Abstract
Obesity is the UK's most prevalent antenatal comorbidity, and reducing rates of maternal obesity and risk management of complications in pregnancy and labour is a priority for the NHS. The emphasis on managing maternal obesity-related risks, rather than dealing with the causes of long-term obesity, is short-sighted and fails to consider the needs of the individual woman. This process of risk management is fuelled by the maternity services' costly litigation insurance that presents measures to manage obesity-related risks, leading to bureaucratic shaping of maternity services. This limits the choices for this group of women by standardising care rather than facilitating their individual needs. This article explores an alternative long-term strategy called Pregnancy Plus that facilitates the management of risk alongside supporting the needs of individual obese pregnant women, offering choice and equal access to maternity services while maintaining the safety of the women and their babies. Pregnancy Plus is an award-winning multi-intervention health education and weight maintenance programme that has presented promising outcomes to date. It utilises a salutogenic approach to health education and care-planning for obese pregnant women and adopts the principles of the US Institute of Medicine guidelines for the maintenance of gestational weight-gain in obese women.
Published Version
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