Atkinson S, McNamara PM. Unconscious collusion: an interpretative phenomenological analysis of the maternity care experiences of women with obesity (BMI≥30 kg/m²). Midwifery. 2017; 49:54-64

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

Maternal obesity in the UK: Findings from a national project.London: CEMACE; 2010

Furber CM, McGowan L. A qualitative study of the experiences of women who are obese and pregnant in the UK. Midwifery. 2011; 27:(4)437-44

Furness PJ, McSeveny K, Arden MA, Garland C, Dearden AM, Soltani H. Maternal obesity support services: a qualitative study of the perspectives of women and midwives. BMC Pregnancy Childbirth. 2011; 11:(1)

Gray CM, Hunt K, Lorimer K, Anderson AS, Benzeval M, Wyke S. Words matter: a qualitative investigation of which weight status terms are acceptable and motivate weight loss when used by health professionals. BMC Public Health. 2011; 11:(1)

Heslehurst N, Newham J, Maniatopoulos G, Fleetwood C, Robalino S, Rankin J. Implementation of pregnancy weight management and obesity guidelines: a meta-synthesis of healthcare professionals' barriers and facilitators using the Theoretical Domains Framework. Obes Rev. 2014; 15:(6)462-86

De Jersey SJ, Nicholson JM, Callaway LK, Daniels LA. An observational study of nutrition and physical activity behaviours, knowledge, and advice in pregnancy. BMC Pregnancy Childbirth. 2013; 13

Keeley A, Gunning M, Denison F. Maternal obesity in pregnancy: women's understanding of risks. Br J Midwifery. 2011; 19:(6)364-69

Knight-Agarwal C, Kaur M, Williams L, Davey R, Davis D. The views and attitudes of health professionals providing antenatal care to women with a high BMI: A qualitative research study. Women Birth. 2014; 27:(2)138-44

Knight-Agarwal C, Williams L, Davis D The perspectives of obese women receiving antenatal care: A qualitative study of women's experiences. Women Birth. 2016; 29:(2)189-95

Lavender T, Smith DM. Seeing it through their eyes: a qualitative study of the pregnancy experiences of women with a body mass index of 30 or more. Health Expect. 2016; 19:(2)222-33

Lindhardt C, Rubak S, Mogensen O Healthcare professionals experience with motivational interviewing in their encounter with obese pregnant women. Midwifery. 2015; 31:(7)678-84

McParlin C, Bell R, Robson S, Muirhead C, Araújo-Soares V. What helps or hinders midwives to implement physical activity guidelines for obese pregnant women? A questionnaire survey using the Theoretical Domains Framework. Midwifery. 2017; 49:110-16

Mills A, Schmied V, Dahlen H. ‘Get alongside us’, women's experiences of being overweight and pregnant in Sydney, Australia. Matern Child Nutr. 2013; 9:(3)309-21

Weight management before, during and after pregnancy [PH27].London: NICE; 2010

Nyman VMK, Prebensen AK, Flesner GEM. Obese women's experiences of encounters with midwives and physicians during pregnancy and childbirth. Midwifery. 2010; 26:(4)424-9

Schmied V, Duff M, Dahlen H, Mills A, Kolt G. ‘Not waving but drowning’: A study of the experiences and concerns of midwives and other health professionals caring for obese childbearing women. Midwifery. 2011; 27:(4)424-30

Shub A, Huning E, Campbell K, McCarthy E. Pregnant women's knowledge of weight, weight gain, complications of obesity and weight management strategies in pregnancy. BMC Res Notes. 2013; 6

Smith D, Lavender T. The maternity experience for women with a body mass index ≥ 30 kg/m 2: A meta-synthesis. BJOG. 2011; 118:(7)779-89

Smith DM, Cooke A, Lavender T. Maternal obesity is the new challenge; a qualitative study of health professionals' views towards suitable care for pregnant women with a Body Mass Index (BMI) ≥30 kg/m2. BMC Pregnancy Childbirth. 2012; 12

Stotland NE, Gilbert P, Bogetz A, Harper CC, Abrams B, Gerbert B. Preventing excessive weight gain in pregnancy: how do prenatal care providers approach counseling?. J Womens Health (Larchmt). 2010; 19:(4)807-14

Volger S, Vetter M, Dougherty M Patients' preferred terms for describing their excess weight: Discussing obesity in clinical practice. Obesity (Silver Spring). 2012; 20:(1)147-50

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

02 September 2018
Volume 26 · Issue 9



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.


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.


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


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


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).

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