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The lived experience of staff caring for women in labour who have a BMI ≥40 kg/m2

02 July 2021
18 min read
Volume 29 · Issue 7



Obesity is a growing health concern nationally and internationally. During the perinatal period, obesity poses increased risks to both mother and fetus; however, few studies consider the challenges staff caring for these women face.


To explore the lived experience of the staff that provide labour care for women with a BMI≥40 kg/m2.


A qualitative study involving semi-structured interviews with practicing midwives was conducted. Interviews were recorded, transcribed verbatim and analysed thematically.


A total of five interviews were conducted and seven themes emerged, namely monitoring the fetal heart and mobilisation, assessing labour progress, different to caring for woman with a lower BMI, emotional issues, opinions regarding women's risk perception, addressing the issue of obesity, and education/training.


Further training would guide staff to deliver timely and appropriate information to women, assisting staff caring for women, particularly in labour, to feel more confident when discussing issues surrounding obesity.

The World Health Organization ([WHO], 2013) has identified that obesity (body mass index ([BMI] ≥30 kg/m2) is the most challenging health epidemic in this century, stating that the incidence has more than doubled in the past 25 years. They postulate that a significant shift in dietary and physical activity cultures that has led to this increase. Table 1 presents the WHO (2020) BMI categories.

Recent figures demonstrate that 29% of the population in England is obese (NHS Digital, 2019). Obesity is responsible for an increased risk of cardiovascular disease, and a generalised increase in morbidity and mortality, and subsequent additional costs to the health and social care system (WHO, 2020). These costs not only include the actual care provision to screen for, monitor and treat the conditions linked to obesity but also the rising costs of additional bariatric equipment required to provide such care (Heslehurst et al, 2007; Heslehurst, 2011; Morgan et al, 2014).

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