“It’s a Wild Ride”: A Phenomenological Exploration of High Maternal, Gestational Weight Gain

Abstract

High maternal, gestational weight gain is associated with high birthweight, large-for-gestational-age birthweights, cesarean delivery, child overweight, and short- and long-term postpartum weight retention. In this phenomenological study, the meaning and experiences of weight gain for pregnant women with high gestational weight gain were investigated. Data were collected through interviews with pregnant women from Atlantic Canada. van Manen’s method of phenomenology was utilized. The data analysis revealed four patterns or major themes: being caught off guard; losing your bearings; hanging on for dear life; and hoping for health. The participants experienced their gestational weight gain as an unexpected “wild ride” that they could not control. The findings highlight the need for health care professionals to provide pregnant women with more support concerning gestational weight gain.

Share and Cite:

Murray, C. (2014) “It’s a Wild Ride”: A Phenomenological Exploration of High Maternal, Gestational Weight Gain. Health, 6, 2541-2552. doi: 10.4236/health.2014.618293.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Viswanathan, M., Siega-Riz, A.M., Moos, M.K., et al. (2008) Outcomes of Maternal Weight Gain. Evidence Report/ Technology Assessment, 168, 1-223.
[2] Institute of Medicine and National Research Council (2009) Weight Gain during Pregnancy: Reexamining the Guidelines. The National Academies Press, Washington DC.
[3] Margerison Zilko, C.E., Rehkopf, D. and Abrams, B. (2010) Association of Maternal Gestational Weight Gain with Short- and Long-Term Maternal and Child Health Outcomes. American Journal of Obstetrics and Gynecology, 202, 574.e1-574.e8.
[4] Bodnar, L.M., Catov, J.M., Klebanoff, M.A., Ness, R.B. and Roberts, J.M. (2007) Prepregnancy Body Mass Index and the Occurrence of Severe Hypertensive Disorders of Pregnancy. Epidemiology, 18, 234-239.
http://dx.doi.org/10.1097/01.ede.0000254119.99660.e7
[5] British Columbia Perinatal Health Program (2009) Maternal Overweight, Obesity and Excess Gestational Weight Gain: Identification of Maternal and Perinatal Implications and Primary Maternity Care Providers’ Opportunities for Interventions to Improve Health Outcomes. B.C. Perinatal Health Program, Vancouver.
[6] Watson, M., Howell, S., Johnston, T., Callaway, L., Khor, S.L. and Cornes, S. (2013) Pre-Pregnancy BMI: Costs Associated with Maternal Underweight and Obesity in Queensland. Australian and New Zealand Journal of Obstetrics and Gynaecology, 53, 243-249.
http://dx.doi.org/10.1111/ajo.12031
[7] Trasande, L., Lee, M., Liu, Y., Weitzman, M. and Savitz, D. (2009) Incremental Charges, Costs, and Length of Stay Associated with Obesity as a Secondary Diagnosis among Pregnant Women. Medical Care, 47, 1046-1052.
http://dx.doi.org/10.1097/MLR.0b013e31819c94b8
[8] Mamun, A.A., Callaway, L.K., O’Callaghan, M.J., et al. (2011) Associations of Maternal Pre-Pregnancy Obesity and Excess Pregnancy Weight Gains with Adverse Pregnancy Outcomes and Length of Hospital Stay. Pregnancy & Childbirth, 11, 62.
http://dx.doi.org/10.1186/1471-2393-11-62
[9] Kowal, C., Kuk, J. and Tamim, H. (2012) Characteristics of Weight Gain in Pregnancy among Canadian Women. Maternal and Child Health Journal, 16, 668-676.
http://dx.doi.org/10.1007/s10995-011-0771-3
[10] National Research Council (2007) Influence of Pregnancy Weight on Maternal and Child Health: Workshop Report. The National Academies Press, Washington DC.
http://www.nap.edu/catalog.php?record_id=11817
[11] Society of Obstetricians and Gynaecologists of Canada (2010) SOGC Clinical Practice Guidelines: Obesity in Pregnancy. International Journal of Gynaecology and Obstetrics, 110, 165-173.
