Committee Opinion No. 650. Obstet Gynecol. 2015; 126:(6)e135-e142

Albarrací D, Gillette JC, Earl AN, Glasman LR, Durantini MR, Ho MH A test of major assumptions about behavior change: a comprehensive look at the effects of passive and active HIV-prevention interventions since the beginning of the epidemic. Psycholl bull. 2005; 131:(6)

Armstrong T, Bull F Development of the World Health Organization Global Physical Activity Questionnaire (GPAQ). J Public Health (Bangkok). 2006; 14:(2)66-70

Braun V, Clarke V Using thematic analysis in psychology. Qual Res Psychol. 2006; 3:(2)77-101

Bravata DM, Smith-Spangler C, Sundaram V Using pedometers to increase physical activity and improve health: A systematic review. JAMA. 2007; 298:(19)2296-2304

Brown MJ, Sinclair M, Liddle D, Hill A, Stockdale D, Madden E Motivating pregnant women to eat healthily and engage in physical activity for weight management: an exploration of routine midwife Instruction. Evidence Based Midwifery. 2013; 11:(4)120-127

Bull FC, Maslin TS, Armstrong T Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health. 2009; 6:(6)790-804

Catalano PM, Ehrenberg HM Review article: the short- and long-term implications of maternal obesity on the mother and her offspring. BJOG: An International Journal of Obstetrics & Gynaecology. 2006; 113:(10)1126-1133

Cleland CL, Hunter RF, Kee F, Cupples ME, Sallis JF, Tully MA Validity of the Global Physical Activity Questionnaire (GPAQ) in assessing levels and change in moderate-vigorous physical activity and sedentary behaviour. BMC Public Health. 2014; 14:(1)

Creswell JW, 3rd Edition. Los Angeles: SAGE Publications; 2009

Currie S, Sinclair M, Murphy MH, Madden E, Dunwoody L, Liddle D Reducing the decline in physical activity during pregnancy: a systematic review of behaviour change interventions. PLoS ONE. 2013; 8:(6)

Foster CE, Hirst J Midwives' attitudes towards giving weight-related advice to obese pregnant women. British Journal of Midwifery. 2014; 22:(4)254-262

Furness PJ, Arden MA, Duxbury AM, Hampshaw SM, Wardle C, Soltani H Talking about weight in pregnancy: an exploration of practitioners' and women's perceptions. J Nurs Educ and Pract. 2015; 5:(2)

Gardner B, Wardle J, Poston L, Croker H Changing diet and physical activity to reduce gestational weight gain: a meta-analysis. Obes Rev. 2011; 12:(7)e602-e620

Guenther PM, Reedy J, Krebs-Smith SM, Reeve BB, Basiotis PP Development and evaluation of the healthy eating index-2005. United States Department of Agriculture.Washington: Center for Nutrition Policy and Promotion; 2007

Handley MA, Harleman E, Gonzalez-Mendez E Applying the COM-B model to creation of an IT-enabled health coaching and resource linkage program for low-income Latina moms with recent gestational diabetes: the STAR MAMA program. Implement Sci. 2016; 11:(1)

Heslehurst N, Rankin J, Wilkinson JR, Summerbell CD A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619 323 births, 1989–2007. Int J Obes. 2010; 34:(3)420-428

Hesketh KR, Evenson KR Prevalence of U.S. pregnant women meeting 2015 ACOG Physical Activity Guidelines. Am J Prev Med. 2016; 51:(3)e87-e89

Lemieux-Charles L, McGuire WL What do we know about health care team effectiveness? A review of the literature. Med Care Res Rev. 2006; 63:(3)263-300

Michie S, Prestwich A Are interventions theory-based? Development of a theory coding scheme. Health Psychol. 2010; 29:(1)1-8

Michie S, van Stralen MM, West R The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implement Sci. 2011; 6:(1)

Michie S, Richardson M, Abraham Johnston M The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013; 46:(1)81-95

