Competing priorities: a qualitative study of how women make and enact decisions about weight gain in pregnancy
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(2020) 20:507
RESEARCH ARTICLE
Open Access
Competing priorities: a qualitative study of how women make and enact decisions about weight gain in pregnancy Meredith Vanstone1,2* , Marina Sadik1, Sherry Van Blyderveen3, Anne Biringer4, Wendy Sword5, Louis Schmidt6 and Sarah D. Mcdonald7,8,9
Abstract Background: Despite ample clinical evidence that gaining excess weight in pregnancy results in negative health outcomes for women and infants, more than half of women in Western industrialized nations gain in excess of national guidelines. The influence of socio-demographic factors and weight gain is well-established but not causal; the influence of psychological factors may explain some of this variation. Methods: This is the qualitative portion of an explanatory sequential mixed-methods study designed to identify predictive psychological factors of excess gestational weight gain (QUAN) and then explain the relevance of those factors (qual). For this portion of the study, we used a qualitative descriptive approach to elicit 39 pregnant women’s perspectives of gestational weight gain, specifically inquiring about factors determined as relevant to excess gestational weight gain by our previous predictive study. Women were interviewed in the latter half of their third trimester. Data were analyzed using a combination of unconstrained deductive content analysis to describe the findings relevant to the predictive factors and a staged inductive content analytic approach to examine the data without a focus on the predictive factors. Results: Very few participants consistently made deliberate choices relevant to weight gain; most behaviour relevant to weight gain happened with in-the-moment decisions. These in-the-moment decisions were influenced by priorities, hunger, a consideration of the consequence of the decision, and accommodation of pregnancyrelated discomfort. They were informed by the foundational information a woman had available to her, including previous experience and interactions with health care providers. The foundational information women used to make these decisions was often incomplete. While women were aware of the guidelines related to gestational weight gain, they consistently mis-applied them due to incorrect understanding of their own BMI. Only one woman was aware that weight gain was linked to maternal and infant health outcomes. (Continued on next page)
* Correspondence: [email protected] 1 Department of Family Medicine, McMaster University, 1280 Main Street W, Hamilton, Ontario L8S 4L8, Canada 2 Department of Family Medicine, DBHSC 5003E, McMaster University, 100 Main St. W, Hamilton, ON L8P 1H6, Canada Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to t
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