title: Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study.
abstract: OBJECTIVE
  to understand the lived experiences and views of being referred to an antenatal dietetic service from the perspective of pregnant women with obesity.
  
  
  METHODS
  a qualitative, interpretive approach using one-to-one in-depth interviews to explore the lived experience of pregnant women with obesity following referral to an antenatal dietetics service. Thematic content analysis was carried out by two researchers independently to develop data-driven themes.
  
  
  METHODS
  one NHS Trust maternity and dietetic services, North East England, UK.
  
  
  METHODS
  fifteen pregnant women with a booking body mass index ≥30kg/m2attending an obesity-specific antenatal dietetic service. All women were White, parity between 0 and 2, and BMI range 30-51kg/m2.
  
  
  RESULTS
  four themes were identified. (1) Women's overall experience of the service: experiences were predominately positive with only two negative cases identified. (2) Process of referral: women placed importance on informative and in-person communication about the service, with health professionals, at the point of referral. (3) Delivery of the service: dietitians were considered to be the experts and women wanted more frequent contact. (4) Content of the service: tailored advice enabled behaviour change, and women desired increased physical activity support and weight monitoring.
  
  
  CONCLUSIONS
  women reported an overall positive experience and thought that dietitians were the expert health professionals to support them. Women in this study felt that tailoring advice specific to their personal circumstances helped them implement changes, and had a strong interest in the nutritional benefits for fetal development. Women considered weight monitoring to be a positive element of the service; however, further research is required given the limited and conflicting evidence-base.
  
  
  CONCLUSIONS
  it is important to incorporate women's experiences in the development and delivery of antenatal weight management services to facilitate person-centred care. Communication by health professionals at the point of referral is particularly important to provide accurate expectations of services and to reduce anxieties. Dietitians are considered to be appropriate experts to deliver these services, although they may need additional support to address women's physical activity needs in pregnancy.
authors.affiliation: Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, England NE2 4AX, United Kingdom. Electronic address: nicola.heslehurst@ncl.ac.uk.
authors.forename: Nicola
authors.initials: N
authors.lastname: Heslehurst
authors.affiliation: Health and Social Care Institute, School of Health & Social Care, Teesside University, Middlesbrough, Tees Valley, England TS1 3BX, United Kingdom. Electronic address: s.dinsdale@tees.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Dinsdale
authors.affiliation: Gateshead NHS Foundation Trust, Queen Elizabeth Avenue, Sheriff Hill, Gateshead, Tyne and Wear, England NE9 6SX, United Kingdom. Electronic address: helene.brandon@ghnt.nhs.uk.
authors.forename: Helene
authors.initials: H
authors.lastname: Brandon
authors.affiliation: Gateshead NHS Foundation Trust, Queen Elizabeth Avenue, Sheriff Hill, Gateshead, Tyne and Wear, England NE9 6SX, United Kingdom.
authors.forename: Camilla
authors.initials: C
authors.lastname: Johnston
authors.affiliation: School of Medicine, Pharmacy and Health, Durham University, Stockton on Tees, England TS17 6BH, United Kingdom. Electronic address: carolyn.summerbell@durham.ac.uk.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Summerbell
authors.affiliation: Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, England NE2 4AX, United Kingdom. Electronic address: judith.rankin@ncl.ac.uk.
authors.forename: Judith
authors.initials: J
authors.lastname: Rankin
mesh_terms: D000328:Adult; D015992:Body Mass Index; D004035:Diet Therapy / Q000379:methods* / Q000523:psychology; D004739:England; D005260:Female; D006801:Humans; D064686:Nutritionists / Q000592:standards; D009765:Obesity / Q000178:diet therapy* / Q000523:psychology; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D011295:Prenatal Care / Q000379:methods*; D011369:Professional-Patient Relations; D036301:Qualitative Research
keywords: Body mass index; Dietetic; Experience; Obesity; Pregnancy; Qualitative