Midwives’ and obstetricians’ perspectives about pregnancy related weight management in Ethiopia: A qualitative study

Abstract

Background Midwives and obstetricians are key maternity care providers; they are the most trusted source of information regarding nutrition and gestational weight gain. However, their views, practices and perceived barriers to managing pregnancy related weight gain have not been studied in Ethiopia. The aim of this study was to explore midwives’ and obstetricians’ observations and perspectives about gestational weight gain and postpartum weight management in Ethiopia. Methods We conducted face-to-face interviews with 11 midwives and 10 obstetricians, from January 2019 to March 2019. All interview data were transcribed verbatim. We analysed the data using thematic analysis with an inductive approach. Results We identified three themes and associated subthemes. Midwives and obstetricians had limited knowledge of the optimal gestational weight gain. Almost all participants were unaware of the presence of the Institute of Medicine recommendations for optimal weight gain in pregnancy. According to the study participants, women in Ethiopia do not want to gain weight during pregnancy, but do want to gain weight after the birth. Counselling about gestational weight gain and postpartum weight management was not routinely provided for pregnant women. This is mostly because gestational weight gain counselling was not considered to be a priority by maternity care providers in Ethiopia. Conclusions The limited knowledge of and low attention to pregnancy related weight management by midwives and obstetricians in this setting needs appropriate intervention. Adapting a guideline for pregnancy weight management and integrating it into antenatal care is essential.

Implementing clinical guidelines for gestational weight gain care: a novel application of Best-Worst Scaling to determine priority barriers

“…Our results add further evidence to support the ndings of previous studies (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39) that have identi ed barriers to providing care for GWG such as lack of con dence; concerns regarding patient sensitivity in discussing these topics; considering GWG, diet and physical activity care a low priority in antenatal care; and poor/limited resources. This is the rst study, however, which extends this existing knowledge base by prioritising barriers.…”

The Effects of Antenatal Interventions on Gestational Weight Gain in Low- and Middle-Income Countries: Protocol for a Systematic Review

“…Several nutritional interventions have been proposed or evaluated to accommodate the increased maternal nutritional needs during pregnancy [30]. Besides nutritional interventions, previous studies in sub-Saharan Africa also suggest alarmingly poor knowledge and practice of gestational weight management among pregnant women [31][32][33] and antenatal health care providers [34] in LMICs. Therefore, educational and behavioral interventions also hold promise for achieving optimal GWG for pregnant women in resource-limited settings.…”

Perspectives of Pregnant Women and Antenatal Service Providers Regarding Gestational Weight Gain and Nutritional Needs: Systematic Review

“…Awareness and practice of antenatal care providers regarding appropriate weight gain are still inconsistent. Midwives lack the confidence to counsel women about weight gain during pregnancy and nutrition, while obstetricians regard other health problems as a higher priority 32 . Different results were conveyed by research conducted by Murray-Davis et al (2020) which found that the same material was provided during pregnancy weight gain counseling between midwives, obstetricians, and family doctors 9 .…”