Healthcare provider advice on gestational weight gain: uncovering a need for more effective weight counselling

Abstract

Limited research has examined the factors related to knowledge of gestational weight gain (GWG) recommendations and the receipt of advice from healthcare providers regarding GWG recommendations among women with pre-pregnancy overweight/obesity. Women with pre-pregnancy overweight/obesity (N = 191) reported the amount of gestational weight they believed they should gain and that healthcare providers advised them to gain. Only 24% (n = 46) of women had a correct knowledge of GWG recommendations. Women were less likely to have a correct knowledge of GWG recommendations if they had pre-pregnancy obesity, were of a minority race, or were socioeconomically disadvantaged. Meanwhile, only 17% (n = 32) of women reported being correctly advised about GWG recommendations by healthcare providers. There were no differences between women who did and did not report being correctly advised about GWG recommendations from healthcare providers. These findings indicate that women with pre-pregnancy overweight/obesity lack knowledge of GWG recommendations and report being incorrectly advised about GWG recommendations from healthcare providers. Impact statement What is already known on this subject? Extant literature indicates that women's knowledge of gestational weight gain (GWG) recommendations and women's receipt of information from their healthcare providers regarding GWG recommendations are predictive of meeting the Institute of Medicine guidelines for GWG. What do the results of this study add? Findings from the present study indicate that the majority of women with pre-pregnancy overweight/obesity lack knowledge of GWG recommendations and report that education on GWG recommendations from healthcare providers is an aspect of their prenatal care that is largely insufficient. Although there were no differences between women who did and did not report being correctly advised about GWG recommendations by healthcare providers, women were less likely to have a correct knowledge of GWG recommendations if they had pre-pregnancy obesity, were of a minority race, or were socioeconomically disadvantaged. What are the implications of these findings for clinical practise and/or further research? These findings highlight a need for more effective tailoring of prenatal care to ensure that women receive accurate advice from healthcare providers regarding GWG recommendations.

MAMMA MIA! Norwegian Midwives’ Practices and Views About Gestational Weight Gain, Physical Activity, and Nutrition

“…This frequent counseling throughout gestation and also that women may be more receptive and motivated to make changes for their own and their babies health have suggested pregnancy to be a particular “teachable moment” ( ACOG, 2015 ). Still, and in line with the present results, qualitative research and surveys have shown that provider–patient communication regarding GWG, PA, and nutrition is infrequent and that, unless requested, few pregnant women receive regular guidance about these health topics ( de Jersey et al, 2012 , 2013 ; Stengel et al, 2012 ; Willcox et al, 2012 ; Whitaker et al, 2016 ; Morris et al, 2017 ; Wilkinson et al, 2017 ; Emery et al, 2018 ; McGee et al, 2018 ; Dalhaug and Haakstad, 2019 ). Hence, this evidence signals a lack of focus on lifestyle behavior in pregnancy and highlights the importance of improving healthcare provider’s knowledge, confidence, and skills in giving such guidance.…”

“…Hence, this evidence signals a lack of focus on lifestyle behavior in pregnancy and highlights the importance of improving healthcare provider's knowledge, confidence, and skills in giving such guidance. On the other side, most of the studies regarding prevalence of prenatal lifestyle counseling are based on the pregnant women's report of provider advice (Stengel et al, 2012;Whitaker et al, 2016;Emery et al, 2018;Dalhaug and Haakstad, 2019), and some have shown little congruence between patient and healthcare providers perceptions of counseling practice (Lutsiv et al, 2012;Ferraro et al, 2013). This discrepancy may be due to the healthcare providers giving socially desirable responses or the pregnant women not recalling having received advice from their healthcare provider.…”

“… McGee et al (2018) reported that fewer than 25% of obstetricians regularly discussed exercise during prenatal care, whereas others have found somewhat higher numbers (30–60%) with respect to combined PA/nutrition counseling ( Whitaker et al, 2016 ; Santo et al, 2017 ; Vinturache et al, 2017 ). Up to date, most studies regarding the prevalence of prenatal lifestyle counseling are based on the women’s report of provider advice and the vast majority are done in the United States or Canada ( Whitaker et al, 2016 ; Morris et al, 2017 ; Santo et al, 2017 ; Vinturache et al, 2017 ; Emery et al, 2018 ; McGee et al, 2018 ), except from a body of work on the management of GWG from Australia ( Wilkinson et al, 2013 ; de Jersey et al, 2018 , 2019 ). In many European countries, like Norway, midwives provide approximately 50% of the antenatal care ( Backe, 2001 ; The Norwegian Directorate of Health, 2019 , see text footnote 1), whereas this is far less prevalent especially in the United States ( Vedam et al, 2018 ).…”

Association of provider advice and gestational weight gain in twin pregnancies: a cross-sectional electronic survey

“…An additional limitation is that this study was limited to a highly educated, predominately white population who were largely recruited from a breastfeeding support website, which limits generalizability. Previous studies examining provider advice and GWG in singleton pregnancies have been conducted in predominately white populations [20,21,23,32,33,[39][40][41][42], as done for the present study, with several exceptions where the majority of participants were Hispanic or African American women [19,22,[43][44][45]. It is also known that women with twins are less likely to initiate breastfeeding compared to women with singletons [46]; thus it is important to acknowledge that the population in the present study is unique as they were largely recruited from a breastfeeding support group.…”

Physical Activity Advice and Counselling by Healthcare Providers: A Scoping Review

“…Conversely, pregnant women regard the prenatal healthcare advice from their healthcare providers as reliable and credible [ 22 , 23 , 24 ], and they may feel motivated to make lifestyle changes; and in this case, prenatal physical activity practice for healthy pregnancy and birth, it would be beneficial. Notably, the majority of studies on prenatal physical activity counselling are based on women’s reports of prenatal care provider advice and counselling [ 23 , 25 , 26 , 27 , 28 , 29 ]. Therefore, the synthetization of evidence on this particular topic from the perspective of the prenatal care providers may serve to inform a best practice model on prenatal physical activity advice and counselling for prenatal healthcare providers working in primary antenatal healthcare services.…”