Exploring obstetricians’, midwives’ and general practitioners’ approach to weight management in pregnant women with a BMI ≥25 kg/m(2): a qualitative study

OBJECTIVE: The aim of this study was to explore healthcare professionals' (HCPs) beliefs and attitudes towards weight management for pregnant women with a body mass index (BMI) ≥25 kg/m(2). DESIGN: Qualitative study. SETTING: A public antenatal clinic in a large academic maternity hospital in Cork, Ireland, and general practice clinics in the same region. PARTICIPANTS: HCPs such as hospital-based midwives and consultant obstetricians and general practitioners (GPs). METHOD: Semistructured interviews were conducted with a purposive sample of hospital-based HCPs and a sample of GPs working in the same region. Interviews were recorded, transcribed and thematically analysed using NVivo software. RESULTS: Seventeen HCPs were interviewed (hospital based=10; GPs=7). Four themes identified the complexity of weight management in pregnancy and the challenges HCPs faced when trying to balance the medical and psychosocial needs of the women. HCPs acknowledged weight as a sensitive conversation topic, leading to a 'softly-softly approach' to weight management. HCPs tried to strike a balance between being woman centred and empathetic and medicalising the conversation. HCPs described 'doing what you can with what you have' and shifting the focus to managing obstetric complications. Furthermore, there were unclear roles and responsibilities in terms of weight management. CONCLUSION: HCPs need to have standardised approaches and evidence-based guidelines that support the consistent monitoring and management of weight during pregnancy.