Teaching about obesity: Caring, compassion, communication and courage in midwifery education
Teaching innovation can be used to promote the 6Cs in one of the most purportedly stigmatising areas of maternity care: obesity. As rates of maternal obesity continue to rise, getting this area of care right becomes more urgent. Although a great deal has been published about the unsatisfactory and stigmatising impact that staff attitudes can have on those with obesity, there is relatively little on how this problematic area of care should be taught to the next generation of midwives. This article presents a case study of learning about obesity management at the pre-registration, undergraduate level. The case study described is an effort to move away from what is currently largely an academic debate, towards a set of tangible practice recommendations.
Higher education institutions (HEIs) are tasked with equipping newly qualified midwives with the skills, knowledge and understanding they need to care for pregnant women. This includes being able to demonstrate all of the 6Cs in their practice: caring, compassion, competence, communication, courage and commitment (Department of Health, 2012).
Using obesity (defined as having a body mass index (BMI) ≥ 30 kg/m2) as a case study, this article presents a series of teaching techniques aimed at enhancing the teaching of the 6Cs in pre-registration midwifery education. In particular, we will use four of the 6Cs—caring, compassion, communication and courage—to frame this article, on the basis that evidence suggests that improvements in these key areas could have a significant impact on improving women's experience of maternity services (Deery and Wray, 2009; Phelan et al, 2015). The case study of obesity was selected to demonstrate the value of teaching innovations in the 6Cs for two reasons. Firstly, because obesity has been identified as one of the most significant current issues facing midwifery (Royal College of Midwives, 2013); despite this, obesity training for health professionals has been found to be inadequate (Fillingham et al, 2014). Secondly, because there is a growing body of concerning evidence to suggest that health-care students and professionals (including midwives) may hold negative, even discriminatory attitudes towards obesity, seeing the condition as a sign of lack of self-control (Schmied et al, 2011; Keyworth et al, 2013). Not surprisingly, research suggests that the lived experience of receiving maternity care when obese is far from positive (Deery and Wray, 2009; Furber and McGowan, 2011). Phelan et al (2015), in their review on obesity stigma, outline how individuals are affected by negative attitudes towards weight. This includes individuals feeling devalued and stereotyped which, in turn, threatens their sense of identity and self-worth. It is the apparent lack of professional principles—including caring, compassion, communication and courage—which makes these findings of particular concern.
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