Weight Stigma Related to Pregnancy

Abstract

The aims of this article are to (1) present a shared definition of weight stigma related to pregnancy and (2) develop a definition to inform valid and reliable nursing research addressing weight stigma in the obstetric setting. Weight stigma is increasingly prevalent in society, especially among women with prepregnancy overweight or obesity. However, a universally accepted definition of weight stigma related to pregnancy has yet to be identified. We followed Walker and Avant's concept analysis methodology using an iterative approach to ensure a robust and conceptually sound definition of weight stigma related to pregnancy.

Weight Stigma across the Preconception, Pregnancy, and Postpartum Periods: A Narrative Review and Conceptual Model

“…Drivers and facilitators of weight stigma in the reproductive context have been most often explored in antenatal healthcare (organizational socioecological layer). In pregnancy, stereotyping of women with overweight and obesity is a key attribute of weight stigma 24 leading to alienation and devaluation of these women. Pregnant women living in a larger body describe "fat shaming" and disrespectful treatment that pervaded their routine care, including during consultations, weighing, ultrasound scans and blood tests, and via medical interventions during labor and delivery.…”

“…They include changes to practice, systems, and training. At the healthcare professional training level, the following practices have been suggested to reduce weight stigma in healthcare and improve antenatal care quality: sensitivity and awareness training to rephrase risk communication 14,24,49,52 ; improving provider confidence in discussing obesity and weight (e.g., weight gain during pregnancy); and developing skills in patient-centered practice. 25,53 At the practicelevel, some researchers have called for cessation of screening for obesity in reproductive-age women.…”

“…At the level of the individual, perceptions of judgment and feeling stigmatized have direct effects on behavior change and psychosocial well-being. 6 For example, body image concerns in the perinatal period are associated with higher gestational weight gain, 59 decreased breastfeeding initiation, 24,60 and depressive symptoms. 61 At the interpersonal level, weight stigma has indirect effects on social relationships due to the impacts of stigmatizing actions and decisions by others.…”

“…Recent reviews and commentaries have focused on healthcare, including reproductive healthcare (e.g., healthcare sought during the process of trying to conceive or receiving fertility treatment, antenatal care, and postpartum care), 21 antenatal/maternity care specifically, and general healthcare. 14,[22][23][24][25][26] Research has also focused on obesity in women, including specifically women who are pregnant. 6,27,28 However, a gap remains in terms of an integrated focus on women on the life course continuum of the preconception, pregnancy, and postpartum periods.…”

Coaching for Childbearing Health

“…2 Despite practice recommendations that state providers should discuss weight selfmanagement during every perinatal care visit, 4 many providers do not spend specific time during prenatal care promoting weight self-management behaviors. 5 Some are reluctant to address weight gain due to the topic's sensitivity 6 or because they do not feel adequately prepared to address the topic in a way that will actually improve patients' health. 7 Others express concern about whether there is time to give more than cursory information to women regarding health behavior change during traditional prenatal care.…”