Obese women's reasons for not attending a weight management service during pregnancy

Abstract

Citation: Olander, E. K. & Atkinson, L. (2013). Obese women's reasons for not attending a weight management service during pregnancy. Acta Obstetricia et Gynecologica Scandinavica, 92(10), pp. 1227Scandinavica, 92(10), pp. -1230Scandinavica, 92(10), pp. . doi: 10.1111 This is the unspecified version of the paper.This version of the publication may differ from the final published version. Permanent AbstractEvaluations of services targeting obese women's gestational weight gain often report low uptake. Thus it is important to elicit the reasons why obese pregnant women decline to participate in these services and to identify their barriers to participation.Sixteen obese pregnant and postnatal women were interviewed regarding their reasons for declining a group-based service targeting their gestational weight gain. All interviews were recorded, transcribed verbatim and analyzed thematically.Both pragmatic and motivational barriers were identified. The most common practical reasons for not attending the service were its inconvenient location and time, and feeling unable to attend due to work commitments. Pregnancy-specific barriers included decreased mobility and feeling unwell. Motivational barriers included lack of interest and not wanting to focus on one's weight in pregnancy. These findings highlight issues that need to be taken into consideration when designing group-based weight management services for this population.

Talking about weight in pregnancy: An exploration of practitioners' and women's perceptions

“…Women's responses were complex: they expressed concerns about feeling judged or upset but, in contrast to health professional opinions, described being keen to avoid gaining excess weight; however it seemed that motivation to manage weight was often gained in retrospect: "I ate what I wanted during pregnancy and after pregnancy I was regretting it, definitely regretting it" (woman). These findings mirror those made by previous research, [19,38,39] which revealed poor perceptions of women's motivation among staff and varying levels of motivation among women themselves. Women's views in this study supported professional perceptions that weight is difficult to discuss, requires a careful and supportive approach, and that motivation is an issue.…”

“…Previous findings have also demonstrated a lack of information about weight management and varying levels of motivation among women during pregnancy. [19,37,39] On the other hand, without weight-related information from the health professionals who act as their key source of information and in a social environment where risks of obesity in pregnancy are not well advertised or understood, a lack of motivation in pregnancy does not seem surprising.…”

An exploration of obese pregnant women’s views of being referred by their midwife to a weight management service

“…A considerable study strength is that we interviewed women who declined the service. There is a lack of evidence exploring why obese pregnant women decline weight management services [5,6] and research has tried and failed to recruit this hard to reach population group in the past [2].…”

A mobile health intervention promoting healthy gestational weight gain for women entering pregnancy at a high body mass index: the txt4two pilot randomised controlled trial

“…The high costs associated with intensive interventions are known to limit reach and scalability, and to increase disparities in service provision . Further, traditional approaches with regular group or face‐to‐face health professional visits may not be convenient for many women …”