Australian women want their healthcare providers to actively advise them about weight management during and after pregnancy, a Monash University study reveals.
Published in BMC Pregnancy and Childbirth, the Public Health and Preventive Medicine study identifies a gap in service provision that could help tackle obesity in pregnancy, a growing health problem that has significant health implications for mothers and their babies.
Women and their pregnancy care providers often find the topic difficult and are reluctant to discuss weight and weight management during pregnancy. Women, especially those who have a high BMI, may feel embarrassed or ashamed to discuss their weight and weight management with pregnancy care providers, and pregnancy care providers may not feel confident to discuss these matters without upsetting women. However, it is important to maintain a healthy weight throughout pregnancy.
The Monash study found that although most women were satisfied with the pregnancy care they had received, both women (with normal and high BMI) and midwives expressed concerns about effective weight management and identified that women would benefit from additional information and support in managing their weight both during pregnancy and postnatally.
Almost 20 pregnant women and midwives took part in interviews for the study led by Dr Sara Holton. Researchers investigated women's and midwives' experiences and perspectives of weight management during pregnancy.
"We found that women, both with and without a high BMI, wanted their care provider to give them advice and information about managing weight and appropriate weight gain during pregnancy, and have opportunities to discuss these with them," Dr Holton said.
Women in the study felt that support and information about weight management should be incorporated into routine pregnancy care, and that care providers should not "criticise" pregnant women who have a high BMI.
"However, it may be that midwives avoid or delay discussing weight management with pregnant women because they are unsure about how to talk to women about weight and don't want to offend, shame, or discourage women or cause them anxiety," Dr Holton said.
The findings of this study suggest that effective pregnancy weight management for women with high BMI requires interventions that address the barriers to weight-management during pregnancy, offer clear advice and non-judgemental support, and are provided during both routine pregnancy care and the postnatal period. Interventions such as these will contribute substantially to enhanced clinical services, and improved weight management, wellbeing, and health outcomes for pregnant women with high BMI.
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Sara Holton et al. Weight management during pregnancy: a qualitative study of women's and care providers' experiences and perspectives, BMC Pregnancy and Childbirth (2017). DOI: 10.1186/s12884-017-1538-7