The maternity experience for women with a body mass index ≥ 30 kg/m2: a meta-synthesis.

Background: Maternal obesity (body mass index, BMI ≥ 30 kg/m(2) ) is a global public health issue. There is a dearth of evidence regarding an effective maternal care pathway for pregnant women with a BMI ≥ 30 kg/m(2).

Objective: This meta-synthesis aims to increase our understanding of the maternity experience for pregnant women with a BMI ≥ 30 kg/m(2).

Methods: Six electronic databases were searched using predefined search terms. Methods: English-language studies using qualitative data to explore the maternity experience for women with a BMI ≥ 30 kg/m(2) were included (defined by a quality appraisal framework). Methods: An interpretative approach was taken and the constructivist framework was central to the synthesis. Searches were conducted in September 2010, and resulted in six papers being synthesised.

Results: Three cluster themes (eight initial themes) were highlighted: acceptance and inevitability of weight gain in pregnancy; depersonalisation of care as a result of medicalisation; and healthy lifestyle benefits for self and baby.

Conclusions: Pregnancy is an ideal period for health professionals to intervene, as women with a BMI ≥ 30 kg/m(2) perceive their weight as more acceptable than when they were not pregnant, and are aware of the benefits of having a healthy lifestyle. Antenatal care should include postnatal weight management advice, as this is the period when women with a BMI ≥ 30 kg/m(2) want to lose weight; this may enable subsequent pregnancies to start with a lower BMI. Such advice should be sensitive and tailored to the individual. Social representations theory provides a framework for understanding maternal obesity.