Mahnaz Bahri Khomami, Ruth Walker, Michelle Kilpatrick, Susan de Jersey, Helen Skouteris, and Lisa J. Moran
Mahnaz Bahri Khomami
Monash Centre for Health Research and Implementation [MCHRI], Level 1, 43-51 Kanooka Grove, Clayton, VIC, 3168, Australia
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Ruth Walker
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Michelle Kilpatrick
Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
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Susan de Jersey
Perinatal Research Centre, Centre for Clinical Research and Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
Department of Nutrition and Dietetics, Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Brisbane, QLD, Australia
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Helen Skouteris
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
Warwick Business School, The University of Warwick, Coventry, UK
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Lisa J. Moran
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Author information Article notes Copyright and License information Disclaimer
Mahnaz Bahri Khomami, Monash Centre for Health Research and Implementation [MCHRI], Level 1, 43-51 Kanooka Grove, Clayton, VIC, 3168, Australia;
Contributor Information.
ude.hsanom@imamohk-irhab.zanham
Received 2020 Aug 23; Accepted 2021 Jun 24.
Copyright © The Author[s], 2021
This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License [//creativecommons.org/licenses/by-nc/4.0/] which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages [//us.sagepub.com/en-us/nam/open-access-at-sage].
Abstract
Women with maternal obesity, an unhealthy lifestyle before and during pregnancy and excess gestational weight gain have an increased risk of adverse pregnancy and birth outcomes that can also increase the risk of long-term poor health for them and their children. Pregnant women have frequent medical appointments and are highly receptive to health advice. Healthcare professionals who interact with women during pregnancy are in a privileged position to support women to make lasting healthy lifestyle changes that can improve gestational weight gain and pregnancy outcomes and halt the intergenerational nature of obesity. Midwives and obstetrical nurses are key healthcare professionals responsible for providing antenatal care in most countries. Therefore, it is crucial for them to build and enhance their ability to promote healthy lifestyles in pregnant women. Undergraduate midwifery curricula usually lack sufficient lifestyle content to provide emerging midwives and obstetrical nurses with the knowledge, skills, and confidence to effectively assess and support healthy lifestyle behaviours in pregnant women. Consequently, registered midwives and obstetrical nurses may not recognise their role in healthy lifestyle promotion specific to healthy eating and physical activity in practice. In addition, practising midwives and obstetrical nurses do not consistently have access to healthy lifestyle promotion training in the workplace. Therefore, many midwives and obstetrical nurses may not have the confidence and/or skills to support pregnant women to improve their lifestyles. This narrative review summarises the role of midwives and obstetrical nurses in the promotion of healthy lifestyles relating to healthy eating and physical activity and optimising weight in pregnancy, the barriers that they face to deliver optimal care and an overview of what we know works when supporting midwives and obstetrical nurses in their role to support women in achieving a healthy lifestyle.
Keywords: gestational weight gain, healthy lifestyle, intervention, midwifery, training
Introduction
One in two Australian women now enter pregnancy overweight or with obesity,1,2 and 60% experience excess gestational weight gain [GWG];3 similar prevalence rates have been reported internationally.4 Excess GWG is associated with adverse maternal and child outcomes including gestational diabetes mellitus [GDM],4 gestational hypertensive disorders [GHDs], caesarean section, macrosomia and babies born large for gestational age.3,5 Excess GWG is also associated with postpartum weight retention and long-term cardiometabolic risk factors for the mother6 as well as childhood and adult adiposity and cardiometabolic risk factors for the child.7–9 Maternal obesity at conception is independently associated with GDM, GHD, caesarean section, macrosomia, induction of labour and resuscitation at birth.10,11 Therefore, the National Academies [formerly the Institute of Medicine] advise women to gain weight during pregnancy according to their pre-pregnancy body mass index [BMI]. For singleton pregnancies, the recommendations are 12.5–18 kg for a BMI