Table 1 Quotes from the 30 interviews with health professionals to illustrate the three themes and subsequent sub-themes highlighted in these interviews
Theme | Subtheme | Example quote (participant code) |
|---|---|---|
Obesity as a conversation stopper | ||
Perceptions of obesity and the impact on communication | “…to try and broach the subject with some women, it can be difficult because they are vulnerable and obviously it can be embarrassing and hurtful…” (HP17) | |
Delivery of information | “…you can give out patient information leaflets but whether they read them is another thing – they’ve got so many” (HP10) | |
“…you don’t want to upset them by saying they’re overweight or fat and you don’t really know what words to use sometimes…” (HP13) | ||
Lack of information | “…we should be able to offer things for obese ladies but it’s about us knowing what there is out there and what we can signpost these ladies off to” (HP5) | |
Knowledge and/or need for training | “When we first started tackling HIV, oh we can’t possibly do that…I mean now we do it all and it’s a matter of course and nobody even thinks about it” (HP13) | |
“…we’re always striving to give better advice to pregnant women…it would be nice to have a bit more knowledge around you to be able to advise people that way…it’s knowing sometimes what’s the right advice to give…only by going and researching yourself…” (HP19) | ||
Obesity as a maternity issue | ||
Intervention is needed | “…they [women they cared for who attended the antenatal lifestyle programme] were quite positive about the programme…had learnt a lot about healthy eating…would actually continue with their lifestyle change even after the baby was born” (HP3) | |
“I think it should be embedded in the health service but also across the community services. It should be a joint venture. And education. I think the opportunities are there everywhere for us all to be delivering on that package and it should be integral to all services so that it’s seen to be the norm … that’s how it becomes acceptable…” (HP26) | ||
Continuous care | “Whoever reviews them, the booking midwife…whoever reviews them in the…reviews like let it be obstetricians and midwives, all levels of doctors…then they go to the GP and the booking midwives, that should be a good start and that should be continued at every visit” (HP11) | |
Impact on clinical practice | “…looking at it practically and realistically it’s just another role [providing information about maternal obesity]…that you’re expected to fill and I just don’t think practically on a day to day basis you would have time to do it…” (HP18) | |
“Main issue with obesity is…shoulder problems…it hurts your shoulder and some people have back problems as well” (HP6) | ||
Long-term impact of maternal obesity intervention | “Healthy eating plans, weight management programmes, exercise programmes…are relevant not just for pregnancy but pre-conceptually and postnatally so that women even if they’ve a problem in this pregnancy can improve their health and well-being for the next pregnancy. I think that’s really important we don’t…ignore what we can see in front of us, we do something about it” (HP26) | |
“…the cycle has to be broken somewhere and it’s finding the right balance of where to break that circle and how to do it effectively” (HP2) |