Behind the Headlines
Are mums-to-be being given enough advice on weight management during and after pregnancy?
Women are not receiving proper support and advice on weight management and healthy eating during and after pregnancy, despite recommendations from NICE, according to reports in the media this month.
The reports are based on a survey of 6,252 women which was conducted by the Royal College of Midwives in collaboration with the parenting website Netmums.
The survey found that nearly three-quarters of women, 63 per cent, said that the NHS should provide midwife-led antenatal classes to address issues of weight and diet, and two-thirds reported that their midwife did not have time for such a discussion.
Almost nine out of 10 women rated the overall care that they received from midwives regarding healthy eating and weight management as 'neutral', 'poor' or 'very poor'
Almost half of those surveyed admitted to anxieties about their weight during pregnancy. Many were concerned about managing their weight gain and whether they would be able to lose weight after the birth.
Of the women surveyed, 41 per cent described themselves when they became pregnant as ‘over what they would like to have weighed' and/or ‘overweight'
Additionally, six out of 10 women said that they feel pressurised by celebrity culture to lose weight quickly after giving birth.
Why is it so important that they are offered weight management advice?
Obesity is a growing problem in the UK and is fast becoming the most significant public health issue.
It is currently estimated that over 50 per cent of women in England are either overweight or obese, with over 20 per cent of women of childbearing age and almost 25 per cent of pregnant women in the UK estimated to be overweight or obese.
Being obese in pregnancy exposes women to a greater risk of developing gestational diabetes, pre-eclampsia and leaves them more likely to suffer a miscarriage.
Mothers with extreme obesity, defined as a body mass index (BMI) of 50 or more, are most at-risk of complications. Their risk of developing gestational diabetes increases by 11 per cent, and they are 23 per cent more likely to develop gestational hypertension than mothers of a normal weight.
Evidence also appears to suggest that babies born to obese mothers are more likely to become obese themselves in later life because of changes that occur inside the womb.
What's more, studies have shown that many maternity trusts across England lack the specialist equipment, such as operating tables in case of an emergency during the delivery, needed to look after obese mothers.
The Royal College of Midwives warns: “As a result of the increase in obesity among pregnant women in the UK, midwives are dealing with more complex births - on top of the continuing baby boom.
“These women need to see a midwife as early as possible in their pregnancy, and midwives need more time to spend with these women to help and advise them, as well as involving the wider health care team. NHS Trusts should be making sure that they have the resources in place to do this.”
What does NICE recommend?
NICE published guidance in July this year on weight management before, during and after pregnancy which recommends that healthcare professionals, such as GPs and midwives, make clear to women with a BMI of 30 or more the health risks of being overweight or obese during pregnancy.
Obese mothers should be given practical advice and encouragement to lose weight before and after pregnancy, including access to specialist help if they need it.
Two key recommendations in the guidance are that women should be encouraged to achieve a healthy weight before they become pregnant and that healthcare professionals should dispel the myth around ‘eating for two' when pregnant.
Instead, women should be encouraged to follow a healthy diet based on starchy and wholegrain foods such as bread, pasta and rice.
“Energy requirements for pregnant women do increase but not until the last trimester,” says Professor Annie Anderson, who worked on the development of the guidance and is an expert in food choice at the University of Dundee.
Although weight loss is recommended before pregnancy, the guidance advises against pressurising women into rapid weight loss or crash diets during or after pregnancy as this can harm the health of the child.
Lucilla Poston, a Professor of Maternal and Fetal Health at King's College London who also worked on the guidance, says: “That is absolutely the worst thing to do because it is potentially dangerous and can lead to a condition known as ketoacidosis where there is very high levels of certain fatty acids in the blood, and that can be associated with death of the baby and cognitive impairment of the child in later life.
“I think that the issue of losing weight quickly after pregnancy can be problematic for younger women, who see celebrities doing this and look to them as role-models.”
Elsewhere, the guidance calls for local authority leisure and community services to offer women with babies and children the opportunity to take part in a range of physical or recreational activities, such as swimming, cycling or dancing.
23 November 2010
This page was last updated: 23 November 2010