Providing prenatal care to pregnant women with overweight or obesity: Differences in provider communication and ratings of the patient-provider relationship by patient body weight.
Katie O Washington Cole, Kimberly A Gudzune, Sara N Bleich and 4 others
PMID 28062155WHAT IT FOUND
Prenatal visits for women with overweight or obesity included fewer lifestyle questions, less lifestyle advice, and less rapport-building talk.
Providers also rated relationships with women with obesity less positively, though patients reported no differences.
Key findings
01Providers asked fewer lifestyle questions when caring for women with overweight and gave less lifestyle information when caring for women with obesity.
02Providers used fewer clarification checks, concern statements, and approval statements with women with overweight, and fewer self-disclosure statements with women with obesity.
03Providers were less likely to agree that women with obesity provided an accurate history or that they liked them, while patients did not rate providers differently by body weight.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Small, convenience sample from one urban teaching hospital obstetric clinic. Most providers were White, female residents, and patients were mainly young Black women or had Medicaid insurance, so other settings may differ. Only one prenatal visit was recorded for each patient, so it may not represent communication across pregnancy. Cross-sectional design and no direct measure of provider weight bias; it shows associations, not that bias caused the differences. RIAS did not separate specific lifestyle topics such as nutrition and physical activity. Provider relationship ratings were self-report after visits, and patient ratings were not the main outcome. Exclusions removed patients with missing height or pre-pregnancy weight, underweight, or no depression questionnaire, and 117 patients were analysed.
Declared interests
No author conflict-of-interest statement is provided in the supplied text. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not conclude that provider weight bias caused the communication differences or that the relationship ratings prove discrimination. The study recorded one visit and measured associations with body weight, not bias, and patient ratings of providers did not differ by body weight.