Background: The preconception period is a significant opportunity to support improved maternal health, but there are no current preconception nutrition guidelines to optimise reproductive success. Entering pregnancy with an elevated body mass index increases the risk of pregnancy complications. Women in the preconception and pregnancy periods are vulnerable to weight stigma by healthcare providers, which can lead to decreased interaction with healthcare providers. The barriers faced by women with overweight when seeking preconception advice have been insufficiently explored.
Objective(s): To explore barriers, facilitators, and motivators towards engagement and uptake of preconception nutrition and lifestyle advice in women living with or without overweight or obesity.
Methods: Twenty semi-structured interviews were conducted with consenting women attending the fertility clinic, Repromed, in South Australia. Interviews were audio recorded, transcribed verbatim, coded, and thematically analysed.
Results: Twenty women participated in interviews, including 13 women living with overweight (BMI 25-29.9kg/m2) or obesity (BMI >30kg/m2). Women perceived their age and the desire for a healthy child as motivating factors when pregnancy planning. Both women with overweight and women of a normal weight reported challenges finding reputable information online, however women with overweight were more likely to utilise online groups and forums when sourcing preconception information. Lack of spousal support was a notable barrier to the implementation of preconception behaviour change and was predominantly experienced by women with overweight. Women with overweight reported a more positive relationship with their general practitioner than women of a normal weight and perceived their information as helpful.
Conclusions: Women engage in multifaceted interactions while pregnancy planning. Women with overweight described positive interactions with their primary health care provider indicating an absence of stigma. However, they experienced greater barriers when implementing changes at home, implying a greater difficulty for women with overweight to optimise nutrition and lifestyle behaviours for reproductive success.