The Impact of Obesity on Childbirth Expectations.
Tamara A Messer, Fabienne Blank, Jean Anthony Grand-Guillaume-Perrenoud and 1 others
PMID 39252417WHAT IT FOUND
Pregnant women living with obesity expected less positive childbirth experiences than those with lower BMI, particularly regarding pain management and medical interventions.
Women receiving midwife-led care reported significantly higher positive expectations across all domains compared to obstetrician-led care.
Key findings
01Women with a BMI over 30 had significantly lower total childbirth expectation scores than women with a BMI of 30 or less.
02Midwife-led prenatal care was associated with significantly higher expectations for support, pain management, and fewer medical interventions compared to obstetrician-led care.
03Obesity and pregnancy complications were associated with a higher likelihood of negative childbirth expectations, largely driven by the anticipation of medicalized birth.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study recruited participants via social media, which limits generalizability to women who do not use these platforms or live outside Switzerland. The sample was highly educated, with 67.8% holding a university degree, which may not reflect the broader population's views on childbirth. Childbirth expectations were measured only once, so it is unknown how they changed throughout the pregnancy or after the birth experience. Self-reported weight and height were used to calculate BMI, which may introduce reporting bias.
Declared interests
The paper does not explicitly state funding sources or conflicts of interest in the provided text, though it notes the project did not require formal ethical approval under Swiss law.
The easy way to misread this
Do not interpret the association between midwife-led care and positive expectations as proof that midwife-led care causes better outcomes. This is a cross-sectional survey of expectations, not a trial of care models, and women who choose midwife-led care may differ in other ways from those who choose obstetrician-led care.