Seeing it through their eyes: a qualitative study of the pregnancy journeys of women with a body mass index of 30 or more

Background: Maternal obesity [body mass index (BMI) ≥ 30 kg/m2] is associated with numerous complications, but currently, little is known about the pregnancy experiences of these women. Objective: To gain insight into the experience of pregnant women with BMI ≥ 30 kg/m2, when accessing maternity services and attending a community lifestyle programme.
Design: Qualitative methodology, utilizing focus groups and semi-structured interviews with post-natal women who had an antenatal BMI ≥ 30 kg/m2. The sample was obtained from a larger study. Results: Thirty-four women participated. Three main themes were identified using thematic analysis. Women described disappointment with their pregnancy. In particular, their informational expectations were not met; some health professionals appeared uninterested, insensitive or unconfident. Women described readiness to make a lifestyle change, but this was not encouraged during routine care. Attending the programme began the process of behavioural change. Women's beliefs that small changes make a big difference led to them being spurred on by success; driven by a desire to improve the health of their family. Discussion and Conclusion: Pregnant women who are obese know this is the case and expect to be provided with information to assist them in making lifestyle changes. Health professionals should be aware of women's readiness for change and view pregnancy as an ideal time to communicate. Pregnant women with a BMI ≥ 30 kg/m2 should contribute to health professional training, to highlight the reality of the maternity system journey; first-hand accounts may improve the way health professionals' approach these women. Lifestyle interventions should be developed with input from the intended target group.