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Call for clear guidance on healthy weight management in pregnancy

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The Royal College of Midwives and Slimming World are calling for clearer guidance on healthy weight management for expectant mothers, along with more support, training and equipment for midwives.

They said NHS data showed that by the time of their booking appointment at eight to 12 weeks, 21% of pregnant women had a body mass index (BMI) in the obese range.

“Many midwives have to use their own initiative and refer to American guidance”

Gill Walton

They highlighted that that data showed excess weight in pregnancy was linked to increased risk of miscarriage, premature birth, gestational diabetes and stillbirth, among other things.

In addition, surveys led by both Slimming World and the RCM revealed that overweight expectant mothers were usually confused by the lack of clear information on their weight management.

Midwives were also concerned that they cannot offer the best support to these women in the absence of clear guidelines, according to the surveys involving 110 midwives and 740 women.

Virtually all the women surveyed (91%) confirmed that pregnancy left them more open to discussions on healthy lifestyle management, yet less than half discussed their weight with their midwives.

Nearly half of the women surveyed (42%) confessed that they never had discussions about their weight with their midwives and one in 10 confessed to never have been weighed the whole process.

“We are calling for clear guidance on healthy weight management in pregnancy”

Gill Walton

Gill Walton, RCM chief executive and general secretary, said: “There is strong evidence of the risks of obesity and excess weight gain in pregnancy and yet there are no UK guidelines on what constitutes a safe weight gain, and many midwives have to use their own initiative and refer to American guidance.”

Carolyn Pallister, Slimming World public health manager and dietitian, said: “The women who participated in this survey told us that they were more open to talking about a healthy lifestyle when they were pregnant so we need to make sure that midwives feel that they have the right training and resources to support that.

“As it stands, this is a significant missed opportunity to share healthy lifestyle messages and guidance,” she said.

Midwives that were surveyed were also troubled by the issue, with 43% confessing that they were not confident about advising women on their weight management during pregnancy.

Around 40% said they were worried about asking women to be weighed unless it was their first appointment.

“As it stands, this is a significant missed opportunity to share healthy lifestyle messages and guidance”

Carolyn Pallister

Nearly two-thirds of midwives (62%) were worried about causing offence if they asked women to be weighed. Almost a quarter (24.7%) said they did not have proper equipment to weigh women in their facilities.

Almost four-fifths of midwives (79%) said they would feel more confident talking about weight management with women if they had more training. The majority also said they would feel more confident if they had formal guidance on healthy weight gain in pregnancy and how to approach the issue.

According to Ms Pallister, though women are normally weighed at their first appointment between week eight and 12 of the pregnancy, they were not weighed routinely in the UK.

Some midwives had no access to weighing scales in their clinic sites, leaving them with the lack of training on how to raise the issue of weight with women, she noted.

Ms Walton said: “There is a clear need for midwives to have the tools, guidance and training they need so that they can offer women the best possible support and care.

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Gill Walton

“This is especially pressing because of the potentially serious complications that can arise in pregnancy as a result of women being overweight or obese,” she said.

“It is a real concern that some midwives do not have access to that most basic piece of equipment, scales,” said Ms Walton.

“We are calling for clear guidance on healthy weight management in pregnancy and will be looking at how we can take this forward so that women and midwives have the information, support and resources needed,” he added.

As part of a partnership with the RCM, Slimming World suggests pregnant women to indulge in a healthier lifestyle and stay physically active.

Instead of urging significant weight loss on their members, their main goal is a “happy, healthy, mum-to-be”.

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