[12] Institute of Medicine and National Research Council of the National Academies (2013) Implementing Guidelines on Weight Gain and Pregnancy for Providers. National Academies Press, Washington DC.
http://www.iom.edu/About-IOM/Leadership-Staff/Boards/Food-and-Nutrition-Board/HealthyPregnancy.aspx
[13] Earle, S. (2003) “Bumps and Boobs”: Fatness and Women’s Experiences of Pregnancy. Women’s Studies International Forum, 26, 245-252.
http://dx.doi.org/10.1016/S0277-5395(03)00054-2
[14] Nash, M. (2012) Weighty Matters: Negotiating “Fatness” and “In-Betweenness” in Early Pregnancy. Feminism & Psychology, 22, 307-323.
http://dx.doi.org/10.1177/0959353512445361
[15] Johnson, S., Burrows, A. and Williamson, I. (2004) “Does My Bump Look Big in This?” The Meaning of Bodily Changes for First-Time Mothers-to-Be. Journal of Health Psychology, 9, 361-374.
http://dx.doi.org/10.1177/1359105304042346
[16] Fairburn, C.G. and Welch, S.L. (1990) The Impact of Pregnancy on Eating Habits and Attitudes to Shape and Weight. International Journal of Eating Disorders, 9, 153-160.
[17] Devine, C.M., Bove, C.F. and Olson, C.M. (2000) Continuity and Change in Women’s Weight Orientations and Life-style Practices through Pregnancy and the Postpartum Period: The Influence of Life Course Trajectories and Transitional Events. Social Science and Medicine, 50, 567-582.
http://dx.doi.org/10.1016/S0277-9536(99)00314-7
[18] Herring, S.J., Henry, T.Q., Klotz, A.A., Foster, G.D. and Whitaker, R.C. (2012) Perceptions of Low-Income African-American Mothers about Excessive Gestational Weight Gain. Maternal and Child Health Journal, 16, 1837-1843.
http://dx.doi.org/10.1007/s10995-011-0930-6
[19] Paul, K.H., Graham, M.L. and Olson, C.M. (2013) The Web of Risk Factors for Excessive Gestational Weight Gain in Low Income Women. Maternal and Child Health Journal, 17, 344-351.
http://dx.doi.org/10.1007/s10995-012-0979-x
[20] Keenan, J. and Stapleton, H. (2010) Bonny Babies? Motherhood and Nurturing in the Age of Obesity. Health, Risk & Society, 12, 369-383.
http://dx.doi.org/10.1080/13698571003792926
[21] Nyman, V.M., Prebensen, A.K. and Flensner, G.E. (2010) Obese Women’s Experiences of Encounters with Midwives and Physicians during Pregnancy and Childbirth. Midwifery, 26, 424-429.
http://dx.doi.org/10.1016/j.midw.2008.10.008
[22] Fox, P. and Yamaguchi, C. (1997) Body Image Change in Pregnancy: A Comparison of Normal Weight and Overweight Primigravidas. Birth, 24, 35-40.
[23] Wiles, R. (1998) The Views of Women of above Average Weight about Appropriate Weight Gain in Pregnancy. Midwifery, 14, 254-260.
http://dx.doi.org/10.1016/S0266-6138(98)90098-5
[24] Furber, C.M. and McGowan, L. (2011) A Qualitative Study of the Experiences of Women Who Are Obese and Pregnant in the UK. Midwifery, 27, 437-444.
http://dx.doi.org/10.1016/j.midw.2010.04.001
[25] Warriner, S. (2000) Women’s Views on Being Weighed during Pregnancy. British Journal of Midwifery, 8, 620-623.
http://dx.doi.org/10.12968/bjom.2000.8.10.17111
[26] Groth, S.W. and Kearney, M.H. (2009) Diverse Women’s Beliefs about Weight Gain in Pregnancy. Journal of Midwifery and Women’s Health, 54, 452-457.
http://dx.doi.org/10.1016/j.jmwh.2009.03.003
[27] Olander, E.K., Atkinson, L., Edmunds, J.K. and French, D.P. (2011) The Views of Pre- and Post-Natal Women and Health Professionals Regarding Gestational Weight Gain: An Exploratory Study. Sexual and Reproductive Healthcare, 2, 43-48.
