University of Wisconsin School of Medicine and Public Health, 750 Highland Avenue, Madison, WI, 53726, USA.
Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 1010 Mound Street, Madison, WI, 53715, USA.
BMC Pregnancy Childbirth. 2021 Feb 15;21(1):139. doi: 10.1186/s12884-021-03629-4.
Stigma and bias experienced during prenatal care can affect quality of care and, ultimately, the health of pregnant women with obesity and their infants. We sought to 1) better understand the bias and stigma that women with BMIs ≥40 kg/m experience while receiving prenatal care, 2) gauge women's interest in group prenatal education for women with obesity, and 3) gather feedback about their preferred weight-related terminology.
We conducted and thematically content-analyzed 30 semi-structured interviews of women with BMIs ≥40 kg/m who received prenatal care at a university-affiliated teaching hospital in the Midwest region of the United States.
All women recalled positive experiences during their perinatal care during which they felt listened to and respected by providers. However, many also described a fear of weight-related bias or recalled weight-based discrimination. Women reacted favorably to a proposed group prenatal care option for pregnant women with obesity that focused on nutrition, physical activity, and weight management. Women rated "weight" and "BMI" as the most desirable terms for describing weight, while "large size" and "obesity" were rated least desirable.
Many pregnant women with BMIs ≥40 kg/m experience bias in the prenatal care setting. Potential steps to mitigate bias towards weight include improving provider awareness of the experiences and perspectives of this population, expanding prenatal care options targeted towards women with high BMIs, including group care, and using patient-preferred weight-related terminology. Through the remainder of this manuscript, wherever possible, the term "high BMI" will be used in place of the term "obesity" to describe women with BMI ≥ 30 kg/m in order to respect the preferred terminology of the women we interviewed.
在产前护理期间经历的污名化和偏见会影响护理质量，并最终影响肥胖孕妇及其婴儿的健康。我们旨在：1）更好地了解 BMI≥40kg/m 的孕妇在接受产前护理时所经历的偏见和污名化；2）评估女性对肥胖孕妇群体产前教育的兴趣；3）收集关于其首选体重相关术语的反馈。
我们对在美国中西部地区一所大学附属医院接受产前护理的 BMI≥40kg/m 的 30 名妇女进行了半结构化访谈，并进行了主题内容分析。
所有女性都回忆起了她们在围产期护理期间的积极经历，在此期间，她们感到被提供者倾听和尊重。然而，许多人也描述了对与体重相关的偏见的恐惧，或回忆起了基于体重的歧视。女性对一项为肥胖孕妇提供的、专注于营养、身体活动和体重管理的群体产前护理方案反应良好。女性认为“体重”和“BMI”是描述体重最理想的术语，而“大尺寸”和“肥胖”则是最不受欢迎的术语。
许多 BMI≥40kg/m 的孕妇在产前护理环境中经历了偏见。减轻对体重的偏见的潜在措施包括提高提供者对这一人群的经验和观点的认识，扩大针对高 BMI 女性的产前护理选择，包括群体护理，并使用患者首选的体重相关术语。在本研究的其余部分，只要有可能，我们将使用术语“高 BMI”代替术语“肥胖”来描述 BMI≥30kg/m 的女性，以尊重我们采访的女性所偏好的术语。
