Table 4 Comparison of National Institute of Clinical Excellence and American Congress of Obstetricians and Gynecologists
Recommendations | ||
|---|---|---|
|  | All Post-partum Women | Post-partum women with BMI ≥ 30 |
NICE | 6–8-week postnatal check | 6-8 week postnatal check |
|  | In women who are overweight, obese or who have concerns about their weight, ask if they would like any further advice and support now – or later. If yes, make an appointment within the next 6 months for advice and support. | Explain the increased risks that being obese poses to them and, if they become pregnant again, their unborn child. |
| Â | Provide current advice about how to lose weight after childbirth. | Encourage them to lose weight. |
| Â | Ensure women have a realistic expectation of the time it will take to lose weight gained during pregnancy. | Offer a structured weight-loss program or a referral to a dietitian or an appropriately trained health professional. |
| Â | Discuss benefits of a healthy diet and regular physical activity, | Â |
| Â | Advice on healthy eating and physical activity should be tailored to individual patient circumstances. | Â |
| Â | Â | Provide Women who are not yet ready to lose weight with information about where they can get support when they are ready. |
| Â | Advise women to seek information from reliable sources | Â |
| Â | Provide details of appropriate community-based services | Â |
| Â | Encourage women to breastfeed. | Â |
| Â | Â | Use evidence-based behavior change techniques to motivate and support women to lose weight. |
| Â | Provide advice on recreational exercise from the Royal College of Obstetrics and Gynecology: | Â |
| Â | A mild exercise program of walking and stretching may begin immediately; after complicated deliveries, or lower segment caesareans, a medical provider should be consulted before resuming pre-pregnancy levels of physical activity. | Encourage breastfeeding |
| Â | Emphasize importance of physical activities that can be built into daily life. | Â |
ACOG | Rapid return to pre-pregnancy activities is acceptable after an uncomplicated pregnancy and delivery | No recommendations based on BMI |
| Â | Moderate weight reduction after delivery does not interfere with lactation or neonatal weight | Â |
| Â | Postpartum exercise may help to reduce postpartum depression symptoms | Â |
| Â | Refer to weight specialist before the next pregnancy | Â |
| Â | Discuss healthy lifestyle behaviors at each visit. | Â |