Abstract
Currently a quarter of British women are obese. It is well known that maternal obesity increases the risk of suboptimal pregnancy outcomes. The National Institute for Health and Care Excellence (NICE) in the UK recommends that pregnant women should be given advice and support on achieving appropriate weight gain during pregnancy. However, evidence suggests that such advice relating to diet and physical activity in pregnancy is inconsistent, as well as sometimes being ineffectual. Recent research shows that many midwives at the forefront of maternity care lack the confidence to discuss weight gain during pregnancy with obese women, and midwives recognise that further training concerning weight gain would enhance their ability to support obese women. Concerns include offending and potentially disengaging women from health services. This paper considers the policy position on diet and activity for obese, pregnant women and the evidence for nutrition and lifestyle intervention for controlling gestational weight gain. It is suggested that the inclusion of a psychological dimension may increase the efficacy of interventions relating to obesity during pregnancy. Recommendation is made for a controlled trial for community midwives examining the efficacy of behaviour change intervention, underpinned by psychological theory that would enable community midwives to offer specific advice and support for obese, pregnant women.
Highlights
The World Health Organisation (2013) defines obesity, as an “abnormal or excessive fat accumulation that may impair health”
The National Institute for Health and Care Excellence (NICE) in the UK recommends that pregnant women should be given advice and support on achieving appropriate weight gain during pregnancy
The intervention group reported increased daily activity, and improved diet (Hui et al, 2012). These findings suggest that utilising a lifestyle intervention of this type may contribute to managing gestational weight gain
Summary
The World Health Organisation (2013) defines obesity, as an “abnormal or excessive fat accumulation that may impair health”. Changing the dietary habits of obese, pregnant women to control gestational weight gain inevitably requires more than informational support and should include a sound psychological, theoretical framework in the design of any intervention to increase the likelihood of behavioural change. A rigorous consultation with obese, pregnant women and healthcare professionals that are involved in their care should be conducted This would gather the experiences of obese, pregnant women and healthcare professionals concerning controlling gestational weight gain to establish what facets an intervention should include; and identify the psychological aspects of gestational weight control such as personal perceptions, barriers, attitudes, beliefs. Increasing intention may in turn increase the likelihood of midwives broaching a discussion about controlling gestational weight gain with obese, pregnant women
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