness. Women perceived medical staff as being unconcerned about weight, and postpartum weight loss support was scarce or absent. Some women reported eating more due to a belief that breastfeeding would automatically lead to weight loss.ConclusionThere is a need to raise awareness about risks with unhealthy gestational weight development and postpartum weight retention in women of childbearing age. The common strategy to cope with psychological, emotional or physical discomfort by eating is an important factor to target with intervention. The postpartum year is a neglected period where additional follow-up on weight and weight loss support is strongly indicated.

Eating Behaviors in Postpartum: A Qualitative Study of Women with Obesity

“…These results suggest the importance of specific attention to these issues during the postpartum period. These findings corroborate previous studies, which the attention and interventions of the health team should continue into postpartum so that the adoption of new habits is guaranteed [37]. …”

“…The relation of these women to the food is of compulsiveness and discharge of the anxiety experienced in the postpartum period. Our results are in accordance with the literature that postpartum begins a new phase for the woman in her experiences and that deserves the attention of the health professionals [37,45]. Those professionals that are willing to assist women with obesity during the postpartum period should be aware of the mothers’ emotional fragility, foster them, and give them support so that they overcome difficulties that arise from motherhood [46].…”

Re‐evaluating the nutritional awareness, knowledge and eating behaviours of women attending a tertiary maternity hospital following iterative service redesign

“…Christensen et al . has noted that women perceived that their maternity health professionals seem unconcerned about their weight and postpartum weight loss, with little or no guidance being provided . Women also had little knowledge of the risks of postpartum weight retention.…”

“…Christensen et al has noted that women perceived that their maternity health professionals seem unconcerned about their weight and postpartum weight loss, with little or no guidance being provided. 40 Women also had little knowledge of the risks of postpartum weight retention. 40 It has also been shown that the primary influence on women's pregnancy and postpartum attitudes towards weight is their pre-pregnancy orientation towards body weight; 41 this lower rating may reflect an underlying dissatisfaction with their pre-pregnancy weight.…”

“…40 Women also had little knowledge of the risks of postpartum weight retention. 40 It has also been shown that the primary influence on women's pregnancy and postpartum attitudes towards weight is their pre-pregnancy orientation towards body weight; 41 this lower rating may reflect an underlying dissatisfaction with their pre-pregnancy weight. However, women's responses also need to be interpreted within the timeframe of questioning.…”