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Patient-provider communication about gestational weight gain among nulliparous women: a qualitative study of the views of obstetricians and first-time pregnant women.

Publication ,  Journal Article
Duthie, EA; Drew, EM; Flynn, KE
Published in: BMC Pregnancy Childbirth
December 11, 2013

BACKGROUND: In 2009 the Institute of Medicine updated its guidelines for weight gain during pregnancy, in part because women of childbearing age now weigh more pre-pregnancy and tend to gain more weight during pregnancy than women did when the previous set of guidelines were released in 1990. Women who begin pregnancy overweight or obese and women who gain weight outside IOM recommendations are at risk for poor maternal and fetal health outcomes. With these concerns in mind, we examined what obstetricians communicate about gestational weight gain to their pregnant patients and how nulliparous patients perceive weight-related counseling from their obstetricians. METHODS: We conducted one-on-one, semi-structured interviews with 19 nulliparous women and 7 obstetricians recruited from a single clinic at a large academic medical center in the United States. Interviews were transcribed verbatim and analyzed inductively using thematic analysis. RESULTS: We identified 4 major themes: 1) Discussions about the amount and pace of gestational weight gain: obstetricians reported variation in the frequency and timing of weight-related discussions with patients while most patients said that weight was not emphasized by their obstetricians; 2) The content of communication about nutrition and physical activity: obstetricians said they discuss nutrition and activity with all patients while most patients reported that their obstetrician either discussed these topics in general terms or not at all; 3) Communication about postpartum weight loss: obstetricians said that they do not typically address postpartum weight loss with patients during prenatal visits while patients had concerns about postpartum weight; and 4) Patient feelings about obstetrician advice: most patients said that their obstetrician does not tend to offer "unsolicited advice", instead offering information in response to patient questions or concerns. Women were divided about whether they desired more advice from their obstetrician on weight gain, nutrition, and activity. CONCLUSIONS: Our analysis revealed discrepancies between obstetricians' and patients' perceptions of their weight-related clinical interactions. Our findings suggest that there is a missed opportunity to use prenatal visits as opportunities to discuss healthy eating and exercise during pregnancy, the postpartum period, and beyond. Additional research on the design, implementation, and testing of interventions to address prenatal nutrition and physical activity is warranted.

Duke Scholars

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Published In

BMC Pregnancy Childbirth

DOI

EISSN

1471-2393

Publication Date

December 11, 2013

Volume

13

Start / End Page

231

Location

England

Related Subject Headings

  • Young Adult
  • Weight Gain
  • Qualitative Research
  • Prenatal Care
  • Pregnancy
  • Physician-Patient Relations
  • Patient Education as Topic
  • Parity
  • Obstetrics & Reproductive Medicine
  • Obstetrics
 

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Duthie, E. A., Drew, E. M., & Flynn, K. E. (2013). Patient-provider communication about gestational weight gain among nulliparous women: a qualitative study of the views of obstetricians and first-time pregnant women. BMC Pregnancy Childbirth, 13, 231. https://doi.org/10.1186/1471-2393-13-231
Duthie, Elizabeth A., Elaine M. Drew, and Kathryn E. Flynn. “Patient-provider communication about gestational weight gain among nulliparous women: a qualitative study of the views of obstetricians and first-time pregnant women.BMC Pregnancy Childbirth 13 (December 11, 2013): 231. https://doi.org/10.1186/1471-2393-13-231.
Duthie, Elizabeth A., et al. “Patient-provider communication about gestational weight gain among nulliparous women: a qualitative study of the views of obstetricians and first-time pregnant women.BMC Pregnancy Childbirth, vol. 13, Dec. 2013, p. 231. Pubmed, doi:10.1186/1471-2393-13-231.
Journal cover image

Published In

BMC Pregnancy Childbirth

DOI

EISSN

1471-2393

Publication Date

December 11, 2013

Volume

13

Start / End Page

231

Location

England

Related Subject Headings

  • Young Adult
  • Weight Gain
  • Qualitative Research
  • Prenatal Care
  • Pregnancy
  • Physician-Patient Relations
  • Patient Education as Topic
  • Parity
  • Obstetrics & Reproductive Medicine
  • Obstetrics