Obese women's experiences of encounters with midwives and physicians during pregnancy and childbirth.
OBJECTIVE
to describe obese women's experiences of encounters with midwives and physicians during pregnancy and childbirth.


METHODS
a qualitative study using a phenomenological approach. Data were collected by means of interviews that were tape-recorded.


METHODS
the women's homes or at a hospital in western Sweden.


METHODS
10 women with body mass index >30, three primiparous and seven multiparous, who had given birth at a hospital in western Sweden in the period between October 2006 and September 2007 were interviewed four to six weeks after childbirth.


RESULTS
the meaning of being both obese and pregnant is living with a constant awareness of the body, and its constant exposure to the close observation and scrutiny of others. It involves negative emotions and experiences of discomfort. Feelings of discomfort increase as a result of humiliating treatment, whilst affirmative encounters alleviate discomfort and provide a sense of wellbeing.


CONCLUSIONS
obese pregnant women are a vulnerable group because obesity is highly visible. Caregivers tend to focus on providing care to obese patients somatically, but are additionally in need of knowledge about care from the woman's point of view. Many obese women have negative experiences of health care that they have to overcome. It is necessary to individualise care for obese pregnant women, which involves taking time to give the women an opportunity to tell their own story. Caregivers have to promote health but it has to be done honestly and respectfully. In order to avoid judgemental attitudes and causing increased suffering for obese pregnant women, midwives and physicians need to be conscious of, reflect upon and verbalise their own attitudes and power.
Nyman
Viola M K
VM
Department of Nursing, Health and Culture, University West, Gustava Melins gata 2, SE-461 81 Trollhättan, Sweden. viola.nyman@vgregion.se
Prebensen
Asa K
AK
Flensner
Gullvi E M
GE
D000328:Adult; D000739:Anecdotes as Topic; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008425:Maternal Behavior / Q000523:psychology*; D008880:Midwifery / Q000379:methods; D009035:Mothers / Q000523:psychology*; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009765:Obesity / Q000451:nursing / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011247:Pregnancy; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires; D013548:Sweden; D055815:Young Adult