Addressing obesity in pregnancy: the design and feasibility of an innovative intervention in NSW, Australia

Objective: Obesity amongst women of child bearing age is increasing at an unprecedented, rate throughout the Western world. This paper describes the design of an innovative, collaborative, antenatal intervention that aims to assist women to manage their weight during pregnancy and, presents aspects of the programme evaluation.

Data sources/study setting: The programme was introduced at two sites, one in South East Sydney and, the other on the Central North Coast of NSW. Data were drawn from both sites and pooled for analysis.

Study design: This evaluation used mixed methods drawing on qualitative and quantitative data.

Data collection methods: Focus groups were held with staff in the antenatal clinic, who were, responsible for recruiting to the new service. Members of staff were also asked to record BMI for all women offered the service and using a simple questionnaire, record the reasons women gave for declining the new service.

Principle findings: The recruitment rate to the new service was 35% though this result should be treated with caution. Those women with a BMI of >35 were twice as likely to elect to participate in the new service as women with a BMI of less than 35. Focus groups with midwives in the antenatal clinic responsible for recruitment identified three themes impacting on recruitment to the service; 'finding the words', 'acknowledging challenges' and 'midwives' knowledge'.

Conclusions: Antenatal clinic midwives were unprepared for talking to women about their weight. Increasing the confidence and skills of staff in offering service innovations to eligible women is a major challenge to be met if new models of care are to be successful in addressing overweight and obesity in pregnancy.