Skip to main content Accessibility help
×
Home

Obese women’s perceptions of weight gain during pregnancy: a theory-based analysis

  • Emily M Nagourney (a1), Dina Goodman (a1), Yukyan Lam (a1), Kristen M Hurley (a1), Janice Henderson (a2) and Pamela J Surkan (a1)...

Abstract

Objective:

Excess gestational weight gain (GWG) in obese women is linked to adverse maternal outcomes and is particularly pervasive among African Americans, who have the highest obesity rates in the USA. A better understanding of culturally relevant attitudes and perceptions of GWG is needed to develop targeted interventions to prevent excess GWG among this group.

Design:

Using the constructs of Social Cognitive Theory, we explored attitudes and perceptions surrounding diet and exercise among low-income obese African-American pregnant women in Baltimore. We conducted twenty-one semi-structured in-depth interviews with pregnant adult women.

Setting:

Participants were recruited from a referral clinic for obese pregnant women at a large urban hospital in Baltimore, MD, USA.

Participants:

Twenty-one low-income African-American adult females in the first two trimesters of pregnancy with BMI > 30·0 kg/m2.

Results:

Lack of knowledge was not the main obstacle to healthy behaviours during pregnancy. Rather, food cravings and fatigue, an unhealthy physical food environment, limited self-efficacy for controlling excessive GWG, and a lack of adequate emotional and informational support impacted women’s agency. While digital technology was discussed as a vehicle to promote maintenance of a healthy weight in pregnancy, further research is needed to test how it can be used to empower women to engage in healthy behaviours during pregnancy.

Conclusion:

Interventions to prevent excess GWG among African-American pregnant women should harness support from partners and family and must go beyond sharing of clinical knowledge to also include strategies that improve the food environment, diet quality and self-efficacy.

