How experiences of weight stigma impact higher-weight women during their maternity care: A meta-ethnography

IF 2.6 3区医学 Q1 NURSING

Midwifery Pub Date : 2025-02-01 DOI:10.1016/j.midw.2024.104242

Jenny Cunningham , Dr. Melania Calestani , Dr. Kirstie Coxon

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引用次数: 0

Abstract

Aim

The aim of this review was to explore the experiences of pregnant women and birthing people with higher weight bodies, to understand the extent to which weight stigma impacted their maternity care.

Methods

We performed a systematic search of seven databases (CINAHL plus, Medline, Social Sciences Full Text [SSFT], International Bibliography of Social Sciences [IBSS], PsychINFO, Maternity and Infant Care [MIC], NIHR Journals Library, EThOS) using the Setting, Perspective, Intervention, Comparison, Evaluation (SPICE) framework search strategy and pre-defined inclusion and exclusion criteria. Included studies underwent a critical appraisal and data richness assessment. We undertook thematic analysis after coding first- and second-order constructs and developed a synthesis from the themes.

Findings

Thirty-eight papers, including six doctoral theses and one book chapter, met the inclusion criteria. Five themes were identified through thematic analysis, and the synthesis demonstrated that women of a higher weight experience shame, harmful attitudes and preconceptions from healthcare professionals regularly and repeatedly while receiving maternity care. This can be alleviated by individualised supportive care from a healthcare professional.

Key conclusions

Negative interactions with maternity care professionals are central to the experience of weight stigma, leading to a sense of ‘shame’, with pervasive feelings of humiliation, judgement and blame. Current guidance does not acknowledge the stigmatising effects of weight related conversations, additional interventions and restrictions on women's birthplace choices. Adopting a shame-sensitive lens within a culturally safe approach to maternity care could transform support for women.

查看原文本刊更多论文

体重耻辱的经历如何影响高体重妇女在产妇护理：一个元人种志。

目的：本综述的目的是探讨孕妇和体重较高的产妇的经历，以了解体重耻辱感在多大程度上影响了她们的产科护理。方法：采用设置、视角、干预、比较、评价（SPICE）框架搜索策略和预定义的纳入和排除标准，对7个数据库（CINAHL plus、Medline、Social Sciences Full Text [SSFT]、International Bibliography of Social Sciences [IBSS]、PsychINFO、母婴护理[MIC]、NIHR Journals Library、EThOS）进行系统检索。纳入的研究进行了严格的评估和数据丰富度评估。在编码一阶和二阶结构后，我们进行了主题分析，并从主题中开发了一个综合。结果：38篇论文符合纳入标准，其中博士论文6篇，图书章节1篇。通过专题分析确定了五个主题，综合表明，体重较高的妇女在接受产科护理期间经常和反复地受到医疗保健专业人员的羞辱、有害态度和先入之见。这可以通过医疗保健专业人员的个性化支持性护理来缓解。关键结论：与产科护理专业人员的负面互动是体重耻辱经历的核心，导致“羞耻感”，普遍感到羞辱、评判和责备。目前的指导没有承认与体重有关的谈话、额外的干预和对女性出生地选择的限制所带来的污名化影响。在一种文化上安全的产科护理方法中采用对羞耻敏感的视角，可以改变对妇女的支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Midwifery 医学-护理

CiteScore

4.50

自引率

7.40%

发文量

221

审稿时长

13.4 weeks

期刊介绍： Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.