Search

Objective To explore the construal of midwives by pregnant women with a body mass index greater than 30 kg/m2 (BMI ≥ 30 kg/m2). Method Ten pregnant women with a BMI ≥ 30 kg/m2 were recruited from antenatal clinics at a maternity hospital in the North West of England. Each participant completed a repertory grid. The participants chose people to match roles including themselves, pregnant women, midwives of different BMIs and hypothetical elements. They also generated psychological constructs to describe them. Results Pregnant women with a BMI ≥ 30 kg/m2 construed themselves as vulnerable and self-conscious. Some women endorsed obesity-related stereotypes for themselves and felt responsible for their weight. The midwife with a BMI 18

OBJECTIVE: To explore the experiences of postnatal women who are obese [body mass index (BMI) ? 30 kg/m(2) ] in relation to making behaviour changes and use of behaviour change techniques (BCTs). DESIGN: Qualitative interview study. SETTING: Greater Manchester, UK. POPULATION OR SAMPLE: Women who were 1 year postnatal aged ?18 years, who had an uncomplicated singleton pregnancy, and an antenatal booking BMI ? 30 kg/m(2) . METHODS: Eighteen semi-structured, audio-recorded interviews were conducted by a research midwife with women who volunteered to be interviewed 1 year after taking part in a pilot randomised controlled trial. The six stages of thematic analysis were followed to understand the qualitative data. The Behavior Change Technique Taxonomy (version 1) was used to label the behaviour change techniques (BCTs) reported by women. MAIN OUTCOME MEASURES: Themes derived from 1-year postnatal interview transcripts. RESULTS: Two themes were evident: 1. A focused approach to postnatal weight management: women reported making specific changes to their eating and physical activity behaviours, and 2. Need for support: six BCTs were reported as helping women make changes to their eating and physical activity behaviours; three were reported more frequently than others: Self-monitoring of behaviour (2.3), Prompts/cues (7.1) and Social support (unspecified; 3.1). All of the BCTs required support from others for their delivery; food diaries were the most popular delivery method. CONCLUSION: Behaviour change techniques are useful to postnatal women who are obese, and have the potential to improve their physical and mental wellbeing. Midwives and obstetricians should be aware of such techniques, to encourage positive changes. TWEETABLE ABSTRACT: BCTs are useful to postnatal women who are obese, and have the potential to improve their wellbeing.

BACKGROUND: Maternal obesity [body mass index (BMI)�?�30�kg/m(2) ] is associated with numerous complications, but currently, little is known about the pregnancy experiences of these women. OBJECTIVE: To gain insight into the experience of pregnant women with BMI�?�30�kg/m(2) , when accessing maternity services and attending a community lifestyle programme. DESIGN: Qualitative methodology, utilizing focus groups and semi-structured interviews with post-natal women who had an antenatal BMI�?�30�kg/m(2) . The sample was obtained from a larger study. RESULTS: Thirty-four women participated. Three main themes were identified using thematic analysis. Women described disappointment with their pregnancy. In particular, their informational expectations were not met; some health professionals appeared uninterested, insensitive or unconfident. Women described readiness to make a lifestyle change, but this was not encouraged during routine care. Attending the programme began the process of behavioural change. Women's beliefs that small changes make a big difference led to them being spurred on by success; driven by a desire to improve the health of their family. DISCUSSION AND CONCLUSION: Pregnant women who are obese know this is the case and expect to be provided with information to assist them in making lifestyle changes. Health professionals should be aware of women's readiness for change and view pregnancy as an ideal time to communicate. Pregnant women with a BMI�?�30�kg/m(2) should contribute to health professional training, to highlight the reality of the maternity system journey; first-hand accounts may improve the way health professionals' approach these women. Lifestyle interventions should be developed with input from the intended target group.