Midwives' attitudes towards giving weight-related advice to obese pregnant women

Abstract

It is estimated that 1 in 5 pregnant women are obese, this poses a significant risk to maternal, fetal and newborn mortality and morbidity and as such, maternal obesity is recognised as a challenge for contemporary and prospective maternity services. As key practitioners in maternity care, midwives are seen as frontline professionals delivering weight-related advice to obese pregnant women. This study aimed to explore midwives' attitudes towards offering obese pregnant women weight-related advice during pregnancy and the puerperium. Nine midwives were interviewed using an in-depth interview schedule. Data were analysed using Colaizzi's (1978) seven-stage thematic approach. Midwives' knowledge of risk associated with maternal obesity was good; advice giving was mainly confined to community practice; the amount and consistency of advice was determined by: women's responses, women's apparent motivation to change and midwives' self-perception as a role model. Four key themes emerged: challenges for practice; perceived proficiency; advice giving skills and midwives' perceived relationship with a woman. Midwives need to address personal issues around body image, as they appear to hinder advice giving, before they can develop effective communication techniques to be able to offer obese pregnant women weight-related advice. The recommendation is to investigate ways in which issues of body image influence midwives ability to offer weight-related advice.