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

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.