Overweight and Obese Women’s Perceptions About Making Healthy Change During Pregnancy: A Mixed Method Study

Abstract

Overweight and obesity during pregnancy is associated with risk of a range of adverse health outcomes. While intervention studies aim to promote behavioral change, little is known about the underlying psychological mechanisms facilitating and hindering change. The aim of this study was to evaluate overweight and obese women's perceptions of making behavior change during pregnancy. We explored beliefs through self-administrated questionnaires (n = 464) and semi-structured face-to-face interviews (n = 26). Questions were designed according to the Health Belief Model. A triangulation protocol was followed to combine quantitative and qualitative data. A total of 269 women (58 %) indicated that high gestational weight gain is a concern, with 348 (75 %) indicating excessive weight gain is associated with complications during pregnancy or child birth. Women were aware of maternal complications associated with high gestational weight gain, but had more limited awareness of neonatal complications. While most women indicated in questionnaires that healthy eating and physical activity were associated with improved health during pregnancy, they were unable to identify specific benefits at interview. Barriers to making healthy behavior changes were highly individualized, the main barrier being lack of time. While the majority (91 %) of women indicated that they would make behavior changes if the change made them feel better, only half felt confident in their ability to do so. Interventions for overweight and obese pregnant women should incorporate education about neonatal health consequences and benefits of healthy behavior change in addition to incorporating strategies to enhance self-efficacy.

The Perspectives of Pregnant Women on Health-Promoting Behaviors: An Integrative Systematic Review

“…However, studies conducted in this field have some limitations and focused on some aspects or behavioral changes during pregnancy in a retrospective approach. Nevertheless, pregnant women were highly motivated to adopt healthpromoting behaviors (32,34). Moreover, the motivating factor was the health of the fetus and achieving a desirable outcome in pregnancy (30,33).…”

“…Viau et al expressed that women experience worries related to the health of fetus, changes in daily activities, risks related to pregnancy such as abortion and social commitment during their pregnancy (31). Various studies on women implied fetal health was the most important motivating factor for making changes in the lifestyle (31,33,34). Addicted women's reasons to change their lifestyle were concerns about the health of the fetus and newborn, loving children and belief that they deserved to have the chance for a healthy life.…”

“…According to the women, having another child and child care, consequences of pregnancy, lack of awareness and family support, changes in the mood, tiredness of pregnancy and worries regarding the security of behavioral changes in children were all considered barriers (35). However, in most studies, time was mentioned as the most important barrier from the women's points of view (33,34). Another barrier was the lack of a comprehensive approach in sanitary care (33).…”

African American and White women׳s perceptions of weight gain, physical activity, and nutrition during pregnancy

“…Other qualitative studies examining perceptions of excessive weight gain have also reported that knowledge of neonatal risks is low (Groth et al, 2012; Herring et al, 2012; Sui et al, 2013). Infants born to mothers with excessive weight gain are at increased risk for many health complications, including low 5-minute Apgar scores, hypoglycemia, large for gestational age, and future overweight or obesity as compared with women who gain within the recommended guidelines (Olson et al, 2009; Stotland et al, 2006; Vesco et al, 2011).…”

“…Other studies have identified misperceptions about the risks and benefits of exercise during pregnancy (Evenson & Bradley, 2010; Goodrich et al, 2013; Padmanabhan et al, 2015). While it appears the health benefits of proper nutrition are better understood, women consistently cite many barriers to healthy eating, including lack of self-control in response to cravings (Goodrich et al, 2013; Padmanabhan et al, 2015; Sui et al, 2013). Some data also suggest there may be racial or ethnic differences in how women view these topics, particularly for weight gain and exercise (Brooten et al, 2012; Evenson & Bradley, 2010; Groth & Kearney, 2009; Groth et al, 2012; Sui et al, 2013).…”