Michie S, Atkins L, West RLondon: Silverback Publishing; 2014

Moore LVWashington: Centres for Disease Control and Prevention; 2015

Morgan KL, Rahman MA, Macey S in pregnancy: a retrospective prevalence-based study on health service utilisation and costs on the NHS. BMJ Open. 2014; 4:(2)

London: NHS England; 2013

National Institute for Clinical Excellence (NICE). Public Health Guideline 27. 2010. (accessed May 10 2017)

Orr ST Social support and pregnancy outcome: a review of the literature. Clin Obstet Gynecol. 2004; 47:(4)842-855

Phelan S Pregnancy: a teachable moment for weight control and obesity prevention. Am J Obstet Gynecol. 2010; 202:(2)135.e1-135.e8

Richardson D, Cavill N, Ells L, Roberts KOxford: National Obesity Observatory; 2011

Edinburgh: The Scottish Government; 2011

Smith D, Taylor W, Lavender T The role of antenatal and postnatal social support for pregnant women with a body mass index ≥ 30 kg/m 2. British Journal of Midwifery. 2014; 22:(8)564-567

Soltani H, Arden MA, Duxbury AMS, Fair FJ An analysis of behaviour change techniques used in a sample of gestational weight management trials. J Pregnancy. 2016; 2016:1-15

Taylor SE Social support: A review. In: Friedman HS Oxford: Oxford Handbooks; 2011

Thangaratinam S, Rogozińska E, Jolly K Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ. 2012; 344:(may16 4)

Wen L, Flood VM, Simpson JM, Rissel C, Baur LA Dietary behaviours during pregnancy: findings from first-time mothers in southwest Sydney, Australia. Int J Behav Nutr Phys Act. 2010; 7:(1)

Wight D, Wimbush E, Jepson R, Doi L Six steps in quality intervention development (6SQuID). J Epidemiol Community Health. 2016; 70:(5)520-525

Bump Start: developing and piloting a healthy living group intervention for obese pregnant women

02 June 2017
Volume 25 · Issue 6


Pregnancy is a time when women may be particularly motivated to make healthy lifestyle changes, which is encouraging when maternal obesity remains such an important modifiable risk factor. However, offering the right ‘recipe’ of support can be challenging for midwives. They report lacking time and confidence for ongoing discussions about diet and physical activity in consultations, and a lack of local evidence-based supportive services to which they can refer interested women. This article reports the efforts of a team of midwives, health psychologists, dieticians and physiotherapists to use theory and evidence to develop and pilot a community-based programme to address this issue. Bump Start aims to encourage healthy lifestyle changes in overweight antenatal women in a health board in Scotland. It presents initial findings from the first pilot, highlighting particular factors that went well and challenges that presented themselves along the way, in the hope of sharing learning with other teams.

Maternal obesity (a body mass index (BMI) of 30kg/m2 or higher at the first antenatal consultation) is a key modifiable risk factor in pregnancy. The health problems linked to maternal BMI for both mother and baby are substantial and well-known to midwives (Catalano and Ehrenberg, 2006), but the UK prevalence of antenatal obesity in 2006 was 18.5% and this figure only seems to be increasing year-on-year (Heslehurst et al, 2010). Inevitably, this puts more pressure on squeezed health services, with health-care costs estimated to be 37% higher among obese women compared to those with a normal weight (Morgan et al, 2014).

In addition, finding the ‘right recipe’ of support and lifestyle advice can be somewhat challenging. In terms of reducing risk factors through healthy eating and physical activity, in one Australian nutrition study, only 7% and 13% of mothers reported consuming the recommended portions of vegetables and fruit, respectively, per day and, in total, 12% consumed more than two takeaways per week (Wen et al, 2010). In an analysis of population survey data, 60% of pregnant women reported engaging in no leisure time physical activity (Hesketh and Evenson, 2016).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month