Abstract
Low maternal, gestational weight gain is associated with preterm birth, intrauterine growth restriction, low birthweight, small-for-gestational-age infants, neural tube defects, infant death, failure to initiate breastfeeding, and childhood asthma. The advantage of qualitative research is it can provide valuable insights for health care professionals into the experience and perceptions of low gestational weight gain from the vantage point of women with first-hand lived experience. In this Heideggarian interpretive phenomenological study, the meaning and experiences of weight gain for pregnant women with low gestational weight gain were explored. Data were collected through interviews with 10 pregnant women from Atlantic Canada. Conroy’s pathway for interpretive phenomenology was utilized. A hermeneutical spiral of interpretation identified six patterns or major themes: confronting one’s mortality; defending oneself against a permanent metamorphosis into a stranger; playing with fire and brimstone; slipping under the radar; trying to find peace; and riding an emotional roller coaster. The findings point to a war that is being waged over pregnant bodies with respect to weight that leaves pregnant women fending for themselves, apparently with little help from their health care providers. Implications of the findings for health practice, education, and research are discussed.
Highlights
Low maternal, gestational weight gain is associated with preterm birth, intrauterine growth restriction, low birthweight, small-for-gestational-age infants, neural tube defects, infant death, failure to initiate breastfeeding, and childhood asthma [1]-[4]
In 2000, Abrams, Altman, and Pickett [6] determined that only 30% - 40% of American pregnant women gained within the Institute of Medicine (IOM) weight gain guidelines
The IOM ascertained that little had changed in this regard, with less than half of pregnant women in the United States gaining within the recommended weight gain ranges [4]
Summary
Gestational weight gain is associated with preterm birth, intrauterine growth restriction, low birthweight, small-for-gestational-age infants, neural tube defects, infant death, failure to initiate breastfeeding, and childhood asthma [1]-[4]. The health care costs of suboptimal gestational weight gains and associated sequelae are exorbitant. The annual cost of preterm/low birth weight admissions totaled $5.8 billion in the United States in 2001, which accounted for half of all expenditures for infant hospitalizations and a quarter of all costs for pediatric stays [5]. The IOM ascertained that little had changed in this regard, with less than half of pregnant women in the United States gaining within the recommended weight gain ranges [4]. While gestational weight gains exceeding the recommendations have garnered greater attention from researchers, up to one-quarter of pregnant women in developed countries, including Canada, undergain in pregnancy [4] [7]-[9]. Phenomenological findings might help health care professionals understand a lived experience from the perspective of those who lived it, which could inform their practice. By listening to first-hand accounts of lived health experiences, health care professionals can “step into the shoes” of those who live these experiences and respond in a more meaningful manner
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