Understanding Prenatal Weight Gain in First Nations Women

Abstract

ABSTRACT OBJECTIVE This qualitative study examined the determinants of excessive prenatal weight gain in First Nations women living on a reserve. METHODS Thirteen women participated: 6 with recommended prenatal weight gain and 7 with excessive prenatal weight gain. Individual, semi-structured interviews were used to understand facilitators of and barriers to healthy weight gain in pregnancy. RESULTS There were multiple, interrelated influences on prenatal weight gain including personal factors (beliefs, individual characteristics, desire, motivation), social environment (advice, support for action, feedback), and economic and physical environment (income, access). Women who gained weight within the recommended range for pregnancy were more likely to have appropriate information about weight gain and eating in pregnancy compared to those who gained in excess. Women with recommended prenatal weight gain also had more social support, which was an instrumental or tangible aid that helped women to adopt health behaviours. Women, irrespective of weight gain in pregnancy, described the lack of access to healthy foods as a barrier to healthy eating and healthy weight gain. CONCLUSIONS Efforts to promote healthy prenatal weight gain in First Nations women must go beyond the individual level and include women's social, community and economic contexts.