Weight stigma in maternity care: women’s experiences and care providers’ attitudes

Kate Mulherin,Phillippa C Diedrichs,Rachel Thompson,Fiona Kate Barlow,Yvette D Miller

doi:10.1186/1471-2393-13-19

Abstract

BackgroundWeight stigma is pervasive in Western society and in healthcare settings, and has a negative impact on victims’ psychological and physical health. In the context of an increasing focus on the management of overweight and obese women during and after pregnancy in research and clinical practice, the current studies aimed to examine the presence of weight stigma in maternity care. Addressing previous limitations in the weight stigma literature, this paper quantitatively explores the presence of weight stigma from both patient and care provider perspectives.MethodsStudy One investigated associations between pre-pregnancy body mass index (BMI) and experiences of maternity care from a state-wide, self-reported survey of 627 Australian women who gave birth in 2009. Study Two involved administration of an online survey to 248 Australian pre-service medical and maternity care providers, to investigate their perceptions of, and attitudes towards, providing care for pregnant patients of differing body sizes. Both studies used linear regression analyses.ResultsWomen with a higher BMI were more likely to report negative experiences of care during pregnancy and after birth, compared to lower weight women. Pre-service maternity care providers perceived overweight and obese women as having poorer self-management behaviours, and reported less positive attitudes towards caring for overweight or obese pregnant women, than normal-weight pregnant women. Even care providers who reported few weight stigmatising attitudes responded less positively to overweight and obese pregnant women.ConclusionsOverall, these results provide preliminary evidence that weight stigma is present in maternity care settings in Australia. They suggest a need for further research into the nature and consequences of weight stigma in maternity care, and for the inclusion of strategies to recognise and combat weight stigma in maternity care professionals’ training.

Highlights

Weight stigma is pervasive in Western society and in healthcare settings, and has a negative impact on victims’ psychological and physical health
In Study Two we found that pre-service care providers hold less positive perceptions of patient self-care of, and attitudes towards caring for, overweight and obese compared to normal-weight, pregnant women. These effects were evident in preservice care providers with both low and high levels of weight stigmatising attitudes. This preliminary evidence suggests that, like in other healthcare settings, weight stigma is present in maternity care
Our results provide evidence that weight stigma is prevalent in Australian maternity care settings

Summary

Introduction

Weight stigma is pervasive in Western society and in healthcare settings, and has a negative impact on victims’ psychological and physical health. In the context of an increasing focus on the management of overweight and obese women during and after pregnancy in research and clinical practice, the current studies aimed to examine the presence of weight stigma in maternity care. Weight stigma is the exhibition of prejudiced attitudes (e.g., attribution of negative labels such as lazy, unclean, and unintelligent) and discriminatory actions (e.g., teasing, providing inferior quality education, health or other services) towards an individual based upon their weight and body size alone (see [1] for a review). Despite its associated negative health outcomes, a large number of studies have documented weight stigma in healthcare settings. The same study showed that physicians report being more annoyed and experiencing less work enjoyment when treating obese patients

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Results

Discussion

Conclusion