An exploratory Interpretative Phenomenological Analysis (IPA) of childbearing women's perceptions of risk associated with having a high Body Mass Index (BMI)

Background: In 2016, the World Health Organization (WHO) labelled 13% of the world's adult population as obese. This increase in obesity is accompanied by mortality and morbidity problems, with maternal obesity and its accompanying risk for mother and infant requiring to be carefully managed.

Aim: To explore childbearing women with a high BMI (>35 kg/m2) perceptions of risk and its potential impacts upon pregnancy and outcome.

Method: Qualitative Interpretative Phenomenological Analysis (IPA) was used to gain deeper understanding of the lived experiences of childbearing women with a BMI>35 kg/m2 and perceptions of their risk and potential pregnancy outcome.

Findings: One of the superordinate themes that emerged was (1) Risk or no risk, and its associated three subthemes of (1a) Emotional consequences of her risky position, (1b) Recognition of high-risk complications finally sinking in, and (1c) Accepting the risk body.

Recommendations for practice: In general, health care professionals are uncomfortable about discussing obesity-associated risks with pregnant women. The participants in this study did not classify themselves as obese, with this absence of acknowledgement and 'risky talk' leaving participants' unaware of their obesity-associated risk. This downplaying of obesity related talk requires to be corrected, simply because women in denial will perceive no need to engage with health promotion messages. In response, directives are required to be embedded into policy and practice.

Conclusion: Specific training is required to teach maternity care professionals how to have difficult, sensitive conversations about obesity related risks with childbearing women with high BMI's. In addition, this risk information needs to be accompanied by relevant advice and support.