Health care providers can support women to have healthy weights during the perinatal period
Studies
show that women want to discuss weight with their health care
providers. In particular, women who are overweight and obese have
questions regarding gestational weight gain. And, there is evidence
that women who have weight gain discussions with their health care
providers are more likely to gain within the recommendations. Women who
are overweight or obese pre-pregnancy, and women who gain outside of
the gestational weight gain recommendations are at higher risk for
complications during pregnancy and later in life. However, women face
many barriers to having healthy weights such as societal messages about
being thin, time stress, financial constraints, and not having
assistance with child care. Recognizing a woman’s personal barriers,
and working with her to identify possible solutions is one way that you
can support her efforts to eat healthfully and be physically active.
Recognizing the barriers that women face to having healthy weights,
what follows are tools to support health care providers to comfortably
engage in conversation with women regarding weight gain during
pregnancy.
Promising practices to support healthy weights:
While there is insufficient evidence to determine ‘best practices’ at this time, the steps identified here are promising.
- Use women-centred practice: A women-centered approach
recognises that for the majority of women, pregnancy and childbirth are
normal life events. This approach places the mother and her baby at the
centre of care, and provides the services to meet their needs.
Developing women-centered care relies, in part, on understanding
women's preferences and needs with respect to care. It also involves
engaging women and their families (as defined by the woman) in the
processes of planning and delivering services.
- Encourage women to have a healthy weight pre-pregnancy, gain
weight within the recommendations during pregnancy, and have a healthy
weight postpartum: Within your practice, engage childbearing women in discussions about weight.
Use the healthy eating, physical activity, and healthy weight
client/patient handouts on this website. During pregnancy, the Gestational Weight Gain charts can be used to identify the recommendations based on pre-pregnancy BMI and track weight gain.
- Explore client’s/patient’s readiness for adoption of healthy lifestyle habits using Brief Motivational Interviewing:
Before clients adopt healthy lifestyle behaviour they need to want to
change and feel capable of making changes. Brief Motivational
Interviewing is a tool that you can use to help your clients/patients
increase their desire to change and increase their belief that they can
do it. The Introduction to Brief Motivational Interviewing and Readiness Ruler are
useful tools for identifying clients’ readiness for change and helping
motivate your client for adopting healthy lifestyle habits.
Checklist of better/promising practices:
For a full checklist of better/promising practices for primary obstetrical health care providers to support women who are overweight or obese pre-pregnancy, during pregnancy and postpartum, see Maternal Overweight, Obesity and Excess Gestational Weight Gain: Identification of Maternal and Perinatal Implications and Primary Maternity Care Providers' Opportunities for Interventions to Improve Health Outcomes
Resources:
Gestational Weight Gain Charts: A tool to support women in having healthy weights when planning a pregnancy, during pregnancy, and postpartum
Introduction to Brief Motivational Interviewing: A technique to support women in having healthy weights when planning a pregnancy, during pregnancy, and postpartum
Readiness Ruler: A tool to support women in having healthy weights when planning a pregnancy, during pregnancy, and postpartum
Maternal Overweight, Obesity and Excess Gestational Weight Gain: Identification of Maternal and Perinatal Implications and Primary Maternity Care Providers' Opportunities for Interventions to Improve Health Outcomes
Client/patient handouts on healthy eating, physical activity, and healthy weight when planning a pregnancy
Client/patient handouts on healthy eating, physical activity, and healthy weight during pregnancy
Client/patient handouts on healthy eating, physical activity, and healthy weight postpartum
Additional Resources:
ActNow BC website: http://www.ActNowBC.ca Baby’s Best Chance: pick up a free copy at your local health unit. Or, online at http://www.health.gov.bc.ca/library/publications/year/2005/babybestchance.pdf BC Perinatal Health Program: educational support to care providers, outcome analysis, networks, and multidisciplinary perinatal guidelines to optimize maternal, neonatal, and fetal health in British Columbia http://www.bcphp.ca/
Canada’s Physical Activity Guide to Healthy Active Living: online at: http://www.phac-aspc.gc.ca/pau-uap/paguide/. Or call 1-800-O-Canada for a free copy.
Dietitian Services at HealthLinkBC: free nutrition information at www.dialadietitian.org or call 8-1-1 no charge in BC to speak with a registered dietitian between 9am to 5pm weekdays. TTY (Deaf and hearing-impaired) call 7-1-1. Eating Well with Canada’s Food Guide: online at www.healthcanada.gc.ca/foodguide. Or call 1-800-O-Canada for a free copy.
HealthLINK BC website:http://www.healthlinkbc.ca/searchhealth.stm. Or call no charge 8-1-1. TTY (Deaf and hearing-impaired) call 7-1-1.
MotivationalInterviewing.org, a web site is to provide resources on Motivational Interviewing, including general information about the approach, training resources, and research: www.motivationalinterview.org
PACE Canada, a comprehensive guide designed to assist healthcare providers in increasing their patients’ physical activity levels and improving their eating habits: http://www.pace-canada.org/
Rollnick Stephen, Miller William R, & Christopher C. Butler. Motivational Interviewing in Health Care: Helping Patients Change Behavior. The Guilford Press, New York. 2008.
Walk BC Physical activity prescription, client planning tool, and stage of readiness for change questionnaire: www.walkbc.ca/engaging-physicians
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