Weight stigma and prenatal physical activity: Exploring the perspectives of pregnant women living with obesity

Taniya S Nagpal; Rebecca H Liu; Maxine Myre; Laura Gaudet; Jocelynn Cook; Danilo F da Silva; Kristi B Adamo

doi:10.1016/j.midw.2021.103186

Weight stigma and prenatal physical activity: Exploring the perspectives of pregnant women living with obesity

Midwifery. 2022 Jan:104:103186. doi: 10.1016/j.midw.2021.103186. Epub 2021 Oct 28.

Authors

Taniya S Nagpal¹, Rebecca H Liu², Maxine Myre³, Laura Gaudet⁴, Jocelynn Cook⁵, Danilo F da Silva⁶, Kristi B Adamo⁷

Affiliations

¹ Faculty of Health Sciences, University of Ottawa, Ottawa K1N 6N5, Canada; Society of Obstetricians and Gynaecologists of Canada, Ottawa K1B 1A7, Canada. Electronic address: tnagpal@uottawa.ca.
² Women's College Hospital, Institute for Health System Solutions & Virtual Care, Toronto, Ontario, M5G 1N8, Canada. Electronic address: Rebecca.Liu@wchospital.ca.
³ Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, T6G 2R3, Canada. Electronic address: myre@ualberta.ca.
⁴ Department of Obstetrics and Gynecology, Queen's University, Kingston K7L 3N6, Canada. Electronic address: Laura.Gaudet@kingstonhsc.ca.
⁵ Society of Obstetricians and Gynaecologists of Canada, Ottawa K1B 1A7, Canada; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa K1N 6N5, Canada. Electronic address: jcook@sogc.com.
⁶ Faculty of Health Sciences, University of Ottawa, Ottawa K1N 6N5, Canada. Electronic address: dfernanc@uottawa.ca.
⁷ Faculty of Health Sciences, University of Ottawa, Ottawa K1N 6N5, Canada. Electronic address: kadamo@uottawa.ca.

PMID: 34788725
DOI: 10.1016/j.midw.2021.103186

Abstract

Objective: To identify sources of weight stigma in physical activity (PA)-related milieus reported by pregnant women living with obesity. We also report person-informed strategies to improve the delivery of PA promotions and prescriptions to prevent weight stigma and improve maternal PA.

Design: This is a qualitative descriptive study and semi-structured interviews were conducted.

Setting and participants: Purposive sampling including pregnant women living with obesity, with a body mass index ≥35.0 kg/m², ≥18 years of age, and receiving specialized prenatal care were recruited from an obstetrics clinic in Kingston, Canada.

Measurement and findings: Data were assessed by a content analysis, whereby coded themes represented sources of weight stigma related to prenatal PA. Demographic characteristics (pre-pregnancy body mass index, age, gestational age) were summarized and presented as means and standard deviations. In-depth interview data were collected from eight women. Average pre-pregnancy BMI, age, and gestational age were 44.6±4.8 kg/m², 32.0±4.1 years, 31.1±5.8 weeks, respectively. Two sources of weight stigma related to prenatal PA were identified: 1. Lack of visual representation - online images and images found in exercise promotional material do not include women who have obesity; 2. Lack of individualized recommendations - currently available prenatal PA guidelines and/or recommendations from healthcare providers do not always consider individual physical barriers or health goals women may have.

Key conclusion and implications for practice: By increasing body positive representation of pregnant women exercising and offering person-centered prenatal PA recommendations, maternal PA may improve including women living with obesity. Findings from this work can inform future PA interventions, health promotion programming, and prescriptions from prenatal care providers to implement person-oriented strategies to prevent weight stigma and improve the delivery of care for pregnant women living with obesity.

Keywords: Exercise; Obesity; Physical Activity; Pregnancy; Stigma.

MeSH terms

Exercise
Female
Humans
Obesity
Pregnancy
Pregnant People*
Prenatal Care
Weight Prejudice*