The medicalising of obesity during pregnancy: forgetting the woman inside.

Background: Maternal obesity is a risk factor of major concern to the UK maternity services in relation to the health outcomes of the mother and her baby. Maternity services have responded by managing care based on identifying potential adverse factors. Difficulties monitoring fetal size mean that obese pregnant women have more frequent ultrasound assessments. All obese pregnant women are screened for gestational diabetes and assessed for possible future complicated birth. The aim of this study was to explore the psychosocial experiences of obese pregnant women. Methods: A qualitative approach was used to gain an in-depth perspective of these women’s experiences. Semi-structured interviews were carried out with 18 obese pregnant women (BMI>35). Data were transcribed verbatim and analysed using the principles of framework analysis. Results: The findings revealed that obese pregnant women felt that the extra screening processes involved served to “medicalise” their pregnancy. The frequent hospital visits were seen as a burden on the woman and her family because of the time and finances involved. Furthermore, the women felt that their emotions and feelings were ignored at the expense of monitoring their physical health and the well being of the fetus. For some women, these feelings were magnified if they had experienced negative interactions with health professionals. Conclusions: There is a need for health professionals to communicate more effectively the need for extra monitoring in pregnancy if they are obese. Awareness and sensitivity to the women’s psychosocial needs will enable women to feel supported throughout pregnancy, birth and the postnatal period.