"What My Doctor Didn't Tell Me": Examining Health Care Provider Advice to Overweight and Obese Pregnant Women on Gestational Weight Gain and Physical Activity
ABSTRACT Appropriate gestational weight gain (GWG) is vital, as excessive GWG is strongly associated with postpartum weight retention and long-term obesity. How health care providers counsel overweight and obese pregnant women on appropriate GWG and physical activity remains largely unexplored.
We conducted semistructured interviews with overweight and obese women after the birth of their first child to ascertain their experiences with GWG. A grounded theory approach was used to identify themes on provider advice received about GWG and physical activity during pregnancy.
Twenty-four women were included in the analysis. Three themes emerged in discussions regarding provider advice on GWG: 1) Women were advised to gain too much weight or given no recommendation for GWG at all, 2) providers were perceived as being unconcerned about excessive GWG, and 3) women desire and value GWG advice from their providers. On the topic of provider advice on exercise in pregnancy, three themes were identified: 1) Women received limited or no advice on appropriate physical activity during pregnancy, 2) women were advised to be cautious and limit exercise during pregnancy, and 3) women perceived that provider knowledge on appropriate exercise intensity and frequency in pregnancy was limited.
This study suggests that provider advice on GWG and exercise is insufficient and often inappropriate, and thus unlikely to positively influence how overweight and obese women shape goals and expectations in regard to GWG and exercise behaviors. Interventions to help pregnant women attain healthy GWG and adequate physical activity are needed.
Full-textDOI: · Available from: Kristen Kjerulff, May 22, 2015
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ABSTRACT: In Sweden, midwives play prominent supportive role in antenatal care by counselling and promoting healthy lifestyles. This study aimed to explore how Swedish midwives experience the counselling of pregnant women on physical activity, specifically focusing on facilitators and barriers during pregnancy. Also, addressing whether the midwives perceive that their own lifestyle and body shape may influence the content of the counselling they provide.BMC Pregnancy and Childbirth 09/2014; 14(343). DOI:10.1186/1471-2393-14-343 · 2.15 Impact Factor
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ABSTRACT: The objective of this study was to characterize pregnant women's gestational weight gain (GWG) knowledge and awareness of healthy eating behaviors known to impact GWG. Formative research was conducted including semi-structured individual interviews and focus group interviews. The participants were mostly Caucasian pregnant women (N = 30; Mage = 28 years old) residing in a suburban/rural region of Central Pennsylvania. Descriptive and thematic analyses were used to examine the primary outcomes of GWG and healthy eating knowledge and informational sources. Many women had no knowledge of how much GWG they should gain in pregnancy (42%). Women appeared to have adequate knowledge on foods they should avoid eating during pregnancy. However, one-fourth of women indicated that they did not feel as though they received adequate information from their healthcare provider about the foods they should be eating and how to meet the healthy eating recommendations. Therefore, one-fourth of women reported using non-healthcare provider resources (e.g., magazines, internet) with questionable reliability to obtain healthy eating guidance. These exploratory findings show that pregnant women have some knowledge of the GWG and healthy eating guidelines; however, most women received this information from a non-healthcare provider resource. Focused efforts are needed to educate pregnant women about GWG and healthy eating using accurate and reliable sources andencourage strategies to meet guidelines in an effort to promote healthy GWG.
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ABSTRACT: Maternal obesity is associated with an increased risk of pregnancy complications, including gestational diabetes. Physical activity (PA) might improve glucose metabolism and reduce the incidence of gestational diabetes. The purpose of this study was to explore patterns of PA and factors associated with change in PA in obese pregnant women. PA was assessed objectively by accelerometer at 16 - 18 weeks' (T0), 27 - 28 weeks' (T1) and 35 - 36 weeks' gestation (T2) in 183 obese pregnant women recruited to a pilot randomised trial of a combined diet and PA intervention (the UPBEAT study). Valid PA data were available for 140 (77%), 76 (42%) and 54 (30%) women at T0, T1 and T2 respectively. Moderate and vigorous physical activity as a proportion of accelerometer wear time declined with gestation from a median of 4.8% at T0 to 3% at T2 (p < 0.05). Total activity as a proportion of accelerometer wear time did not change. Being more active in early pregnancy was associated with a higher level of PA later in pregnancy. The intervention had no effect on PA. PA in early pregnancy was the factor most strongly associated with PA at later gestations. Women should be encouraged to participate in PA before becoming pregnant and to maintain their activity levels during pregnancy. There is a need for effective interventions, tailored to the needs of individuals and delivered early in pregnancy to support obese women to be sufficiently active during pregnancy. Current Controlled Trials ISRCTN89971375 (Registered 28/11/2008).BMC Pregnancy and Childbirth 12/2015; 15(1):479. DOI:10.1186/s12884-015-0479-2 · 2.15 Impact Factor