Anne Christenson1, Eva Johansson2, Signy Reynisdottir3, Jarl Torgerson4, Erik Hemmingsson5. 1. Department of Medicine, Obesity Center, Karolinska University Hospital, Karolinska Institute, Norra Stationsgatan 93, 113 64 Stockholm, Sweden. Electronic address: anne.christenson@ki.se. 2. Department of Public Health Sciences (IHCAR), Karolinska Institute, Tomtebodavägen 18a, 171 77 Stockholm, Sweden. Electronic address: eva.johansson@ki.se. 3. Department of Medicine, Obesity Center, Karolinska University Hospital, Karolinska Institute, Norra Stationsgatan 93, 113 64 Stockholm, Sweden. Electronic address: signy.reynisdottir@ki.se. 4. Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 3, 413 90 Göteborg, Sweden. Electronic address: jarl.torgerson@vgregion.se. 5. Swedish School of Sports and Health Sciences, GIH, Lidingövägen 1, 114 33 Stockholm, Sweden. Electronic address: erik.hemmingsson@gih.se.
Abstract
INTRODUCTION: Excessive gestational weight gain, regardless of initial BMI, is associated with perinatal risks for both mother and offspring and contributes to obesity in women. Studies report that healthcare professionals find it difficult to communicate about weight and pregnant women perceive healthcare professionals as unconcerned, leaving many women uninformed about weight recommendations and risks. We aimed to explore how midwives approach communication about gestational weight gain recommendations, and to characterize communication barriers and facilitators. METHODS: Seventeen midwives from different areas in Sweden were interviewed by a therapist using semi-structured interviews. Interviews were transcribed verbatim and analysed by three researchers using latent content analysis. Recurrent themes were identified and formulated. RESULTS: The main theme identified in the latent part of the analysis was "midwives use avoidant behaviours to cope with fear of inflicting worries, shame or feelings of guilt in pregnant women". Avoidant behaviours include: adjusting weight recommendations, toning down risks and avoid talking about weight. Subthemes identified were (I) Conflicting responsibilities in midwives' professional identity (II) Perceived deficiencies in the working situation. CONCLUSION: Midwives' empathy and awareness of weight stigma strongly affects communication about weight with pregnant women, and midwives' use of avoidant behaviours constitutes salient information barriers. More research is needed on whether gestational weight guidelines and weighing routines for all women, resources for extra visits, training in specific communication skills and backup access to other professions can facilitate for midwives to initiate and communicate about healthy gestational weight development, enabling more pregnant women to make well-informed lifestyle choices.
INTRODUCTION:Excessive gestational weight gain, regardless of initial BMI, is associated with perinatal risks for both mother and offspring and contributes to obesity in women. Studies report that healthcare professionals find it difficult to communicate about weight and pregnant women perceive healthcare professionals as unconcerned, leaving many women uninformed about weight recommendations and risks. We aimed to explore how midwives approach communication about gestational weight gain recommendations, and to characterize communication barriers and facilitators. METHODS: Seventeen midwives from different areas in Sweden were interviewed by a therapist using semi-structured interviews. Interviews were transcribed verbatim and analysed by three researchers using latent content analysis. Recurrent themes were identified and formulated. RESULTS: The main theme identified in the latent part of the analysis was "midwives use avoidant behaviours to cope with fear of inflicting worries, shame or feelings of guilt in pregnant women". Avoidant behaviours include: adjusting weight recommendations, toning down risks and avoid talking about weight. Subthemes identified were (I) Conflicting responsibilities in midwives' professional identity (II) Perceived deficiencies in the working situation. CONCLUSION: Midwives' empathy and awareness of weight stigma strongly affects communication about weight with pregnant women, and midwives' use of avoidant behaviours constitutes salient information barriers. More research is needed on whether gestational weight guidelines and weighing routines for all women, resources for extra visits, training in specific communication skills and backup access to other professions can facilitate for midwives to initiate and communicate about healthy gestational weight development, enabling more pregnant women to make well-informed lifestyle choices.
Authors: Susan de Jersey; Nina Meloncelli; Taylor Guthrie; Hilary Powlesland; Leonie Callaway; Angela T Chang; Shelley Wilkinson; Tracy Comans; Elizabeth Eakin Journal: BMC Health Serv Res Date: 2022-05-03 Impact factor: 2.908