Copyright

Corresponding author

*Corresponding author: Email psurkan@jhu.edu

References

Hide All
1.Abenhaim, HA, Kinch, RA, Morin, L et al. (2007) Effect of prepregnancy body mass index categories on obstetrical and neonatal outcomes. Arch Gynecol Obstet 275, 3943.
2.Leddy, MA, Power, ML & Schulkin, J (2008) The impact of maternal obesity on maternal and fetal health. Rev Obstet Gynecol 1, 170178.
3.McDonald, SD, Han, Z, Mulla, S et al. (2010) Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: systematic review and meta-analyses. BMJ 341, c3428.
4.Ogden, CL, Carroll, MD, Kit, BK et al. (2014) Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA 311, 806814.
5.Goodrich, K, Cregger, M, Wilcox, S et al. (2013) A qualitative study of factors affecting pregnancy weight gain in African American women. Matern Child Health J 17, 432440.
6.Headen, I, Mujahid, MS, Cohen, AK et al. (2015) Racial/ethnic disparities in inadequate gestational weight gain differ by pre-pregnancy weight. Matern Child Health J 19, 16721686.
7.Institute of Medicine, Committee on Nutritional Status During Pregnancy and Lactation (1990) Nutrition During Pregnancy: Part I Weight Gain; Part II Nutrient Supplements. Washington, DC: National Academies Press.
8.Chang, M-W, Nitzke, S, Guilford, E et al. (2008) Motivators and barriers to healthful eating and physical activity among low-income overweight and obese mothers. J Acad Nutr Diet 108, 10231028.
9.Reyes, NR, Klotz, AA & Herring, SJ (2013) A qualitative study of motivators and barriers to healthy eating in pregnancy for low-income, overweight, African-American mothers. J Acad Nutr Diet 113, 11751181.
10.Bandura, A (1978) The self system in reciprocal determinism. Am Psychol 33, 344358.
11.Bandura, A (1986) Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall, Inc.
12.Baranowski, T, Perry, CL & Parcel, GS (2002) How individuals, environments, and health behavior interact. In Health Behavior and Health Education: Theory, Research, and Practice, pp. 165184 [Glanz, K, Rimer, B, and Viswanath, K, editors]. San Francisco, CA: Jossey-Bass.
13.Davison, J, Share, M, Hennessy, M et al. (2015) Caught in a ‘spiral’. Barriers to healthy eating and dietary health promotion needs from the perspective of unemployed young people and their service providers. Appetite 85, 146154.
14.Ledoux, T, Van Den Berg, P, Leung, P et al. (2015) Factors associated with knowledge of personal gestational weight gain recommendations. BMC Res Notes 8, 349.
15.Whitaker, KM, Wilcox, S, Liu, J et al. (2016) Patient and provider perceptions of weight gain, physical activity, and nutrition counseling during pregnancy: a qualitative study. Womens Health Issues 26, 116122.
16.Cramp, AG & Bray, SR (2009) A prospective examination of exercise and barrier self-efficacy to engage in leisure-time physical activity during pregnancy. Ann Behav Med 37, 325334.
17.Herring, SJ, Cruice, JF, Bennett, GG et al. (2016) Preventing excessive gestational weight gain among African American women: a randomized clinical trial. Obesity (Silver Spring) 24, 3036.
18.Charmaz, K (2006) Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. London: SAGE Publications Ltd.
19.SocioCultural Research Consultants, LLC (2017) Dedoose. Los Angeles, CA: SocioCultural Research Consultants, LLC.
20.Setse, R, Grogan, R, Cooper, LA et al. (2008) Weight loss programs for urban-based, postpartum African-American women: perceived barriers and preferred components. Matern Child Health J 12, 119127.
21.Shub, A, Huning, EYS, Campbell, KJ et al. (2013) Pregnant women’s knowledge of weight, weight gain, complications of obesity and weight management strategies in pregnancy. BMC Res Notes 6, 278.
22.Downs, DS, Savage, JS & Rauff, EL (2014) Falling short of guidelines? Nutrition and weight gain knowledge in pregnancy. J Womens Health Care 3, 1000184.
23.Stengel, MR, Kraschnewski, JL, Hwang, SW et al. (2012) ‘What my doctor didn’t tell me’: examining health care provider advice to overweight and obese pregnant women on gestational weight gain and physical activity. Womens Health Issues 22, e535e540.
24.Chasan-Taber, L (2012) Physical activity and dietary behaviors associated with weight gain and impaired glucose tolerance among pregnant Latinas. Adv Nutr 3, 108118.
25.Franco, M, Diez Roux, AV, Glass, TA et al. (2008) Neighborhood characteristics and availability of healthy foods in Baltimore. Am J Prev Med 35, 561567.
26.Kim, M, Budd, N, Batorsky, B et al. (2017) Barriers to and facilitators of stocking healthy food options: viewpoints of Baltimore City small storeowners. Ecol Food Nutr 56, 1730.
27.George, GC, Hanss-Nuss, H, Milani, TJ et al. (2005) Food choices of low-income women during pregnancy and postpartum. J Acad Nutr Diet 105, 899907.
28.Sui, Z, Turnbull, D & Dodd, J (2013) Enablers of and barriers to making healthy change during pregnancy in overweight and obese women. Australas Med J 6, 565577.
29.Misiaszek, C, Buzogany, S & Freishtat, H (2018) Baltimore City’s Food Environment Report. Baltimore, MD: John Hopkins Center for a Livable Future.
30.Davis, AM, Wambach, KA, Nelson, EL et al. (2014) Health behavior change in pregnant women: a two-phase study. Telemed J E Health 20, 11651169.
31.Jackson, RA, Stotland, NE, Caughey, AB et al. (2011) Improving diet and exercise in pregnancy with Video Doctor counseling: a randomized trial. Patient Educ Couns 83, 203209.
32.Mercado, A, Marquez, B, Abrams, B et al. (2017) Where do women get advice about weight, eating, and physical activity during pregnancy? J Womens Health 26, 951956.
33.Willcox, JC, van der Pligt, P, Ball, K et al. (2015) Views of women and health professionals on mHealth lifestyle interventions in pregnancy: a qualitative investigation. JMIR Mhealth Uhealth 3, e99.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed