Management of excess weight in pregnancy in Otago, New Zealand: a qualitative study with lead maternity carers.

AIM: To investigate the knowledge and practice of midwives providing lead maternity care (LMC) in Otago, regarding gestational weight gain (GWG). METHODS: A qualitative study was conducted using three semi-structured focus groups and one in-depth interview. A total of 12 midwives, including one student midwife, were interviewed. Transcripts were analysed using generic coding and thematic analysis. At the conclusion of the focus groups no new themes were emerging. RESULTS: Themes discussed included midwives' knowledge of GWG, methods used to identify BMI and weight gain throughout pregnancy, current management, barriers to management and tools used to overcome these barriers. There was satisfactory knowledge of the risks associated with excess GWG, however, adherence to current New Zealand guidelines and awareness of international guidelines in this area was limited. Management of GWG was highly varied and the weighing of pregnant women was not common practice. Sensitivity around the topic of weight management was identified as a major barrier to care. CONCLUSIONS: The management inconsistencies highlighted in this study have identified a need for New Zealand guidelines for the management of GWG. Clear guidelines along with increased education and collaboration between health professionals would help alleviate the current uncertainty regarding weight management in pregnancy.