Weight bias may affect healthcare for overweight and obese pregnant women.

31 January 2017

An American study suggests using patient-centred communication for overweight or obese pregnant women may improve prenatal care.

The study, published in the journal Patient Education and Counseling, looked at differences in communication styles between health practitioners and pregnant women of normal weight and those who were obese or overweight.

They found that health practitioners asked the overweight or obese pregnant women fewer lifestyle questions and provided less lifestyle information than to women of normal weight.

The authors note that pregnancy presents a unique opportunity to deliver preventive health services as women use the health system more frequently and may be more motivated to make behaviour changes.

However, a number of studies suggest that health provider weight bias – both implicit and explicit – may act as an unacknowledged barrier to high quality care for pregnant women who are overweight or obese.

The authors say evidence suggest that health practitioners may associate obesity with a number of negative words, including “lazy,” “non-compliant,” “weak-willed,” “awkward” and “sloppy”.

Their study aimed to use audio recordings of routine prenatal visits to examine the association between health provider communication and patient body weight.

The results revealed that the healthcare providers:

  • Asked fewer lifestyle questions when providing prenatal care to overweight women
  • Gave significantly less lifestyle information when providing care to obese women
  • Used fewer “concern and approval statements” when providing care to overweight women
  • Were less likely to seek clarification in consultations with overweight women.

The authors say providers used less patient-centred communication and gave lower ratings to the patient-provider relationship when providing prenatal care to pregnant women who were overweight or obese.

“These findings are concerning, given that The American College of Obstetricians and Gynaecologists recommends that providers provide non-judgmental, compassionate and high quality care to all women, irrespective of body weight, noting that negative attitudes towards women with overweight and obesity may undermine the patient-provider relationship.”

They conclude that women who are overweight or obese may not be receiving effective behavioural counselling across a number of domains, including nutrition, tobacco use, physical activity, postpartum contraception, and breastfeeding.

The authors acknowledge that this study was small and did not cover a diverse range of healthcare providers.  They say further studies are needed.

You can read more about this study looking at health practitioners interactions with pregnant women of different weights here.

If you want to improve your communication with clients about lifestyle behaviour change, check out our Healthy Conversation Skills courses.