A qualitative study of obese pregnant women’s understanding of weight gain in pregnancy.

The primary aim of this study is to explore the understanding of gestational weight gain amongst obese pregnant women. A secondary aim is to identify obese pregnant women's view of their behaviour in order to help identify appropriate care pathways for them. By directly talking to women, the study sought to discover what women understand about healthy weight gain in pregnancy, what further information they needed and their opinions about where this information should come from. This qualitative study conducted eight semi-structured interviews with women who were 32-35 weeks pregnant and in the obese weight category. Thematic analysis revealed six themes: (1) unhealthy relationship with eating; (2) does my bump look big in this?; (3) pick and mix approach to advice; and (4) why weight matters; (5) honesty; and (6) weighing it up. This study has illustrated that women who are already obese at booking seek clear advice regarding gestational weight gain that is delivered in a compassionate and individualised manner. Not discussing the issue can negatively influence their health and wellbeing and that of their babies. Weighing women routinely as a standard aspect of antenatal care should be reintroduced in order to bring this public health message to the forefront of clinical care.