Experiences of maternal weight management services among women with a raised body mass index

Abstract

Abstract Background Obesity is associated with increased maternal morbidity and mortality. Maternal weight management services (MWMS) are a good opportunity to influence lifestyle behaviours of mothers. To understand what constitutes the most suitable service, women's views on MWMS are paramount. Methods A purposive sample of 13 women with a BMI≥40kg/m² were interviewed at 36 weeks gestation. A semi-structured interview schedule explored their experiences of MWMS provision and advice, awareness of services and the barriers and facilitators to antenatal weight management. Interviews were recorded and transcribed verbatim. Inductive thematic analysis was undertaken. Results Four themes emerged. 'Understanding where I am at' showed women's readiness and motivation varied, from being avoidant or unaware of weight as an issue to already making changes. 'Getting information' revealed while a few women felt that they received good information during pregnancy most reported a lack of information or minimal information provided in a 'tick-box' fashion. Women particularly wanted practical advice. 'Difficulties I face' identified physical, emotional and financial barriers and the strategies some women used to overcome these. 'Encountering professionals - a mixed experience' demonstrated women wanted to be treated with respect and sensitivity and that how weight management information was addressed was more important than who provided it. The fine line professionals need to tread was evidenced by women thinking they had received inadequate information and yet that there was too much focus on their weight and its related risks during pregnancy. Conclusions MWMS should not be seen as a 'tick box' exercise but should be woman-centred to assist women to move forward in their weight management journey, no matter what their starting point. Women desired practical advice provided in a sensitive, respectful manner not just the continual repetition of the risks of being obese during pregnancy. Key messages Maternal weight management services require a woman-centred approach to enable women to move forward on their weight management journey. Women want practical, sensitive advice not just the continual repetition of the risks of being obese during pregnancy.