The University of Queensland, Queensland Centre for Mothers and Babies, School of Psychology, Brisbane, Australia.
BMC Pregnancy Childbirth. 2013 Jan 22;13:19. doi: 10.1186/1471-2393-13-19.
Weight stigma is pervasive in Western society and in healthcare settings, and has a negative impact on victims' psychological and physical health. In the context of an increasing focus on the management of overweight and obese women during and after pregnancy in research and clinical practice, the current studies aimed to examine the presence of weight stigma in maternity care. Addressing previous limitations in the weight stigma literature, this paper quantitatively explores the presence of weight stigma from both patient and care provider perspectives.
Study One investigated associations between pre-pregnancy body mass index (BMI) and experiences of maternity care from a state-wide, self-reported survey of 627 Australian women who gave birth in 2009. Study Two involved administration of an online survey to 248 Australian pre-service medical and maternity care providers, to investigate their perceptions of, and attitudes towards, providing care for pregnant patients of differing body sizes. Both studies used linear regression analyses.
Women with a higher BMI were more likely to report negative experiences of care during pregnancy and after birth, compared to lower weight women. Pre-service maternity care providers perceived overweight and obese women as having poorer self-management behaviours, and reported less positive attitudes towards caring for overweight or obese pregnant women, than normal-weight pregnant women. Even care providers who reported few weight stigmatising attitudes responded less positively to overweight and obese pregnant women.
Overall, these results provide preliminary evidence that weight stigma is present in maternity care settings in Australia. They suggest a need for further research into the nature and consequences of weight stigma in maternity care, and for the inclusion of strategies to recognise and combat weight stigma in maternity care professionals' training.
体重歧视在西方社会和医疗保健环境中普遍存在,对受害者的身心健康产生负面影响。在研究和临床实践中越来越关注超重和肥胖女性在怀孕期间和之后的管理的背景下,目前的研究旨在检查产妇保健中是否存在体重歧视。为了解决体重歧视文献中的先前限制,本文从患者和护理提供者的角度定量探讨了体重歧视的存在。
研究一通过对 2009 年在澳大利亚出生的 627 名澳大利亚女性进行的全州性自我报告调查,研究了孕前体重指数(BMI)与产妇保健体验之间的关联。研究二涉及向 248 名澳大利亚预备医疗和产妇保健提供者进行在线调查,以调查他们对不同体型孕妇提供护理的看法和态度。这两项研究都使用了线性回归分析。
与体重较低的女性相比,BMI 较高的女性在怀孕期间和分娩后更有可能报告负面的护理体验。预备产妇保健提供者认为超重和肥胖的女性自我管理行为较差,并对超重或肥胖孕妇的护理态度不太积极,而不是正常体重的孕妇。即使报告体重歧视态度较少的护理提供者对超重和肥胖的孕妇的反应也不那么积极。
总的来说,这些结果初步证明了体重歧视在澳大利亚的产妇保健环境中存在。它们表明需要进一步研究产妇保健中体重歧视的性质和后果,并需要在产妇保健专业人员的培训中纳入识别和打击体重歧视的策略。