Student midwives’ perceived facilitators and barriers to discussing weight management with obese pregnant women

Abstract

Background: Maternal obesity and excessive gestational weight gain is of growing concern within maternity care. However, many qualified midwives do not feel comfortable discussing weight management with pregnant women whose BMI is ≥30. This can result in these women being unaware of the risks. Student midwives are at a unique stage in their professional development and should receive up-to-date teaching about the risks of maternal obesity, but it is unclear if this recently acquired knowledge improves confidence, comfort and engagement in discussing weight management. This research aimed to investigate the barriers and facilitators student midwives encounter in discussing weight management with pregnant women whose BMI is ≥30. Methods: Eight student midwives took part in one-to-one semi-structured interviews. Interviews were transcribed verbatim and analysed thematically according to the Theoretical Domains Framework. Findings: Students were motivated to discuss weight management with pregnant women whose BMI is ≥30. They viewed the discussion as part of their professional role and had a high degree of awareness of the impact of maternal obesity. However, these facilitators were outweighed by perceived barriers, similar to those reported by qualified midwives, including overcoming personal issues (e.g. BMI status), low self-efficacy in highlighting the risks of obesity and a fear of damaging the relationship with the woman in their care. Discussion: The factors which influence the discussion of weight management should be considered and addressed in midwifery training. Applying health psychology principles into midwifery training may improve students’ confidence and skills at approaching this topic with at risk women.