Experiences of lifestyle management and support during pregnancy: a qualitative study

Abstract

Background Overweight and obesity during pregnancy is associated with the risk of gestational diabetes mellitus (GDM) among other complications. Lifestyle interventions have been shown to be effective in this population however, studies often fail to identify the behavioural mechanisms by which the intervention is expected to be effective. Our aim is to identify the barriers and enablers to behaviour change from the perspective of overweight and obese pregnant women and healthcare professionals (HCPs) in order to inform the development of a lifestyle intervention. Methods Semi-structured interviews are being conducted with a purposive sample of overweight or obese women at different stages of pregnancy, recruited from a public antenatal clinic in a large academic maternity hospital in Cork (CUMH) (n=30). A purposive sample of HCPs will also be recruited (n=10-15). The Framework approach is being used for analysis, drawing on the Theoretical Domains Framework (TDF) and the COM-B model of behaviour change. . Results Analyses of pregnant woman interviews suggest that pregnancy is ‘a wake-up call’ as the risks of overweight and obesity are made explicit. Social influences were identified as a potential facilitator; pregnant woman suggested behaviour change was easier for them when their partners engaged in a healthy lifestyle. Analysis of HCPs identified the environmental context and resources within the health system as barriers, particularly the lack of dedicated obesity clinics. Conclusion Both pregnant woman and HCPs see pregnancy as ‘a wake-up call’ for changing behaviour. However, there are limited resources available to support women to make these changes.