http://dx.doi.org/10.1016/j.srhc.2010.10.004
[28] Everette, M. (2008) Gestational Weight and Dietary Intake during Pregnancy: Perspectives of African American Women. Maternal and Child Health Journal, 12, 718-724.
http://dx.doi.org/10.1007/s10995-007-0301-5
[29] Johnson, M., Campbell, F., Messina, J., Preston, L., Woods, H.B. and Goyder, E. (2013) Weight Management during Pregnancy: A Systematic Review of Qualitative Evidence. Midwifery, 29, 1287-1296.
http://dx.doi.org/10.1016/j.midw.2012.11.016
[30] Keely, A., Gunning, M. and Denison, F. (2011) Maternal Obesity in Pregnancy: Women’s Understanding of Risks. British Journal of Midwifery, 19, 364-369.
http://dx.doi.org/10.12968/bjom.2011.19.6.364
[31] Khazaezadeh, N., Pheasant, H., Bewley, S., Mohiddin, A. and Oteng-Ntim, E. (2011) Using Service-Users’ Views to Design a Maternal Obesity Intervention. British Journal of Midwifery, 19, 49-56.
http://dx.doi.org/10.12968/bjom.2011.19.1.49
[32] van Manen, M. (1990) Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. Althouse, London.
[33] Crane, J., White, J., Hutchens, D., Burrage, L. and Murphy, P. (2007) The Effects of Gestational Weight Gain by Body Mass Index on Obstetric and Neonatal Outcomes. American Journal of Obstetrics and Gynecology, 197, S88.
http://dx.doi.org/10.1016/j.ajog.2007.10.291
[34] Health Canada (2010) Prenatal Nutrition Guidelines for Health Professionals: Gestational Weight Gain. Health Canada, Ottawa.
http://www.hc-sc.gc.ca/fn-an/nutrition/prenatal/ewba-mbsa-eng.php#a2
[35] Morse, J.M. and Field, P.A. (1995) Qualitative Research Methods for Health Professionals. Sage, London.
[36] Kvale, S. (1983) The Qualitative Research Interview: A Phenomenological and a Hermeneutical Mode of Understanding. Journal of Phenomenological Psychology, 14, 171-196.
http://dx.doi.org/10.1163/156916283X00090
[37] Merriam-Webster Incorporated (2014) Merriam-Webster Online Dictionary: Weight.
http://www.merriam-webster.com/dictionary/weight
[38] Harper, D. (2014) Online Etymology Dictionary: Weight.
http://www.etymonline.com/index.php?allowed_in_frame=0&search=weight&searchmode=none
[39] Guba, E.G. and Lincoln, Y.S. (1981) Effective Evaluation. Jossey-Bass, San Francisco.
[40] Guba, E.G. and Lincoln, Y.S. (1989) Fourth Generation Evaluation. Sage, Newbury Park.
[41] Lindseth, A. and Norberg, A. (2004) A Phenomenological Hermeneutical Method for Researching Lived Experience. Scandinavian Journal of Caring Sciences, 18, 145-153.
http://dx.doi.org/10.1111/j.1471-6712.2004.00258.x
[42] Swami, V., Frederick, D.A., Aavik, T., Alcalay, L., Allik, J., Anderson, D., et al. (2010) The Attractive Female Body Weight and Female Body Dissatisfaction in 26 Countries across 10 World Regions: Results of the International Body Project I. Personality and Social Psychology Bulletin, 36, 309-325.
http://dx.doi.org/10.1177/0146167209359702.
[43] Young, I.M. (1990) Throwing Like a Girl and Other Essays in Feminist Philosophy and Social Theory. Indiana University Press, Bloomington.
