title: Adopting a healthy lifestyle when pregnant and obese - an interview study three years after childbirth.
abstract: Obesity during pregnancy is increasing and is related to life-threatening and ill-health conditions in both mother and child. Initiating and maintaining a healthy lifestyle when pregnant with body mass index (BMI) ≥ 30 kg/m(2) can improve health and decrease risks during pregnancy and of long-term illness for the mother and the child. To minimise gestational weight gain women with BMI ≥ 30 kg/m(2) in early pregnancy were invited to a lifestyle intervention including advice and support on diet and physical activity in Gothenburg, Sweden. The aim of this study was to explore the experiences of women with BMI ≥ 30 kg/m(2) regarding minimising their gestational weight gain, and to assess how health professionals' care approaches are reflected in the women's narratives.
  
  
  
  Semi-structured interviews were conducted with 17 women who had participated in a lifestyle intervention for women with BMI ≥ 30 kg/m(2) during pregnancy 3 years earlier. The interviews were digitally recorded and transcribed in full. Thematic analysis was used.
  
  
  
  The meaning of changing lifestyle for minimising weight gain and of the professional's care approaches is described in four themes: the child as the main motivation for making healthy changes; a need to be seen and supported on own terms to establish healthy routines; being able to manage healthy activities and own weight; and need for additional support to maintain a healthy lifestyle.
  
  
  
  To support women with BMI ≥ 30 kg/m(2) to make healthy lifestyle changes and limit weight gain during pregnancy antenatal health care providers should 1) address women's weight in a non-judgmental way using BMI, and provide accurate and appropriate information about the benefits of limited gestational weight gain; 2) support the woman on her own terms in a collaborative relationship with the midwife; 3) work in partnership to give the woman the tools to self-manage healthy activities and 4) give continued personal support and monitoring to maintain healthy eating and regular physical activity habits after childbirth involving also the partner and family.
authors.affiliation: Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden. anna.dencker@gu.se.|Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. anna.dencker@gu.se.
authors.forename: Anna
authors.initials: A
authors.lastname: Dencker
authors.affiliation: Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.|Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|Primary Health Care, Närhälsan, Gothenburg, Sweden.
authors.forename: Åsa
authors.initials: Å
authors.lastname: Premberg
authors.affiliation: Centre for Maternal and Child Health Research, City University London, London, UK.
authors.forename: Ellinor K
authors.initials: EK
authors.lastname: Olander
authors.affiliation: Centre for Maternal and Child Health Research, City University London, London, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: McCourt
authors.affiliation: Antenatal Health Care, Primary Health Care, Research and Development Unit, Närhälsan, Gothenburg, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Haby
authors.affiliation: Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.|Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Sofie
authors.initials: S
authors.lastname: Dencker
authors.affiliation: Primary Health Care, Närhälsan, Gothenburg, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Glantz
authors.affiliation: Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.|Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Berg
mesh_terms: D000328:Adult; D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D000070497:Healthy Lifestyle; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D009042:Motivation; D009765:Obesity / Q000628:therapy*; D011247:Pregnancy; D011295:Prenatal Care; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012944:Social Support; D015430:Weight Gain
keywords: Antenatal health care; Body mass index; Gestational weight gain; Interview study; Lifestyle intervention; Obesity