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Help instead of blaming obese mums-to-be

Health professionals worried about the increasing number of obese pregnant women could learn lessons from successful smoking cessation campaigns, according to a study into how maternity services could be developed to effectively tackle maternal obesity.
With more than one in six pregnant women now classed as obese in the UK, the issue is of concern due to the added health risks for both the pregnant women and their future infants.
The recent study, funded by Public Health North East, was carried out by a team of academic researchers led by Dr Nicola Heslehurst from Teesside University and including experts in the field from Durham and Newcastle universities, and the North East Public Health Observatory.
The findings, published in the journal, Midwifery, show substantial improvement in some areas of clinical practice such as  health and safety, but slow progress in other areas of maternity services since earlier research by Dr Heslehurst and colleagues in 2005/06. 
She says little is being done to address the actual obesity. "We found there were no weight gain guidelines in place, largely due to a lack of national guidance on this issue, and a lack of psychosocial input. Mothers were being told they were putting their babies at risk and then left to deal with it as there was an absence of support services available to help the women.  This is an area that needs further development."
Midwives told Dr Heslehurst they wanted training in how to talk to obese women about the clinical risks without upsetting their patients.
"There has been intensive training on alcohol and drug misuse and smoking and domestic violence, but obesity is still seen as a very sensitive issue. Women don't want to be stigmatised or patronized because of their weight. They know they are obese and need support", said Dr Heslehurst.
She says: "There is an urgent need for obesity training along the lines that midwives have for other health issues, and the research team is continuing to work closely with Public Health North East to identify how the training would be best developed in our region.  
"There are lots of obesity public health services out there that are not being targeted at pregnant women. There's a real lack of communication between public health services and maternity services, and there is no continuity of care in the transition from the woman being pregnant to postnatal."

In her research, she found many healthcare professionals saying pregnancy was a good time to intervene as midwives and others had a captive audience, but feared identifying obesity without appropriate support services could make matters worse. It could heighten stigma by drawing attention to the risks without offering any structured support.
Dr Heslehurst believes midwives and other healthcare professionals could learn from successful smoking cessation campaigns about how to best tackle maternal obesity. The emotional aspects and the obesity itself are not being dealt with. With obesity being viewed negatively in society and by the media there is a need for obesity messages to be more positive rather than "condemning", says the report.