A mixed methods systematic review of midwives' clinical practices related to prenatal care of women with obesity.
Suzanne Hyer, Jean W Davis, Jordan Lee Slowik and 2 others
PMID 36907010WHAT IT FOUND
Midwives reported lacking confidence, training, and clear guidelines to manage obesity in pregnancy.
While they counseled on risks like diabetes and hypertension, weight bias and resource gaps hindered care. No interventions were tested, so effectiveness remains unknown.
Key findings
01Midwives frequently reported lacking the knowledge, confidence, and specific clinical guidelines needed to effectively manage pregnant women with obesity.
02A significant portion of midwives counselled patients on obesity-related risks, including gestational diabetes (83.3%) and hypertensive disorders (74.0%), but practices varied widely.
03Weight bias, stigma, and a lack of sensitive communication training were identified as barriers to care, with some midwives expressing derogatory views toward patients.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only high-income countries, limiting generalizability to low- and middle-income settings. No intervention studies were found, so the review cannot determine if any of the reported practices improve health outcomes. Study participants were mostly female, over 40, and self-selected, which may not represent all midwives. Quantitative measures varied widely across studies, preventing data pooling or meta-analysis. Qualitative studies relied on self-reported experiences, which may be subject to social desirability bias.
Declared interests
No specific conflicts of interest or funding sources were reported in the provided text.
The easy way to misread this
Do not interpret the high rates of counselling or guideline use as evidence that these practices improve maternal or infant health outcomes. The review found no intervention studies, so it reports on what midwives do and think, not on whether those actions work.