title: Weight management in Pregnancy: Participants' experiences of 'Healthy Eating and Lifestyle in Pregnancy (HELP)', a maternity care intervention for obese pregnant women.
abstract: BACKGROUND
  Around 1 in 5 pregnant women in the UK are obese. Obesity is linked to poor health and pregnancy complications. We developed and tested in a cluster RCT a group-based intervention for obese pregnant women, facilitated by midwives and slimming world consultants. It was designed to support obese women during pregnancy to moderate weight gain and reduce BMI one year after birth, in addition to targeting secondary health and wellbeing outcomes. This paper aims to explore participants' experiences of engaging in the 'HELP' trial in particular their views of the intervention and ongoing weight challenges.
  
  
  METHODS
  Thirty participants took part in semi-structured telephone interviews as part of the process evaluation. The data were analysed using thematic analysis.
  
  
  RESULTS
  Participants' accounts offered insights into the intervention group environment, the importance of social support and the value of each facilitator's involvement. Reasons for compliance were highlighted, with interesting discussion on aspects that encouraged and supported women to make behaviour changes during their pregnancy, barriers to engaging with the intervention and longer term behaviour change. Participants, especially those who had previously accessed maternity care, emphasised the benefits of this service being available where they obtained knowledge, skills and support in relation to weight and pregnancy.
  
  
  CONCLUSIONS
  Engaging in the intervention can help women to adopt healthier habits leading to avoidance of excess weight gain during pregnancy, better outcomes for mother, baby and the wider family. Consideration of other factors may be required for impact on long term outcomes.
authors.affiliation: Cardiff School of Medicine, United Kingdom.
authors.forename: Dunla
authors.initials: D
authors.lastname: Cassidy
authors.affiliation: Cardiff School of Medicine, United Kingdom.
authors.forename: Ellinor
authors.initials: E
authors.lastname: John
authors.affiliation: Cardiff School of Medicine, United Kingdom.
authors.forename: Lauren
authors.initials: L
authors.lastname: Copeland
authors.affiliation: Cardiff School of Medicine, United Kingdom.
authors.forename: Sharon A
authors.initials: SA
authors.lastname: Simpson