Women's experience of body weight management during and post-pregnancy: a mixed methods approach

Background: Gaining excessive weight during pregnancy has been linked with adverse effects including increased risk of caesarean delivery and postpartum weight retention. Despite these recognised risks, currently no UK/Ireland gestational weight gain (GWG) guidelines exist, women are not routinely weighed throughout pregnancy and consequently, women's understanding of the importance of weight management during, and post-pregnancy remains poor. The present study explored factors influencing weight change during and post-pregnancy and identified potential opportunities that could help women manage weight during these periods.

Methods: Women aged 18-45 years-old who had an uncomplicated pregnancy within the last 3 years were invited to complete an online questionnaire (n = 108) regarding their experience of changes in body weight during and post-pregnancy. Follow on focus groups (n = 13 women) were conducted online within the same population to delve deeper into the topic, the sessions were recorded, transcribed verbatim and data subjected to directive content analysis based on the socio-ecological model.

Results: Respondents reported in the online questionnaire, they did not receive enough information around weight management during (81.5%) and post-pregnancy (86.1%). Focus group qualitative data identified barriers to managing weight at each level of the ecological model, at the intrapersonal (e.g., changes in diet), interpersonal (e.g., conflicting advice), environment and society (e.g., COVID-19 pandemic), and institutional and policy (e.g., system failing) levels. Potential strategies to help manage weight were also identified, at the intrapersonal (e.g., need for further information), interpersonal (e.g., support groups), environment and society (e.g., messaging), and institutional and policy (e.g., further follow-up care) levels.

Conclusions: Mothers report receiving insufficient information around weight management, with barriers identified at each level of the ecological model. Highlighting that support and change is needed on multiple levels both during and post-pregnancy, with potential strategies identified, which could potentially inform future studies.