title: The Construal of Midwives by Pregnant Women with a Body Mass Index Greater Than or Equal to 30 kg/m2(BMI ≥ 30 kg/m2): A Repertory Grid Study.
abstract: OBJECTIVE
  To explore the construal of midwives by pregnant women with a body mass index greater than 30 kg/m2(BMI ≥ 30 kg/m2).
  
  
  METHODS
  Ten pregnant women with a BMI ≥ 30 kg/m2were recruited from antenatal clinics at a maternity hospital in the North West of England. Each participant completed a repertory grid. The participants chose people to match roles including themselves, pregnant women, midwives of different BMIs and hypothetical elements. They also generated psychological constructs to describe them.
  
  
  RESULTS
  Pregnant women with a BMI ≥ 30 kg/m2construed themselves as vulnerable and self-conscious. Some women endorsed obesity-related stereotypes for themselves and felt responsible for their weight. The midwife with a BMI 18 < 30 kg/m2was considered to be most similar to the ideal midwife, while the midwife with a BMI ≤ 18 kg/m2was construed as having an undesirable interpersonal style. The midwife with a BMI ≥ 40 kg/m2was often construed as sharing similar experiences to the pregnant women with a BMI ≥ 30 kg/m2, such as struggling with the psychological consequences of a raised BMI. Some women construed the midwife with a BMI 30 < 40 kg/m2in a positive way, whereas others viewed it as sharing similar feelings about weight as the midwife with a BMI ≥ 40 kg/m2.
  
  
  CONCLUSIONS
  The pregnant women with a BMI ≥ 30 kg/m2in this study described perceptions of themselves and the midwives responsible for their care, which may affect their engagement and satisfaction with services. Pregnant women with a BMI ≥ 30 kg/m2should be involved in service development activities to ensure the structure of services and the language used by midwives are acceptable and do not confirm weight-related stereotypes. Copyright © 2016 John Wiley & Sons, Ltd.
  
  
  CONCLUSIONS
  Pregnant women with a BMI ≥ 30 kg/m2construe themselves as vulnerable and self-conscious and perceive themselves responsible for their weight. Pregnant women with a BMI ≥ 30 kg/m2construe midwives with a low BMI as having an undesirable, cold, interpersonal style. Midwives with a raised BMI are construed as similar to the women, because they share the uncomfortable psychological consequences of a raised BMI. The nature of pregnant women's construal may affect their engagement and satisfaction with maternity services and midwifery care.
authors.affiliation: University of Manchester, School of Psychological Sciences, Manchester, United Kingdom.
authors.forename: Emma L
authors.initials: EL
authors.lastname: Hodgkinson
authors.affiliation: University of Manchester, School of Psychological Sciences, Manchester, United Kingdom.
authors.forename: Debbie M
authors.initials: DM
authors.lastname: Smith
authors.affiliation: Cardiff University, South Wales DClinPsy Programme, Cardiff, United Kingdom.
authors.forename: Dougal Julian
authors.initials: DJ
authors.lastname: Hare
authors.affiliation: University of Manchester, School of Psychological Sciences, Manchester, United Kingdom.|Manchester Mental Health and Social Care Trust, Manchester, United Kingdom.
authors.forename: Anja
authors.initials: A
authors.lastname: Wittkowski
mesh_terms: D015992:Body Mass Index; D004739:England; D005260:Female; D006801:Humans; D008880:Midwifery / Q000706:statistics & numerical data*; D009765:Obesity / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D011369:Professional-Patient Relations
keywords: Body Mass Index; Midwives; Pregnancy; Repertory Grid Technique; Women