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Communication with health professionals: The views of pregnant women with a raised BMI

02 September 2018
14 min read
Volume 26 · Issue 9

Abstract

Background

There is evidence that midwives may find discussions about weight difficult with pregnant women with a raised body mass index (BMI). In previous studies, pregnant women have reported a lack of information and negative experiences.

Aim

To explore the experiences of pregnant women with a raised BMI to investigate if their pregnancies were affected by their interactions with midwives and other health professionals.

Methods

Women (n=11) were interviewed using an standardised framework. The discussions were recorded and then transcribed. Thematic analysis was used.

Findings

Three themes emerged from the data: ‘feeling judged’, ‘knowledge gap’ and ‘doing your best’.

Conclusion

Pregnant women with a raised BMI can feel judged in their communications with midwives and other health professionals. They do not have the information necessary to make informed decisions on their care but they do their best to follow guidelines and have a healthy pregnancy.

Women with a raised body mass index (BMI) of ≥30 kg/m2 have an increased risk of pregnancy-related complications and adverse outcomes (Centre for Maternal and Child Enquiries, 2010). For most adults, the stated ideal BMI is in the 18.5–24.9 kg/m2 range; between 25–29.9 kg/m2 a person is in the ‘overweight’ range; and at 30 kg/m2 and above, the individual falls into the ‘obese’ range. For the purposes of this study, a raised BMI was defined as 30 kg/m2 and above.

There is an expectation that midwives and other health professionals will discuss the risks of raised BMI with pregnant women and give diet and exercise advice, as per National Institute of Health and Care Excellence (NICE) guidelines (NICE, 2010). However, there is evidence that midwives find the discussion of weight, diet and exercise difficult (Stotland et al, 2010; Schmied et al, 2011; Knight-Agarwal et al, 2014). This finding is mirrored in the experiences of pregnant women, who have reported feeling humiliated and stigmatised (Furber and McGowan, 2011), with negative emotions heightened through interactions with health professionals (Nyman et al, 2010).

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