title: Weight management during pregnancy: a systematic review of qualitative evidence.
abstract: BACKGROUND
  increasing overweight and obesity rates in pregnant women present health risks to mother and unborn infant.
  
  
  OBJECTIVE
  to identify barriers and facilitators to implementing and carrying out maternal weight management interventions.
  
  
  METHODS
  searches were carried out in medical, midwifery and nursing databases, augmented by hand searching of midwifery journals.
  
  
  METHODS
  articles were included that were published in the UK after 1990, with a focus on women's and health professional's views about weight management during pregnancy.
  
  
  METHODS
  from 6423 citations, 126 full text papers were retrieved. Of these, 18 (reporting 17 studies) fulfilled the inclusion criteria. Included papers were assessed for quality. Reported findings were analysed and synthesised using thematic analysis.
  
  
  RESULTS
  a major theme was access to relevant and appropriate information; advice was reported as vague or inadequate. Overweight or obese women reported feelings of stigmatisation during routine examinations. Health professionals reported a reluctance to discuss weight with larger women. Perceived risk to the fetus as well as changes in women's physiological responses to pregnancy, were reported barriers to optimal physical activity and dietary intake. Perceptions of control were related to women's feelings about their body image.
  
  
  CONCLUSIONS
  evidence suggests that the complexity of interactions with advice sources, bodily changes, feelings of control, as well as perceived risks may explain the relative ineffectiveness of weight management interventions during pregnancy. Focusing on healthy diet and physical activity levels may be more useful and less stigmatising than focusing on weight.
authors: School of Health and Related Research (ScHARR), University of Sheffield, United Kingdom. Electronic address: m.johnson@sheffield.ac.uk.
authors: Maxine
authors: M
authors: Johnson
authors: Fiona
authors: F
authors: Campbell
authors: Josie
authors: J
authors: Messina
authors: Louise
authors: L
authors: Preston
authors: Helen
authors: H
authors: Buckley Woods
authors: Elizabeth
authors: E
authors: Goyder
mesh_terms: D000328:Adult; D001835:Body Weight / Q000502:physiology*; D004032:Diet / Q000379:methods / Q000523:psychology; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005260:Female; D006801:Humans; D009765:Obesity / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology; D010346:Patient Care Management / Q000379:methods / Q000458:organization & administration; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology; D037841:Pregnant People / Q000523:psychology*; D006113:United Kingdom
keywords: Pregnancy; Qualitative evidence synthesis; Weight management