Table 2 Barriers to effective weight management during pregnancy among prenatal care providers, and potential interventions and/or policy changes
Category | Theme | Representative quote | Potential intervention or policy change |
|---|---|---|---|
Priority | Low Priority | “I have to say that I probably don’t focus on the weight gain as a concern.” (6) | Increase focus in medical education on morbidity of excess weight gain during pregnancy. Increase awareness through popular media and empower patients to voice their concerns to providers. |
Approach to Care | Unfamiliarity with established guidelines | I don’t know if it is right, but in my own mind it’s about 25 pounds for the average woman.” (1) | Increase focus on weight gain guidelines and effective interventions in medical education. |
Reactive approach | “If they are gaining a lot, then we’ll deal with it.” (2) | Develop practice-level policies that promote appropriate weight gain. | |
Lack of accessible resources | “No, there isn’t anything (resources) out there. If you refer to nutrition, they have to pay for it.” (4) | More high quality research on effective interventions for weight management during pregnancy. | |
Attitudes and Beliefs | Skepticism about counseling’s impact on patient | “I think it is important to talk about why it is healthy for the baby but I think it is good to tell them what your goals are and to make sure you are following it… but I don’t know how much it matters.” (1) | Encourage providers and patients to set appropriate expectations for weight gain. Establish systems to monitor and follow-up so providers and patients can observe results. |
Sensitivity of Topic | “It’s important to try to get a sense of where they are at- their feeling about that (weight gain) because I think you can offend people. Pregnant people are easily offended.” (3) | Educate providers on counseling strategies that are culturally appropriate and sensitive as well as effective. | |
Patient more influenced by other factors | “I think there are a lot of cultural issues about expectations and then I think that there is just a common perception you gain as much weight during pregnancy and it doesn’t matter because you’re eating for two.” (8) | Actively involve support people (partners, family, friends) in prenatal care so that others who influence mothers are empowered to ask questions, understand risks, and have the same goals in regards to weight gain. |