[44] Murray, C.L. and Conroy, S.A. (2014) Experiences of Low Gestational Weight Gain: A Phenomenological Study with Pregnant Women. Health. (In Press)
[45] Stengel, M.R., Kraschnewski, J.L., Hwang, S.W., Kjerulff, K.H. and Chuang, C.H. (2012) “What My Doctor Didn’t Tell Me”: Examining Health Care Provider Advice to Overweight and Obese Pregnant Women on Gestational Weight Gain and Physical Activity. Women’s Health Issues, 22, e535-e540.
http://dx.doi.org/10.1016/j.whi.2012.09.004
[46] Clark, A., Skouteris, H., Wertheim, E.H., Paxton, S.J. and Milgrom, J. (2009) My Baby Body: A Qualitative Insight into Women’s Body-Related Experiences and Mood during Pregnancy and the Postpartum. Journal of Reproductive and Infant Psychology, 27, 330-345.
http://dx.doi.org/10.1080/02646830903190904
[47] Chang, S.R., Chao, Y.M. and Kenney, N.J. (2006) I Am a Woman and I’m Pregnant: Body Image of Women in Taiwan during the Third Trimester of Pregnancy. Birth, 33, 147-153.
http://dx.doi.org/10.1111/j.0730-7659.2006.00087.x
[48] Nash, M. (2012) Making “Postmodern” Mothers: Pregnant Embodiment, Baby Bumps and Body Image. Palgrave Macmillan, Hampshire.
http://dx.doi.org/10.1057/9781137292155
[49] O’Donohoe, S. (2006) Yummy Mummies: The Clamor of Glamour in Advertising to Mothers. Advertising & Society Review, 7.
http://muse.jhu.edu/journals/asr/v007/7.3odonohoe.html
[50] Musial, J. (2014) From “Madonna” to “Whore”: Sexuality, Pregnancy, and Popular Culture. Sexualities, 17, 394-411.
http://dx.doi.org/10.1177/1363460713516335
[51] Douglas, P. (2010) Yummy Mummy and the Medicalised Milkmother. Hecate: An Interdisciplinary Journal of Women’s Liberation, 36, 119-135.
[52] Longhurst, R. (2005) (Ad)dressing Pregnant Bodies in New Zealand: Clothing, Fashion, Subjectivities and Spatialities. Gender, Place and Culture, 12, 433-446.
[53] Nash, M. (2013) Brides N’ Bumps. Feminist Media Studies, 13, 593-612.
http://dx.doi.org/10.1080/14680777.2012.678877
[54] Nash, M. (2014) Breasted Experiences in Pregnancy: An Examination through Photographs. Visual Studies, 29, 40-53.
http://dx.doi.org/10.1080/1472586X.2014.862992
[55] Bacon, L. and Aphramor, L. (2011) Weight Science: Evaluating the Evidence for a Paradigm Shift. Nutrition Journal, 10, 9.
http://dx.doi.org/10.1186/1475-2891-10-9
[56] Murray, C.L., Walsh, G.W. and Gorber, S.C. (2014) Improved Obesity Prevalence Estimates for Atlantic Canada. Canadian Journal of Public Health, 105, 154-155.
[57] Murray, C.L., Walsh, G.W. and Gorber, S.C. (2012) A Comparison between Atlantic Canadian and National Correction Equations to Improve the Accuracy of Self-Reported Obesity Estimates in Atlantic Canada. Journal of Obesity, 2012, Article ID: 492410.
http://dx.doi.org/10.1155/2012/492410
[58] Murray, C.L., Walsh, G.W. and Gorber, S.C. (2013) Using Correction Equations Based on Measured Height and Weight Weakens Associations between Obesity Based on Self-Reports and Chronic Diseases. Epidemiology Research International, 2013, Article ID: 890762.
http://dx.doi.org/10.1155/2013/890762
[59] Murray, C.L., Small, S.P. and Burrage, L. (2014) The Lived Experience of Smoking in Pregnancy. Open Journal of Nursing, 4, 762-773.
http://dx.doi.org/10.4236/ojn.2014.411082
[60] Heffernan, K., Nicolson, P. and Fox, R. (2011) The Next Generation of Mothers: More Freedom in the Public Sphere or Just an Illusion? Journal of Gender Studies, 20, 321-332.
http://dx.doi.org/10.1080/09589236.2011.617602
[61] Hutchinson, M.G. (1994) Imaging Ourselves Whole: A Feminist Approach to Treating Body Image Disturbance. In: Fallon, P., Katzman, M.A. and Wooley, S.C., Eds., Feminist Perspectives on Eating Disorders, The Guildford Press, New York, 152-168.
