Obesity in pregnancy: a study of the impact of maternal obesity on NHS maternity services

Abstract

Objective To gain a detailed understanding of healthcare professionals' perceptions of the impact that caring for obese pregnant women has on maternity services.Design Qualitative interview study using purposeful sampling and face-to-face interviews.Setting Sixteen maternity units in NHS Trusts in the North East Government Office Region of England, UK.Sample Thirty-three maternity and obstetric healthcare professionals with personal experience of managing the care of obese pregnant women.Methods Semi-structured interviews with healthcare professionals representing each maternity unit in the region. Transcripts were analysed using systematic content analysis.Main outcome measures Views on the impact maternal obesity has on maternity services, the facilities required to care for obese mothers in pregnancy, and existing services directed towards maternal obesity.Results Five dominant themes relating to service delivery emerged; booking appointments, equipment, care requirements, complications and restrictions, and current and future management of care. Many of the issues identified were associated with managing the care of obese women in pregnancy safely, resources and cost issues to be able to do this, multidisciplinary care requirements because of coexisting morbidities when the mother is obese, and restricted care options and patient choice.Conclusions Healthcare professionals in the North East of England feel that maternal obesity has a major impact on services and resource, on the health of both the mother and child, and on the psychological wellbeing of the mother.

The views of pre- and post-natal women and health professionals regarding gestational weight gain: An exploratory study

“…Due to the set-up of the current maternity services however, the health professionals did not have enough time to discuss this information. This has previously been reported by English health professionals and is partly due to all the pregnancy related information midwives have to provide to women [30]. In this study, this lack of gestational weight gain information was interpreted by the pregnant women as gestational weight gain being unimportant.…”

“…This may be a difficult issue as women do not like to be told about the risks associated with excessive weight and pregnancy [16,30]. It is thus reassuring that the health professionals in this study, in line with past research [16], were aware that weight issues may need to be discussed with great care.…”

“…In addition to eliciting the views of pre-and post-natal women, this study also elicited the views of a group of health professionals. This adds to the literature as commonly only women and not their health providers are interviewed [for example 20,21] or alternatively only health professionals are interviewed [for example 16,30]. Including health professionals as participants allowed a comparison of views regarding gestational weight gain and whether they were aware of the women's views regarding gestational weight gain.…”

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

“…The issue of time poverty and pressures is not a novel finding. [37,42] This combination of factors means that the clinically significant issue of weight is simply not being raised adequately with the pregnant woman by her healthcare professional team. Although professionals believe they discuss weight and nutrition, [43] surveys of women suggest that fewer than half are receiving weight management advice.…”

The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome

“…8 In 2005, the prevalence of obesity in pregnant women in the United Kingdom at their booking visit was between 16 and 19%. 9 The impact of obesity on pregnancy outcome and parturition is now considered a primary obstetric issue. Numerous studies have shown that a raised pre-pregnancy BMI is associated with a linear increase in adverse maternal and fetal outcomes.…”