Perinatal care experience and interest in weight-inclusive pregnancy intervention among pregnant and postpartum individuals living in larger bodies: A qualitative study.

BACKGROUND: Weight stigma, the devaluation of individuals based on size/weight, is pervasive throughout medicine and negatively impacts physical and mental wellbeing. Health at Every Size (HAES) promotes people of all body sizes achieving health through weight inclusivity, health enhancement, respectful care, eating for well-being, and life-enhancing movement. While HAES-based interventions have been shown to decrease internalization of weight stigma and improve various health markers, including mental health, no such intervention has been adapted for obstetric care. We aimed to elucidate the perspectives of pregnant and postpartum individuals on weight stigma in obstetric care and elicit feedback and assess interest for the adapted Health at Every Size intervention utilizing a qualitative approach. METHODS: We conducted interviews of 20 pregnant and postpartum people with BMI ≥ 30 kg/m2 who reported experiencing stigma. Participants were asked about their obstetric care experiences and to provide feedback on a five-session obstetric-focused HAES intervention prototype. Qualitative description methodology was used to generate the codebook and identify themes. Transcripts were double-coded, and discrepancies were discussed until consensus was reached. RESULTS: Identified themes included: (1) Negative experiences related to weight and/or body size during pregnancy, (2) Positive experiences with individual providers, (3) Support and excitement for the weight-inclusive obstetric intervention, and (4) Suggestions for the adapted program and general obstetric care. CONCLUSION: Individuals in larger bodies report negative experiences related to their weight when engaging in prenatal care. An obstetric intervention focused on optimizing physical and mental well-being through a weight-inclusive lens may be a method for improving obstetric experience of individuals in larger bodies and was well received by all participants.