How can maternity services be developed to effectively address maternal obesity? A qualitative study

Objective: to identify developments in maternal obesity services and health-care practitioners' views on how maternity services need to be further developed to be more effective in the care of obese pregnant women. Design: follow-up qualitative study using purposive sampling, interviews and focus groups. Setting: 10 maternity units in the North East Government Office Region of England, UK. Participants: 30 maternity unit health-care practitioners with personal experience of maternal obesity services. Measurements and findings: semi-structured interviews and focus groups were carried out with health-care practitioners representing each National Health Service trust in the region that provides maternity services to identify views on the barriers, facilitators, advantages and disadvantages of developing maternal obesity services, and how maternity services can be more effective in managing maternal obesity. Transcripts were analysed using thematic content analysis. Three dominant themes emerged: questioning maternal obesity service development; psychosocial issues and maternal obesity service development; and the way forward. Key conclusions: there has been a substantial improvement in the management of the health and safety aspects of maternal obesity over the last three years. However, more work is needed around the psychosocial issues, weight management and public health aspects of maternal obesity. Implications for practice: to meet the needs of obese pregnant women, maternity services should consider the transition of care between pregnancy and the postnatal period, improve communication between hospital and public health services, and develop services that will engage pregnant women to address their obesity.