[62] Lupton, D. (1999) Risk and the Ontology of Pregnant Embodiment. In: Lupton, D., Ed., Risk and Sociocultural Theory, Cambridge University Press, Cambridge, 59-85.
[63] Kristeva, J. (1982) Powers of Horror: An Essay on Abjection. Columbia University Press, New York.
[64] Miles, M.R. (1989) Carnal Knowing: Female Nakedness and Religious Meaning in the Christian West. Beacon Press, Boston.
[65] Fahs, B. (2014) Genital Panics: Constructing the Vagina in Women’s Qualitative Narratives about Pubic Hair, Menstrual Sex, and Vaginal Self-Image. Body Image, 11, 210-218.
http://dx.doi.org/10.1016/j.bodyim.2014.03.002
[66] Creed, B. (1993) The Monstrous-Feminine: Film, Feminism, Psychoanalysis. Routledge, London.
[67] Patterson, M. and O’Malley, L. (2013) Bouncing Back: Reclaiming the Body from Pregnancy. In: O’Donohoe, S., Hogg, M., MacLaran, P., Martens, L. and Stevens, L., Eds., Motherhoods, Markets and Consumption, Routledge, New York, 131-144.
[68] Harper, E.A. and Rail, G. (2011) Contesting “Silhouettes of a Pregnant Belly”: Young Pregnant Women’s Discursive Constructions of the Body. Aporia, 3, 6-15.
[69] Stotland, N.E., Gilbert, P., Bogetz, A., Harper, C.C., Abrams, B. and Gerbert, B. (2010) Preventing Excessive Weight Gain in Pregnancy: How Do Prenatal Care Providers Approach Counseling? Journal of Women’s Health, 19, 807-814.
http://dx.doi.org/10.1089/jwh.2009.1462
[70] Chang, T., Llanes, M., Gold, K.J. and Fetters, M.D. (2013) Perspectives about and Approaches to Weight Gain in Pregnancy: A Qualitative Study of Physicians and Nurse Midwives. Pregnancy and Childbirth, 13, 47.
http://dx.doi.org/10.1186/1471-2393-13-47
[71] Upton, R.L. and Han, S.S. (2003) Maternity and Its Discontents “Getting the Body Back” after Pregnancy. Journal of Contemporary Ethnography, 32, 670-692.
http://dx.doi.org/10.1177/0891241603257596
[72] Davies, K. and Wardle, J. (1994) Body Image and Dieting in Pregnancy. Journal of Psychosomatic Research, 38, 787- 799.
http://dx.doi.org/10.1016/0022-3999(94)90067-1
[73] Fox, R., Heffernan, K. and Nicolson, P. (2009) “I Don’t Think It Was Such an Issue Back Then”: Changing Experiences of Pregnancy across Two Generations of Women in South-East England. Gender, Place & Culture: A Journal of Feminist Geography, 16, 553-568.
http://dx.doi.org/10.1080/09663690903148424
[74] Murray, C.L. (2009) The Meaning and Experiences of Weight Gain for Pregnant Women with Low Gestational Weight Gain. Doctoral Dissertation, University of Alberta, Edmonton.
[75] Lupton, D. (2013) The Social Worlds of the Unborn. Palgrave Macmillan, Basingstoke.
http://dx.doi.org/10.1057/9781137310729
[76] Thurer, S. (1995) The Myths of Motherhood: How Culture Reinvents the Good Mother. Penguin, New York.
[77] Fern, V.A., Buckley, E. and Grogan, S. (2013) Women’s Experiences of Body Image and Weight Loss after Childbirth. British Journal of Midwifery, 20, 860-865.
http://dx.doi.org/10.12968/bjom.2012.20.12.860
[78] Bailey, L. (2001) Gender Shows: First-Time Mothers and Embodied Selves. Gender & Society, 15, 110-129.
http://dx.doi.org/10.1177/089124301015001006

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.