Abstract
Background. Excessive gestational weight gain poses significant short- and long-term health risks to both mother and baby. Professional bodies and health services increasingly recommend greater attention be paid to weight gain in pregnancy. A large Australian tertiary maternity hospital plans to facilitate the (re)introduction of routine weighing of all women at every antenatal visit. Objective. To identify clinicians' perspectives of barriers and enablers to routinely weighing pregnant women and variations in current practice, knowledge, and attitudes between different staff groups. Method. Forty-four maternity staff from three professional groups were interviewed in four focus groups. Staff included midwives; medical staff; and dietitians. Transcripts underwent qualitative content analysis to identify and examine barriers and enablers to the routine weighing of women throughout pregnancy. Results. While most staff supported routine weighing, various concerns were raised. Issues included access to resources and staff; the ability to provide appropriate counselling and evidence-based interventions; and the impact of weighing on patients and the therapeutic relationship. Conclusion. Many clinicians supported the practice of routine weighing in pregnancy, but barriers were also identified. Implementation strategies will be tailored to the discrete professional groups and will address identified gaps in knowledge, resources, and clinician skills and confidence.
Highlights
Excessive gestational weight gain for women of any prepregnancy Body Mass Index (BMI) is associated with adverse maternal and infant outcomes, including diabetes, preeclampsia, caesarean section, fetal macrosomia, admission to neonatal nursery, increased risk of postpartum weight retention, and risk of chronic disease for both mother and baby [1,2,3,4,5,6].Routine weighing of women throughout their pregnancy used to be standard practice
Forty-four staff participated in four separate group interviews: 16 hospital staff midwives; 12 midwifery group practice (MGP) midwives; two dietitians; and 14 medical staff, comprising obstetric registrars and consultant obstetricians
In addition to reporting on current weighing practices, four main themes were identified from the interviews, including (1) Systems and Resources; (2) Patient and Clinician’s Personal Characteristics; (3) Advantages and Disadvantages of Routine Weighing; and (4) Evidence for Routine Weighing and Interventions
Summary
Excessive gestational weight gain (eGWG) for women of any prepregnancy Body Mass Index (BMI) is associated with adverse maternal and infant outcomes, including diabetes, preeclampsia, caesarean section, fetal macrosomia, admission to neonatal nursery, increased risk of postpartum weight retention, and risk of chronic disease for both mother and baby [1,2,3,4,5,6].Routine weighing of women throughout their pregnancy used to be standard practice. Excessive gestational weight gain (eGWG) for women of any prepregnancy Body Mass Index (BMI) is associated with adverse maternal and infant outcomes, including diabetes, preeclampsia, caesarean section, fetal macrosomia, admission to neonatal nursery, increased risk of postpartum weight retention, and risk of chronic disease for both mother and baby [1,2,3,4,5,6]. In the 1990s the practice was challenged after studies found that monitoring weight was not effective in identifying women who would give birth to infants small for gestational age or for the development of preeclampsia. To identify clinicians’ perspectives of barriers and enablers to routinely weighing pregnant women and variations in current practice, knowledge, and attitudes between different staff groups. Many clinicians supported the practice of routine weighing in pregnancy, but barriers were identified.
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